Q:  What is health insurance?

A:  Health insurance is a type of coverage that helps pay for medical expenses incurred by the insured. Health insurance is designed to give you peace of mind when getting a yearly check-up, or medical treatment for a health concern. It can also help cover your bills if you need to go to the emergency room or have surgery.

Q:  Why do I need health insurance?

A:  (1) To reduce the risk of financial ruin.  You may be healthy now, but the onset of a sudden or serious illness or a traumatic event can leave you with staggering medical bills.   The inability to pay high medical bills can ruin your credit history and set you back for years.  This is the most common reason people file for personal bankruptcy. (2) To eliminate paying a penalty on your taxes.  If you don"t have health insurance, you will need to pay a tax penalty of $695 per adult or 2.5 percent of annual income (whichever is greater).

Q:  How much does health insurance cost?

A:  When you purchase a health insurance plan, you will pay a premium, which is a fixed monthly amount.   The premium is determined by the type of plan you have, as well as your age and your geographical location. In addition, you may have to pay deductibles, copayments, or coinsurance amounts when you see your doctor or buy prescription drugs.  Generally, you will pay higher premiums for plans that include out-of-network benefits; plans that have low or no deductible, copayment, or coinsurance amounts; or both.  You can choose to lower your monthly premium by purchasing a plan with a higher deductible.

Q:  When is 2018 Open Enrollment for Individual & Family plans?

A:  Open enrollment for Individual & Family plans begins November 1, 2017 and ends January 31, 2018 for 2018 plans.

Q:  What are qualifying events?

 A:  Qualifying events allow you to enroll in a health insurance plan outside of open enrollment.  Here are the qualifying events:
  • Loss of health coverage (for example losing existing health coverage, losing eligibility for Medi-Cal, or turning 26 and losing coverage through a parent’s plan).  Changes in household (for example getting married or divorced, having a baby or adopting a child or death in the family.)  Changes in residence (moving to a different ZIP code or county.)  Becoming a U.S. citizen

Q:  What is a deductible?

A:  A deductible is the amount you pay for medical care and prescriptions before your health plan starts paying. The amount can vary depending on the type of plan. In some cases, you may not have to meet your entire deductible first before you can receive certain plan benefits. For example, you do not have to meet a deductible for preventive care such as an annual check-up.

Q:  What is a Summary of Benefits and Coverage?

A:  The Affordable Care Act requires your health insurance company to provide you with a summary of your health plan’s benefits and coverage. All health plans must provide you with certain information to make “apples-to-apples” comparisons when you’re looking at different health care plans.