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Navigating the World of Health Insurance

by Maria Ramsdell

UniteNews Contributing Writer

 

Springfield, MO—Navigating the world of health insurance can be a daunting task. Insurance brokers are licensed with multiple insurance carriers and can help take the confusion out of finding a health plan. I have detailed conversations with clients to find plans that fit their needs and budget. I offer cafeteria-style plans that include dental, vision, and life insurance just like you may find through an employer. My mission is to educate my clients on all the available options as well as advocate for them throughout the year. HIPPA regulations prohibit brokers from seeing a client’s personal medical records. But some things I can help with are finding doctors in a plan’s network, ordering misplaced insurance cards, and advising clients on where to seek further help for complicated cases.

If you are offered insurance through your workplace, your options may be limited. Sometimes you are offered one plan, but you may have a choice between a few. If you believe your work insurance is too expensive, you should call a broker to find out if you qualify for other programs available or if another plan may suit you better.

If you are not offered insurance through your job or if you are a small business owner, you have a few choices. The first option available to you would be to get insurance through the Affordable Care Act. You may have heard this referred to as the marketplace, healthcare.gov, or Obamacare. The premiums for these plans are based on household size and income. You and your family may qualify for a tax subsidy to help with the premium cost on these plans. Consult with a broker to determine your subsidy eligibility and amount. Marketplace plans also cover pre-existing conditions and preventative wellness visits, like your yearly visit with your primary care physician or OBGYN. Mammograms and diagnostic colonoscopies are also covered. These plans are the only plans that are considered major medical coverage outside of coverage offered through an employer. There is not one company that offers plans on the marketplace. Multiple insurance carriers offer plans and it can be helpful to work with a broker to make sure your specific plan covers any prescriptions and includes a network of doctors that works for you.

Short-term medical plans are an alternative option to the plans on the marketplace. These plans differ in that they do not cover pre-existing conditions that have been diagnosed within a certain time period prior to the enrollment of the plan. Short-term plans are not run through the government, and as such, the premiums are based on age and how many people are insured on the plan. These plans can be a great option for clients or families who are healthy but may not qualify for a tax subsidy through the Affordable Care Act.

Working with a broker can ensure that you choose the path that best fits the needs of you and your family.

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