What is Health Insurance?Health insurance is coverage that provides for the payments of benefits as a result of sickness or injury. Includes insurance for losses from accident, medical expense, disability, or accidental death and dismemberment.
Health Insurance TypesAffordable Care Act (ACA)
The comprehensive health reform law that is sometimes referred to as "Obamacare". Under the ACA, individual medical plans are required to cover ten “Essential Health Benefits” to be recognized as a "Qualified Health Plan" and provide “minimum essential coverage” to enrollees(“MEC”). Based on qualifications, you may be eligible for Advanced Premium Tax Credits (ATPC) to help offset monthly premiums. Premium tax credits are not guaranteed and are subject to eligibility requirements determined exclusively by the Federal Marketplace Open Enrollment is normally November 1 - December 15th of each year. Outside of an Open Enrollment (OEP), you must have a Special Enrollment Period (SEP) granted to enroll in an ACA plan outside of the OEP. The most popular SEP is "losing other qualified health plan" such as employer group coverage. Short Term Medical (STM) STM Insurance does not provide comprehensive medical coverage and is not minimum essential coverage as defined in the Affordable Care Act (also known as “Obamacare”). STM insurance may not cover all Essential Health Benefits. Check your plan carefully before enrolling. Plans are subject to medical underwriting, and generally do not cover preexisting conditions, and may have lifetime and/or annual dollar limits on health benefits. If your coverage expires, or you lose eligibility, you may have to wait until an Open Enrollment Period to get ACA health insurance coverage. However, STM plans do NOT follow the OEP and SEP timelines. You can enroll any day of the year. Health Maintenance Organizations (HMOs) and Exclusive Provider Organizations (EPOs)
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