What You Need to Know Before Purchasing Health Insurance

September 23, 2021

Health Insurance

Health insurance is one of the most necessary and valuable benefits you can purchase. Medical services can be expensive, whether you have an ongoing health concern or experience an accident or sudden illness. 

If you need health insurance in Jacksonville, Florida, discover what is included in health coverage and select the plan you need.


Benefits Covered by Health Insurance

In recent years, the Affordable Care Act was formed to offer health insurance plans to those who don’t have access to healthcare coverage through an employer. The ACA mandates that each plan must cover the following benefits:

  • Doctor visits and outpatient services
  • Hospitalization
  • Emergency services
  • Pregnancy and newborn care
  • Mental health and substance abuse
  • Prescription drugs
  • Rehabilitation services to learn or recover physical and mental skills
  • Laboratory testing
  • Preventative medicine and chronic disease management
  • Pediatric services


Depending on the plan you select, you may have access to additional services.


Supplemental Coverage

You have the option to purchase further coverage that goes beyond the standard plan. Popular supplemental coverage options include dental and vision insurance. These benefits are included for children under the ACA, but not adults.

Other plans cover critical illnesses such as cancer, heart attack, or stroke. Some supplemental plans pay for medical services only, and others can be used to pay your out-of-pocket costs, such as copays and deductibles.


Factors that Determine Cost

The cost of your insurance plan depends on the following factors:

  • Age
  • Household Adjusted Gross Income
  • Tobacco use
  • Family size
  • Location – local rules, cost of living, and provider competition are considered
  • Plan category – a bronze plan has low premiums but higher out-of-pocket costs, while a platinum plan has a high premium and low out-of-pocket expense


Your gender, health, and medical history cannot be used as a cost factor for ACA plans.


Best Time to Buy

You can purchase a plan through the marketplace at Healthcare.gov during open enrollment, which usually begins on the first of November. If you miss open enrollment, you can apply for coverage if you experience a qualifying life event. Examples include loss of group coverage, change in marital status, and gaining a dependent.

It’s simple to go online and compare plans on the marketplace. You need to enter some information about your income and household to browse options in the available categories.


Buying Online vs. Through an Insurance Agent

If you are unsure which coverage level and plan are best for you, consider purchasing your health insurance through an agent. You can get the same plans and coverage that you buy for yourself online but will have someone to answer your questions and navigate the vast amount of information. An agent will help you compare the plans and determine which networks your preferred physicians and facilities are included in, so you can make an informed choice based on more than just cost.

Contact Thomas & Associates today to learn more about your healthcare coverage options and get expert assistance to select the best coverage.


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