Health Insurance

Health insurance is critically important because it provides financial protection against unexpected medical expenses, as well as the following:

  • Access to Medical Care: Health insurance provides access to medical care when you need it without the worry of high medical bills. It covers the costs of doctor visits, hospitalizations, surgeries and prescription drugs.
  • Financial Protection: Health insurance protects you from financial risks associated with high healthcare costs. Without health insurance, you may have to pay for medical expenses out of pocket, which can be very expensive and even financially devastating.
  • Preventive Care: Health insurance encourages preventive care, such as routine checkups, screenings and vaccinations. Preventive care can help detect and treat health problems early, which can reduce the need for more serious and expensive treatments later on and, most importantly, maintain you in good health much longer.
  • Peace of Mind: Health insurance provides peace of mind knowing that you and your family are protected in case of a medical emergency or illness. It eliminates the stress and worry associated with paying for medical expenses.

What is the health insurance marketplace and how does it work?

The health insurance marketplace is an online platform that allows individuals and small businesses to compare and purchase health insurance plans. The marketplace was created as part of the Affordable Care Act (ACA) and is also known as the Health Insurance Exchange.

Here’s how the health insurance marketplace works:

  • Open Enrollment: Individuals and small businesses can enroll in health insurance plans for the upcoming year during the open enrollment period, which is usually from November to December each year.
  • Eligibility: To be eligible to purchase health insurance through the marketplace, you must be a U.S. citizen or lawfully present in the country, not have access to affordable coverage through your employer or government programs, and not be incarcerated.
  • Plan Selection: The marketplace offers a variety of health insurance plans with different levels of coverage and costs (including premium, co-insurance and co-payments). You can compare plans and choose the one that best meets your needs and budget. The plans are divided into four categories: Bronze, Silver, Gold, and Platinum. Bronze plans have the lowest monthly premiums but the highest out-of-pocket costs, while Platinum plans have the highest monthly premiums but the lowest out-of-pocket costs.
  • Financial Assistance: If you meet certain income requirements, you may be eligible for financial assistance to help you pay for your health insurance premiums and out-of-pocket costs. This assistance components are called a premium tax credit and cost-sharing reductions.
  • Enrollment: Once you’ve selected a plan, you can enroll in it through the marketplace. Your coverage will start on January 1st of the following year, as long as you enroll during the open enrollment period.
  • Special Enrollment: If you experience a qualifying life event, such as getting married, having a child or losing your job-based coverage, you may be able to enroll in a health insurance plan outside of the open enrollment period.

Before purchasing health insurance, you should determine if you are eligible for Medicaid or Medicare. If you are eligible, you may not need to purchase private health insurance.

Contact Essex Insurance Brokers for assistance whether you need to purchase health insurance though the health insurance marketplace or directly from one of the health insurance companies. Call us at (847) 954-2222 or email us at [email protected].