Are all pre-existing conditions allowed?

Yes, all pre-existing conditions are allowed and can no longer be used to bar an individual from obtaining health insurance coverage. This provision of health care reform and guarantee of coverage went into effect for children in 2010 and will apply to adults in 2014.  Premiums will not be allowed to use pre-existing conditions as a factor for establishing rates.

The cost of coverage can be adjusted using only these four factors:

1) whether the policy covers an individual or …

What is the difference between bronze, silver, gold and platinum plans?

In order to be included in the Health Insurance Marketplace, each insurance company can offer four different types of “qualified” health insurance plans– Bronze, Silver, Gold, and Platinum.

A Bronze Plan will cover 60% of health care costs with the consumer responsible for paying 40%. For Silver plans insurance companies pay 70% of costs and the consumer pays 30%. For Gold Plans, the split is 80%-20% and for Platinum the split is 90%-10%.  In general, the more the company …

Can grandchildren being taken care of by grandparents be on our insurance until age 26 and what if we go on Medicare?

Grandparent

Grandparent

If you are the legal guardian or foster parent, your grandchildren can be added to a healthcare plan you purchase on your own through your employer until they reach the age of 26. If you are not the legal guardian, they will not be covered in your individual or employer plans and you will have to look at other options.

Medicare is and will remain as individual health insurance only for those 65 and over. If you are on …

What is the difference between a premium, a co-pay and and out-of-pocket expense?

Health Insurance Plan costs can be broken into two categories: cost of having the plan and costs of using the plan. In order to purchase and continue to have health insurance coverage, you have to pay a premium. The premium is paid on a regular basis such as a certain amount monthly, quarterly or yearly. It is typical that when purchased through your employer, the plan premium is deducted from each paycheck. Basically, the premium buys you the health …

Can I cancel my health insurance at any time if my premiums are deducted pre-tax?

Because your premiums are deducted pre-tax, this means that you purchase your health insurance through your employer and are responsible for paying a portion of the cost. Health insurance is canceled when you quit paying the premiums.

Assuming that you will be receiving health insurance from another source in the future, work with your employer’s human resources office (in a small company that might even be the person who handles payroll) to stop paying the health insurance premiums.

Make sure …

Does your health insurance premium go toward your deductible?

In most instances, the answer is no. Premiums and deductibles are two separate payments related to an insurance policy. A premium is paid to simply have insurance coverage in place regardless of whether or not a claim is ever made. A deductible is paid if there is a claim and is the amount paid out of pocket by the insured before insurance benefits are received.

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