Due to the COVID-19 pandemic, you may have lost or need health insurance coverage. Here is a review of what you need to know in order to enroll in a plan, whether you are getting insured for the first time or are switching plans.
What Are the Terms You Need to Know?
When you review your options for health insurance, there are some terms you need to know so that you can make the best decision for you and your family.
Open enrollment refers to the time period when you can add or change your health insurance. Outside of that time frame, you can only make changes if you have a certain change in circumstance, like getting married or having a baby.
Your monthly premium is what you pay each month for the cost of your plan.
There are also costs you pay each time you need care. These are called
Out-of-pocket pocket costs include:
- Deductibles: what you pay each year before your insurance begins paying.
- Copayments: what you pay to see a health care provider. For instance, your primary care doctor might be $15, and your asthma specialist might be $30.
- Coinsurance: the percentage of your bill you must pay.
Covered services means what your health plan will pay for. This includes medical treatments and prescription medicine.
Finally, know which doctors, specialists and other health care providers are in-network or out-of-network.
In-network means that your health plan has an agreement with that provider for your health care. Copayments and other costs are generally less expensive if you use in-network providers.
Out-of-network means there is no agreement between the health insurance company and the provider. Your costs will be higher to see a health care provider out of network.
For more insurance definitions, see this list of common terms.
The Asthma and Allergy Foundation of America (AAFA) has a chatbot to help you better understand health insurance. The chatbot is available 24 hours a day, seven days a week on AAFA's Facebook page. Simply use Facebook Messenger to start chatting.
Where do you get health insurance?
Millions of Americans get health insurance through their jobs. If your employer does not offer health insurance benefits, you have other options.
You can buy insurance through the Health Insurance Marketplace, created by the Affordable Care Act. Open enrollment for these plans ends on Aug. 15, 2021.
When you apply for insurance, you'll find out if you qualify for financial help to pay your monthly premiums. In our next blog post about health insurance, we’ll talk about how to enroll in a health insurance plan through the Marketplace.