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First Time Buyers Guide For Health Insurance

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First Time Buyers Guide For Health Insurance


Updated: March 21, 2017    Published: December 10, 2015

Congratulations! You are now responsible for purchasing your own health insurance plan. But buying health insurance for the first time can feel daunting, especially if the variables involved when comparing healthcare plans are completely foreign. If an anxiety attack feels imminent, remember there is no reason to sweat the small stuff your first time out. You have options.

Here are some top tips to remember when buying a health insurance plan for the first time:

Ask a Parent or Friend for Help

You will be amazed at the stories people have about their personal experience with health insurance. Some have learned invaluable lessons, and will be more than willing to share their tales of triumph and woe. Don’t get discouraged by the negative experiences, but focus on what was learned in the outcome. Ask a parent, friend or hit up your social network to see if someone might be willing to explain the differences between deductibles, coinsurance and copayments between plans. If you don’t find good advice, online web brokers or local health insurance agents cost nothing and provide expert advice.

You Might Qualify for Cost Assistance

More than 80% of Americans qualify for a subsidy to help lower their health insurance costs, which comes in the form of a tax subsidy. Use a website that will calculate your health insurance savings based on your household annual income. If you fall under the 400% federal poverty level, you could receive a break on your monthly health insurance expenses.

More States Have Expanded Medicaid

If you are a small business owner or an hourly employee, you may qualify for Medicaid, depending on your income. In the past it was harder to meet Medicaid standards to receive health insurance assistance. But with the implementation of the Affordable Care Act, 30 states have changed their guidelines and expanded the pool of people who qualify for financial assistance. Check to see if you are a candidate for additional assistance.

Preventive Services are Free

Wellness checks, screenings and other preventive services are now covered 100% under Obamacare. This includes annual physicals, and for women, mammograms and cervical cancer screening. Immunization vaccines (like the flu shot) are also covered 100%. These preventive services are only available with qualifying Obamacare coverage purchased on your state exchange, the federal marketplace or through the off-exchange marketplace.

You Can’t be Denied Coverage

Before the Affordable Care Act was in place, individuals could be denied health insurance due to a pre-existing condition like cancer or heart disease. Today every American is eligible for health insurance, and medical questions are no longer asked when applying for a healthcare plan.

You Can Face a Hefty Fine Remaining Uninsured

Since health insurance is required by law, not carrying a health insurance policy could total an estimated $1,000 fine in 2016. The Kaiser Family Foundation estimates that 78% of Americans will be subject to this tax penalty for remaining uninsured (the rest will qualified for exemptions due to income or outlining circumstances). The fine is due when income taxes are filed, and are taken from refunds or subject to payment to the IRS.

The first deadline for 2016 open enrollment with January 1 coverage is December 15. The second deadline is January 15, which will provide coverage February 1, 2016, and the final deadline is January 31, for March 1, 2016 coverage. Failing to carry health insurance for more than three months subjugates an individual to the tax fine.

REMINDER: You are not necessarily stuck with your health insurance plan for the entire year. The special open enrollment period begins February 1, 2016, and runs until the next open enrollment period. Those that qualify for special open enrollment and can change their insurance policies typically encounter special life circumstances that require an alteration to their health insurance, which include:

  • Getting married or divorced
  • Having a baby or adopting a child
  • Moving to a different ZIP code
  • Losing employer group health insurance
  • Having COBRA coverage expire
  • Losing parent’s coverage on 26th birthday
  • And more

EXPERT TIP: After purchasing a health insurance plan, don’t automatically enroll in the same plan next year when open enrollment begins. Health insurance premiums historically increase each year, deductibles change and provider networks don’t necessarily stay the same. It’s important to make shopping for a new health insurance plan part of your annual routine every year to ensure you receive the best coverage at the best price.

Insuring your health is one of the most important decisions you will make, so take your time, research your options and ask for help when needed.

The views expressed here are those of the author and do not necessarily represent or reflect the views of Healthcare, Inc. and

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