TODAY'S WEATHER
Sponsored by Maverik
32°
overcast clouds
humidity: 96%
wind: 7mph SSW
H 31 • L 28
Nominate someone in need for Secret Santa 2019

Your guide to shopping for medical insurance (and why you should do it now)

Health & Fitness

Share This
Stock photo
This story is brought to you by Grand Peaks Medical and Dental, a multi-specialty, nonprofit community health center in St. Anthony and Rexburg.

Not having medical insurance can be detrimental.

When you live without insurance, even basic care like a flu shot or an annual wellness check can take a huge financial toll on you and your family. This also means that you run the risk of avoiding preventative care or other necessary medical services you may need.

Having health insurance is vital, said Becky Crapo, a certified enrollment counselor at Grand Peaks Medical and Dental. She said there are many options for health insurance right now.

However, whether you are shopping for the right plan from your employer, or buying one on your own, deciding what will be best for you can be intimidating and confusing. Understanding a few pointers could help the process go smoother.

First, there are some important terms to understand before you dive in any further:

  • Premiums are the amount you have to pay each month to have an insurance policy.
  • Out-of-pocket expenses are what you actually have to pay when you receive a medical service.
  • Co-payment is a set amount you have to pay each time you visit a health care provider. This payment can be higher when you visit a specialist.
  • Deductible is the amount of money you pay out-of-pocket before your insurance company will pay their portion of the service. Some services do not have a deductible, while others do.
  • Co-insurance is the percentage of medical costs you’ll have to pay after you reach your deductible. Each insurance company will have its own percentage.
  • If you’d like even more details on understanding health insurance, click here.

It’s important to know what your options are when it comes to insurance. A lot of people receive health insurance through their employer. Employers pay a portion of the plan, so it is usually cheaper than the individual market, depending on the benefits the employee may receive.

The Affordable Care Act created insurance exchanges to help people who need an individual or family plan, but don’t have employer options. You can choose different plans that differ on out-of-pocket costs. If you want to find out more information, go to https://www.yourhealthidaho.org/.

Other common insurance options are Medicaid, Medicare, and Children’s Health Insurance Plans (CHIP). These options are all provided by the federal government or a federal-state partnership.

Insurance open enrollment periods are important to keep in mind. Open enrollment is a time of year when you can change your current plan or sign up for health insurance. Open enrollment dates vary with insurance plans, so make sure you check with a benefits person for those exact dates.

Open enrollment plans for ACA coverage in 2020 is happening now until Dec. 15 this year. If you want an individual plan for 2020, head to http://www.yourhealthidaho.org/.

For those eligible for Medicare, the open enrollment period is currently going on until Dec. 7.

Don’t hesitate to look at your options for 2020, because if you miss your open enrollment period, you won’t be able to change your current plan or sign up for coverage in 2020, unless you qualify for special enrollment. However, if you qualify for Medicaid or CHIP you are eligible for coverage any time of the year. There is no open enrollment period for these plans.

Spend time reviewing your options. Even if you currently have coverage, it is always a good idea to take time to review your policy during your insurance’s open enrollment period. Double-check to make sure you are happy with your policy.

Make sure to find a plan that covers your preferred providers. Always check to make sure your current doctors accept the plan that you are looking at before you enroll, especially if you don’t want to shop for other doctors.

“We are working hard to educate as many community members about insurance options. Many people put off necessary health care issues because they do not have coverage. It is a whole new landscape now, and many people who were unable to get coverage in the past will now qualify,” said Crapo.