Test Your Healthcare IQ

Think you know health insurance inside and out? We asked our insurance industry experts what questions they are most frequently asked, and what information is lesser known, but vital to making an informed health plan purchase. Answer the questions and find out how advanced your health plan IQ really is.

Questions

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A. What is the official name of the health care mandate that was passed into law, and is currently referred to as “Obamacare?”

B. How many deductibles are included in a health insurance plan?

C. When is the open enrollment period for signing up for health insurance for 2019?

D. If you purchase health insurance on your own because you’re self-employed or don’t have access to coverage through your employer, does the government subsidize the cost of the plan?

Answers

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A. The Patient Protection Affordable Care Act is the name of the health insurance mandate, which was passed and signed into law in 2010. The name of the mandate has been shortened over the years to “Affordable Care Act” in mainstream media.

B. It depends. Many health insurance policies have two deductibles – one for medical expenses and one for prescription drug expenses. However, some policies only have one deductible that combine both medical and prescription costs. It pays to investigate is you have one or two deductibles, especially if you use your prescription benefits frequently.

C. The health insurance open enrollment period begins November 1, 2018, and runs through December 15, 2018. In order to have coverage on January 1, 2019, you must either renew the plan you have or select and enroll in a new plan by December 15, 2018.

D. In many cases, yes. More than 85% of Americans who purchase health insurance through their state exchange or the federal marketplace receive cost assistance to help with their monthly health insurance premium.

Top Three Insurance Terms

Shopping for health insurance can be confusing as soon as large words not part of the average English vocabulary become part of the conversation. You have to know what the words mean in order to understand what you’re getting with your health insurance coverage. So here are three insurance terms you can master to become a more informed healthcare purchaser.

Deductible: This is a fixed dollar amount the health insurance company will require you to pay before they begin paying for your medical bills. For example, if you have a $5,000 deductible, you will have to pay $5,000 out of your own pocket for medical services (outside of covered preventive care) before your health insurance company will begin taking responsibility for a majority of the expenses.

Coinsurance: Once you meet your health insurance deductible, you typically are still required to pay a percentage of medical costs going forward. Typical coinsurance can be 80/20 or 70/30 (meaning that the insurance company pays for 80% or 70% of the expenses, and you pay the remainder). That means, if you have met your deductible and have a $200 medical bill, you are responsible for $40 of the bill if you have 80/20 coinsurance.

Out-of-Pocket Maximum: There is a cap on how much you have to pay for in-network services over the course of a year to help curb extreme medical expenditures. Always look to see what the maximum amount you would be responsible for if major medical services were required.

Knowing these three definitions can save you time, headache and money along the way.