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Health insurance: 5 things you must know

Health insurance: 5 things you must know

By Allison Laypath | Posted - Nov. 14, 2014 at 2:27 p.m.



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Like it or not, you need health insurance. It's the law, and life-changing health problems can happen to anyone without warning.

A minor bout with cancer — if there is such a thing — can cost hundreds of thousands of dollars, and an accident would be called something different if you saw it coming.

Bankruptcy should be the last thing you have to worry about when you or someone in your family is facing a health crisis. Having good health insurance limits the financial damage and lets you focus on recovery.

If you are uninsured, or if you're due to renew, here is what you need to know before you buy health insurance.

1. You will qualify

Gone are the days when you couldn't get insurance if you already had health problems. New health care laws ensure that everyone can get health insurance. No health questions will be asked when you apply, and pre-existing conditions will be covered right away. No matter your health history, you're in.

2. If you don't buy insurance, it'll cost you

You will be charged a penalty if you do not buy health insurance. Insurance costs might be tough to swallow, but giving away your money to the government is even worse.

If you do not have health insurance in 2015, you'll pay the higher of these two penalties:

  • 2 percent of your yearly household income. The maximum penalty is the national average premium for a basic health plan.
  • $325 per adult and $162.50 per child. The maximum penalty per family using this method is $975. 3. Don't wait to buyHealth insurance isn't like auto insurance; you can't buy anytime. The current health insurance enrollment period is Nov. 15, 2014, through Feb. 15, 2015. After that, you're out of luck — and paying a penalty — for another year.

If you get married, have a baby, lose your health coverage or your circumstances change in other ways, you may qualify for a special enrollment at other times of the year.

4. Financial help is available

Many people can get financial help to reduce their insurance payments. According to healthcare.gov, two types of aid are available:

  • Premium Subsidies help pay your premium. You are eligible for a subsidy if you are single with an annual income under $46,680. A family of four earning under $95,400 per year is eligible as well. The larger the family, the larger the subsidy.
  • A Cost Sharing Reduction decreases the amount you have to pay for deductibles, coinsurance, and copayments. 5. You can consult a professional for freeNeed help sorting out your options and navigating the websites? A professional health insurance agent can help find the best plan for you and make sure you get the subsidies for which you qualify.

Lloyd Coleman, past president of the Utah Association of Health Underwriters, says,

"Recent studies show that people who worked with an agent had the highest satisfaction rates and lower premiums. Agents are better equipped to compare plans and help people find a health plan that meets their unique needs and circumstances. People appreciate that."

Using an agent costs you nothing and will not increase your premium. Be aware that not all agents are the same. Choose an experienced local agent who understands plans, networks and other choices specific to your state or region.

Navigating the many health insurance options can be a headache, but smart shopping should result in an affordable health plan that provides you with peace of mind. Allison Laypath is an MBA, freelance writer and the founder of two successful blogs, Tips for Family Trips and Living with Burkitt's. Her work has been featured on The Huffington Post, ABC television, Parents Magazine and KSL.com.

Allison Laypath

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