Health Insurance: FAQ Frequently Asked Questions
1. The Health Insurance Marketplace
is for people who don’t have health coverage.
If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, we can help you get covered.
If you have job-based insurance: You can buy a plan through the Marketplace, but you’ll pay full price unless your employer’s insurance doesn’t meet certain standards. Most job-based plans do meet the standards.
If you have Medicare: You can’t switch to Marketplace insurance, supplement your coverage with a Marketplace plan, or buy a Marketplace dental plan. Learn about Medicare and the Marketplace.
What you pay for insurance depends on your income – and you’ll probably save
Your savings depend on your estimate of your expected income for THE COMING YEAR, not your income for the previous year. In 2015, for example, about 8 in 10 of the uninsured who are eligible for Marketplace coverage qualify for financial assistance to lower the cost of their monthly premiums. Get a quick idea if your expected income is in the range to save.
Based on the income estimate you put on your application, you'll find out if you qualify for a health insurance plan with savings. Most people who apply qualify for a premium tax credit that lowers their monthly insurance bill. Some also save on out-of-pocket costs like deductibles and copayments.
The plans are offered by private insurance companies with a range of prices and features. All plans cover Essential health benefits such as Pre-existing conditions, including pregnancy, Preventive care, Mental Health treatment and other such conditions deemed manditory. You can add dental to a health plan, but be careful that you don't think that the Dental Plan you pick is for everyone - some of them are only for children under 18. Read carefully before picking dental! And you don’t have to pick a dental plan. It is not required in Utah. But You can’t buy a dental plan through the marketplace unless you enroll in a health plan.
You might be told that you qualify for Medicaid and the Children’s Health Insurance Program (CHIP). Medicaid and CHIP provide free or low-cost coverage to millions of people and families with limited income, disabilities, and some other situations. Although some States have expanding Medicaid to cover all households below certain incomes, UTAH HAS NOT!. Your children may qualify for CHIP even if you don’t qualify for Medicaid.
If you don’t have health insurance, you may have to pay a fee.
Apply now. But remember, Open Enrollment only comes once each year which is usually between November 1 and December 15. For the Plan year 2017, for example, the date will be extended from November 1, 2016 until January 31, 2017. If you miss that date, you can’t buy a health insurance plan for the rest of 2017 unless you have a life change — like having a baby, getting married, or losing other employer group health coverage — that qualifies you for a Special Enrollment Period.