Health Insurance – Part 1.


Need to find health insurance? How do you even begin?  

Finding health insurance can be a daunting task, and understanding what you’re buying is even more stress-inducing and painful!  So how do you even begin?    First, don’t panic! There is always help.   Finding health insurance is NOT, I repeat, NOT something you should do alone.  I’ll break this down in steps:

Step One: Know your timing.

If you are an individual, then there are certain rules and times of year you need to be aware of:

You can’t just acquire a health insurance policy any time of year.   The Affordable Care Act “open enrollment” is for January 1 of each year, or extended to February 1. Beware of your enrollment deadline– which is generally around December 15.  A couple of rules of thumb:

You can terminate your healthcare policy any time.

You can only enroll in a policy during open enrollment, unless you have a “qualifying event.”

Qualifying Events:

  • You involuntarily lose your group coverage
  • Your COBRA coverage expires (generally after 18 months of participation)
  • Your spouse/partner loses the coverage that you’re participating in
  • You lose eligibility for subsidized coverage such as Obamacare, Medicaid or Medicare
  • Legally separate or divorce and you lose coverage
  • You have a baby, foster or adopt (allows your child to be enrolled)
  • Change in residence: Move to new home, zip, county or state

There are others, but the above are the most common qualifying events

Step Two:  Find a good insurance agent. 

Why should you do that?   Several reasons:

  • It doesn’t cost you anything, but s/he can save you a LOT of money
  • Your agent is “carrier agnostic.” What I mean is that s/he is paid by the insurance carriers, and they generally all pay the same, so there is no incentive to place your business with any one carrier. Your agent is free to find the best plan for your specific needs.
  • An agent can get you access to healthcare plans that you might not know about or have access to on your own.
  • Your agent will teach you about your insurance plan, take the mystery and guesswork out of your benefits, and help you optimize your benefits, while keeping more money in your own pocket.

How to find a GOOD agent:

  • Ask your friends and colleagues for a good referral. OR,
  • Simply “Google” health insurance agent, and your zip code.  

Look for these important indicators of a good agency and agent:

  • A smaller agency generally will give you the personal touch you deserve.
  • Do they call you back quickly, and are they willing to meet with you in person?
  • Unless you got a good referral from someone you trust, avoid choosing an agent from a Property/Casualty company. These are the companies that sell car or home insurance; Allstate, State Farm, Geico, Farmers...  There are many exceptions, but I have found that generally, they don’t know the healthcare market as well as someone who specializes in healthcare.
  • Is she a good teacher? Is she asking you questions about yourself, so that she can match a plan to your needs? Is she teaching you the healthcare lingo? Are you learning how to wisely use your benefits?
  • Is she asking you income questions so that she can fit you to a plan you can afford, or to appropriate subsidies if you qualify?
  • And last but not least, is she trying to “upsell” you, or are they truly trying to find you the best fit, even if what you need is less, not more?

Now what?   Next article will be the difference between a traditional medical plan and an HSA qualified medical plans.