Question 1

What is the minimum number of hours required for employees in the city of New Bedford to be eligible for health insurance?

Accepted Answer

Employees of the City of New Bedford must work at least 18.75 hours per week in a 37.5-hour workweek or 20 hours per week in a 40-hour workweek and contribute to the public sector retirement system of their employer. Your health insurance coverage will begin on the first of the month, 60 days, or two full calendar months after you begin working the required hours.

Question 2

Does your employer pay some of the premiums for your New Bedford employer-sponsored health insurance?

Accepted Answer

It depends. Some businesses in New Bedford pay a portion of their employees' health insurance premiums. If the employer pays a portion of the premium, the insurance company must ensure that the employer does not pay a higher proportion of the premium for higher-paid employees than for other employees. Prices vary depending on whether insurers offer health insurance plans to large or small groups or individuals.

Question 3

Will you lose MassHealth coverage if you have private health insurance through your spouse or a non-custodial parent in New Bedford?

Accepted Answer

No, you can have both private health insurance and MassHealth coverage in New Bedford. Most children who qualify for MassHealth have health insurance through a parent who is not the primary caregiver. If you are having difficulty obtaining private health insurance information for the non-custodial parent, call the MassHealth Third-Party Liability Unit at (888) 628-7526.

Question 4

How do you ensure that the costs of your care are covered when you have both private health insurance and MassHealth in New Bedford?

Accepted Answer

You must follow the guidelines of your private health insurance plan in New Bedford and see a physician who is in both your private plan's network and the MassHealth network in order for MassHealth to pay for your care, including copays, deductibles, and other out-of-pocket expenses. In addition, before scheduling an appointment, make sure that your preferred provider accepts MassHealth and your private health insurance. Coordination of Benefits details are available on the MassHealth website for more information.

Question 5

Can undocumented individuals purchase health insurance in New Bedford?

Accepted Answer

Everyone in New Bedford, regardless of immigration status, has access to private health insurance and MassHealth. If you have any questions about the cost of care, how to apply for free or reduced-cost care, or whether the Health Center accepts your health insurance, please call the Benefits Counselor at (508) 992-6553.

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

What is the minimum number of hours required for employees in the city of New Bedford to be eligible for health insurance?

Does your employer pay some of the premiums for your New Bedford employer-sponsored health insurance?

Will you lose MassHealth coverage if you have private health insurance through your spouse or a non-custodial parent in New Bedford?

How do you ensure that the costs of your care are covered when you have both private health insurance and MassHealth in New Bedford?

Can undocumented individuals purchase health insurance in New Bedford?

How can you find affordable health insurance?