Health Insurance FAQs

The Health Insurance Literacy ASK group provides answers to your questions about the Affordable Care Act to help you make smart health insurance choices and to plan your personal finances.

Here is a collection of the most common questions. If you can’t find the answer to your question among the list, you can search for additional information using the search box at the top of the page or submit your own personal question to our Ask an Expert Feature. …

What happens if even the bronze plan under the Affordable Care Act (ACA) costs too much?

The Affordable Care Act mandates that most people are insured either through their place of employment or purchasing a policy on their own. Remember, beginning in October 2013 there will be options in every state for purchasing insurance through a state-wide Marketplace.

There are exemptions from that mandate for several reasons including financial hardship, which is an official definition based on income and family size. The good news is that, depending upon your income level, you may qualify for

Do children fall off my insurance policy on the day of their 26th birthday? How do they avoid a lapse in coverage?

Under the Affordable Care Act, children and step children can stay on their parent’s insurance policies until their 26th birthday, provided the parent’s plan allows dependent coverage. Retiree insurance plans, for example, are not required to extend coverage to dependents. Children can be covered by the parent’s insurance plans even if they are married, do not live with the parent or are not financially dependent on the parent. They can also be covered even if they are eligible to …

How do I take on a new cost for health insurance when I can barely pay my bills now?

A spending plan is just exactly that, a plan for how you will spend all the dollars your earn and those given to you (including, hopefully, directing some to savings). To make a change in your spending plan such as adding in health insurance costs or taking on a new car payment, it helps to be as inclusive as possible when calculating all of your monthly expenses. In other words, don’t write in only the premium cost, but include some …

How are health insurance and car insurance similar and different?

Car (automobile) insurance is similar to health insurance in a very important way: both types of policies provide protection against financial losses. 

Automobile and health insurance both help policyholders cover large costs that could financially devastate the individual or the family, like those experienced in unexpected car accidents or major medical procedures such as surgery, chemotherapy, expensive tests, or hospital stays. 

Health insurance generally provides a wider range of benefits than car insurance. Car insurance, for example, will not pay …

Is there anyone who can help me determine my best health insurance option?

Each state will have consumer helpers available to assist individuals with health insurance decision-making. Find these helpers at Healthcare.gov the official site which provides accurate information to guide you through health insurance decision-making, and which also connects you to the Health Insurance Marketplace in your state.

Beware of commercial insurance industry professionals offering “free advice” or “assistance;” their efforts may be just a ploy to get you to buy their company’s policy regardless of other options that may meet …

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 …