Question 1

Why should residents of Danbury be covered by health insurance?

Accepted Answer

Residents of Danbury should be covered by health insurance because medical care can be expensive. There could be life-and-death situations wherein the only choice is to pay up, even if doing so will destroy one's finances. Having a health insurance plan in place would help cushion the monetary blow.

Question 2

What are the pros and cons of a health maintenance organization plan in Danbury?

Accepted Answer

In Danbury, a health maintenance organization plan has the advantage of being more affordable than most plans. As a downside, the insured has to seek treatment from a primary care provider selected from the insurer's network. Selecting a physician from outside the network is frowned upon without a referral and could result in the entire treatment being out-of-pocket.

Question 3

Why would a resident of Danbury consider supplementing a health insurance plan with a long-term care policy?

Accepted Answer

A resident of Danbury may consider supplementing a health insurance plan with a long-term care policy because even if one has health insurance, there may be gaps. The insured may eventually have to stay in a retirement home and require 24/7 care that health insurance alone cannot cover sufficiently.

Question 4

What benefits can health insurance plans cover in Danbury?

Accepted Answer

Health insurance plans in Danbury can cover an assortment of concerns like dental care and disability. There are plans that have long-term care integrated into the contract, and those that have an annuities component. Vision care is also covered, depending on the provider and option one settles on.

Question 5

If a resident of Danbury has a pre-existing condition, is there no chance of obtaining health insurance?

Accepted Answer

A resident of Danbury who has a pre-existing condition can still be covered by health insurance. Under the ACA, insurance companies cannot discriminate on the basis of pre-existing conditions when selecting who to grant healthcare policies to. This applies however to contracts purchased from the health insurance marketplace.

Question 6

How can you find affordable health insurance?

Accepted Answer

Affordable insurance is available through employers, Medicare, Medicaid, and the federal Health Insurance Marketplace, which offers subsidies in the form of tax credits. You can also purchase coverage through private insurance companies and independent agents. Nearly half of all Americans have employer-sponsored health insurance, and about 10% of the population is uninsured.

Question 7

What is health insurance?

Accepted Answer

Health insurance policies are contracts that require an insurer to pay some or all of a beneficiary's health care expenses in exchange for a premium and deductible. Plans cover preventive care and emergency medical services arising from an injury or illness. They may also offer optional coverage for dental and vision.

Question 8

How do health insurance companies make money?

Accepted Answer

Health insurance companies make money by collecting premiums from consumers and reinvesting the funds. Federal law requires insurers to put approximately 80-85% of collected funds toward claims, and 15-20% is used to pay for administrative expenses.

Question 9

What is subsidized health insurance?

Accepted Answer

Subsidized health insurance is available exclusively through the Health Insurance Marketplace. This system applies federal tax credits that can reduce or eliminate premiums. Tax credits are available to consumers who earn up to 400% of the federal poverty level based on household size.

Question 10

What is a health insurance deductible?

Accepted Answer

A deductible is a fixed amount you must pay out-of-pocket before normal copays or coinsurance rates apply. Under the Affordable Care Act, some services, such as annual physicals and wellness screenings, must be covered at no charge.

Question 11

Is it illegal to not have health insurance?

Accepted Answer

No. Starting in 2019, the federal government eliminated the penalty that applied to individuals who could afford health insurance but chose not to purchase it. Financial penalties still apply in California, Massachusetts, New Jersey, Rhode Island, Vermont, and Washington, D.C.

Question 12

Does health insurance cover therapy?

Accepted Answer

All Marketplace plans must cover behavioral health care services, including counseling, inpatient care, and substance abuse treatments. However, there are coverage limits, and preauthorization may be required.

Question 13

What is a copay?

Accepted Answer

A copay is a fixed price that you pay at the time of service after your deductible is satisfied. Insurance companies set specific rates for primary and specialty care and other services, such as emergency room visits and X-rays. Alternatively, plans may have coinsurance rates that require beneficiaries to pay a certain percentage of covered charges.

Question 14

What is the Health Insurance Marketplace?

Accepted Answer

The Health Insurance Marketplace is a federal service designed to help consumers compare and purchase subsidized health insurance plans that comply with the Affordable Care Act. A number of states operate their own insurance marketplaces, including California, Colorado, New York, and Pennsylvania.

Question 15

How can you find health insurance without a job?

Accepted Answer

Individuals who don't have access to health insurance through their job can purchase ACA-compliant plans through the Health Insurance Marketplace. Off-exchange plans are also available through private insurers and independent agents. The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives certain individuals who are losing their coverage the right to maintain the same plan for a limited time period.

Question 16

Can you cancel health insurance at any time?

Accepted Answer

Consumers can cancel their health coverage at any time. Cancellations may be effective immediately or at a specified date. However, you must wait until Open Enrollment to sign up for a new plan unless you qualify for a Special Enrollment period.

Question 17

Can you have more than one health insurance policy?

Accepted Answer

It's possible to have primary and secondary health insurance. This is most common with Medicare and Medicaid beneficiaries, including dual enrollees and individuals who purchase supplemental plans. Secondary plans can cover some additional expenses, but you're still responsible for premiums and deductibles.

Question 18

Is health insurance pretax?

Accepted Answer

Premiums for employer-sponsored health plans are generally deducted from the worker's pretax income. The same is true for voluntary contributions made to Flexible Spending Accounts and Health Savings Accounts that are paired with a qualifying high-deductible health plan.

Question 19

How long can a child stay on a parent\'s health insurance policy?

Accepted Answer

Children can stay on their parents' health insurance plan until their 26th birthday. There's a 60-day special enrollment period following this date. Exemptions allow disabled adult children to remain on their parents' policy beyond this age.

Question 20

Do you have to pay a health insurance deductible upfront?

Accepted Answer

In most cases, out-of-pocket expenses for approved services count toward your deductible. However, it's increasingly common for hospitals to request all or part of the deductible upfront when scheduling major services, such as CT scans and surgeries.

Question 21

Do employers have to offer health insurance?

Accepted Answer

The Affordable Care Act requires companies with at least 50 full-time employees to make essential health benefits available to 95% of their workforce. Companies that choose not to offer such benefits may have to pay a penalty.

Question 22

Is there a tax credit for having health insurance?

Accepted Answer

The Advance Premium Tax Credit is a federal tax rebate designed to lower the cost of health insurance plans purchased through the Marketplace. Eligibility is based on income and household size. Consumers can decide how much of their tax credit to put toward their premiums.

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Frequently Asked Questions

Introduction

Why should residents of Danbury be covered by health insurance?

What are the pros and cons of a health maintenance organization plan in Danbury?

Why would a resident of Danbury consider supplementing a health insurance plan with a long-term care policy?

What benefits can health insurance plans cover in Danbury?

If a resident of Danbury has a pre-existing condition, is there no chance of obtaining health insurance?

How can you find affordable health insurance?