Best Health Insurance Agencies in Lawrence, KS

Lawrence, KS Health Insurance FAQs

• When can Lawrence residents enroll in ACA health insurance plans in Kansas?

  Citizens in Lawrence can sign up for ACA health insurance plans primarily between November 1 and December 15 of each year. However, Special Enrollment Periods (SEP) become available following major life changes such as marriage or relocation. The federal government may from time to time introduce new SEPs. The ACA intends to provide 10 critical benefits, including emergency care. Many may be eligible for subsidies, which could reduce premiums to zero for certain plans.

• What are the primary health insurance options available in Lawrence?

  Residents in Lawrence can choose from a variety of health insurance plans. The Fee-For-Service (FFS) plan reimburses medical professionals for services rendered. Managed Care plans include Health Maintenance Organizations (HMO), in which primary care physicians coordinate care; Preferred Provider Organizations (PPO), which offer flexibility with potentially lower costs within the network; and Point-Of-Service (POS) plans, which combine HMO and PPO characteristics. The best option is determined by personal preferences and medical requirements.

• What is KanCare and how does it operate for residents of Lawrence?

  KanCare is Kansas' Medicaid program, and managed care organizations provide integrated care to Lawrence residents. Although similar to Medicaid, KanCare is a more comprehensive version that provides broader managed care. It is a fee-for-service system that includes plans from Aetna Better Health of Kansas, Sunflower State Health Plan, and UnitedHealthcare Community Plan of Kansas. While the state pays providers directly, members may have to pay coinsurance fees.

• Can individuals in Lawrence remove certain benefits from a Health Insurance Marketplace plan if they don't need them?

  No, individuals are not permitted to remove specific benefits from a plan. Every plan available on the Lawrence Health Insurance Marketplace must include all essential health benefits mandated by the ACA. Though an individual may not use every benefit, this comprehensive coverage spreads risk and protects against unforeseeable health risks throughout a person's life.

• How can residents of Lawrence determine which medications are covered by their health insurance plan?

  Individuals in Lawrence should consult the insurer's formulary, which is a list of covered drugs, to determine which drugs are covered. Typically, insurers use a tiered system for drug cost-sharing, which means that generics are often less expensive than brand-name medications. The Summary of Benefits and Coverage provides links to drug coverage details, and the Health Insurance Marketplace connects to insurers' formularies. Residents can also seek assistance from their insurer directly.