Health Insurance Open Enrollment
Purchasing your own health insurance can be a lot of pressure. We're here to help you navigate the journey from account set up, network options and which plan will ultimately be best for you.
Check out our how to enroll video below as well as the most Frequently Asked Questions (FAQ) we see year in and year out when it comes to applying for health insurance.
As a Broker we are able to help advise our clients on differences between insurance carriers, plan levels, deductibles, networks and so much of what goes into an insurance policy. We have in depth knowledge about each plan and can help weigh the options to figure out which company and plan level is right for you and your family. We aren't able to help set up the basic items of your account like username, password and security questions. Once you get the basics set up, we can help get you to the finish line!
If you have no current coverage this one is easy, if you are losing coverage from an existing employer the answer is "NO". They're trying to find out if you will have any duplicate coverage regarding this upcoming application
A Tax Credit is the way the Federal Government helps offset the costs of health insurance. The less income you make, the less you'll pay and vice versa. A Tax Credit is applied up front on a monthly basis based on your income. We consider this a "conditional loan" from the IRS. Each month you will pay a portion of your insurance premium, while the IRS chips in with your "Tax Credit". At the end of the year when you file your federal taxes, the IRS will balance the books. If you made exactly what you estimated, the books are balanced. If you made more than you estimated, the IRS will ask for some or all of your tax credits back on your filing. If you made less than you estimated, the IRS will increase your refund portion as they should have been giving you a larger Tax Credit each month.
For most individuals this questions should be answered YES. The Affordable Care Act provides reduced cost insurance in the form of a "Tax Credit" based upon your income. By applying for tax credits/Apple Health the Washington Health Plan Finder will calculate your income eligibility to see if you qualify for reduced monthly premiums.
When it comes to estimating your income for the Washington Health Plan Finder, you are encouraged to estimate your future earnings for the year in which you are asking for coverage. IE: If you are applying in Fall of 2021, for a Health Plan to cover you for the 2022 year, you need to estimate your earnings for 2022. While we understand for most, hitting the nail on the head with income projections is impossible, you're encouraged to give your best estimate. We often encourage you to round up when it comes to estimating as this will result in less surprises with the IRS when filing taxes.
Each Insurance company contracts with different providers, doctors and hospitals to create their own network. It's pretty darn important to make sure you understand the extent of your policies network. When you seek care within your network the costs will be lower and help you avoid big unexpected bills. If you seek care outside of your network you can see some serious sticker shock from procedures and visits. Like most things in life, the better you understand your insurance policy before you use it, the less surprised you'll be throughout the year.
A deductible is the amount that you are responsible to pay prior to your insurance policy kicking in. If your policy has a $3,000 deductible, this means that you'll pay the first $3,000 worth of major procedures like surgeries, MRI's, ER visits etc. Unlike car insurance, once you have met your deductible on a health insurance plan you still have costs. After you have met your deductible your insurance company then begins to pay their % of additional costs. For many policies you'll hear the term 80/20. This means the insurance carrier will pay 80% of all bills AFTER you've met your deductible. That % share continues until you've reached your Maximum Out of Pocket (MOOP). While we of course encourage clients to look at deductibles, for many the MOOP is a key component to evaluating which policy makes the most for them.
When it comes to applying for health insurance, your household is made up of those in the same Tax Filing Household. A live in family member that files their own taxes (child or relative that is not a dependent) is not part of your household. Much like each individual on the Tax Filing paperwork counts, so too does their income when it comes to estimating annual income. If one spouse is a high earner, it does not mean the low or no earning spouse can qualify for greatly reduced costs. The IRS looks at the household in its' entirety for calculating incoming limits and premium asssistance.
Individual Health Insurance is subject to an annual Open Enrollment Period (November 1 - December 15th). This means you can evaluate and choose new plans during that 6 week period, but the plan is locked in for the calendar year (January - December). Having a change in health does not qualify you to change which type of policy you elected for the year.