Can you shop around for health insurance?

Where can I get health insurance?

There are four possible options for private health insurance (if you don’t qualify for Medicare, Medicaid, or CHIP)

1. An insurance company or HealthCare.gov. Use HealthCare.gov to see if you can get a tax credit.
2. Employer: If your employer has a plan, it may pay for part of your premium.
3. Spouse’s employer: If your spouse’s employer offers a plan, you may want to compare the costs and benefits of being added to it.
4. Parent: If you’re under 26, you may be able to join your parents’ plan. You don’t have to live at home, be enrolled in school, or be a dependent, to be added to your parents’ plan.

What dates do I need to know when shopping?

Open enrollment for HealthCare.gov ends on January 15. If you want a plan that starts on January 1, then the enrollment deadline will be December 15. January 15 is the deadline to sign up for coverage that starts on February 1. If you don’t sign up by January 15, 2023, you may not be able to get coverage until 2024.

Are those the only times I can buy a plan?

There are special enrollment periods, which are times outside the annual open enrollment when you can sign up for health insurance if you’ve had certain life events, like losing a job, moving, getting married, having or adopting a child, or your income falls below a certain amount.

How do I select a health care plan?

Review the plan’s key documents, including the summary of benefits and coverage, provider list, and drug list, for the information that matters to you. If you want to read the fine print, you can also review the full policy or evidence of coverage document.

If you have a medical or mental health issue, you want to make sure the plan you buy has the benefits you need.

The same thing goes for your doctors and prescriptions. Make sure the plan will let you see your doctors and will cover your medicines.

You also want to look at the price (the monthly premium) and what you’ll have to pay when you get care (cost-sharing). There are copays, deductibles, and coinsurance.

Copays are what you pay every time you go to the doctor. The deductible is the part you must pay before the plan will start sharing the cost. After you’ve met your deductible, coinsurance is the percent of the cost of care that you will continue to pay until you meet the plan’s out-of-pocket maximum.

If a plan has a low premium, make sure it has the benefits you need at a price you can afford.

How do I shop for health insurance?

Our checklist will help you get the facts you need to pick a good health plan. Texas Department of Insurance's health plan shopping guide.

How can I spot problems with a plan or agent?

Here are a few red flags to look for when buying a plan:

· The agent or salesperson can’t answer basic questions about the plan, or give you specific plan information in writing.
· You feel pressured to decide right away. There are no limited time offers in health insurance.
· A price that is much lower than other companies you’ve checked with probably means the plan has fewer benefits and more limits.
· You get a call or email from a company or person you didn’t contact first. Be especially careful giving out your Social Security, Medicare, or credit card numbers. Never give them to anyone you didn’t call first or ask to call you.

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The Texas Insurance PodcastBy Texas Department of InsuranceSep 30, 2021