Finding Health Insurance

Learn how to get health insurance.

Affordable Care Act

Learn About the Affordable Care Act  

The Affordable Care Act (ACA) is intended to lower health care costs, provide more health care choices, and improve the quality of health care for individuals and families.

When and How to Enroll

The open enrollment period begins on November 1, 2016 and ends on January 31, 2017.

Apply for health insurance coverage through the ACA Marketplace:

During the open enrollment period, you can also re-enroll, or change your existing insurance plan.

You can enroll year-round if you have certain life changes--like getting married, having a baby, losing other coverage, or moving--or if you qualify for Medicaid or CHIP. See if you qualify for a Special Enrollment Period.

Get more information about common ACA questions.

Using Your Coverage

Major provisions include:

Small Businesses

Businesses with 50 employees or fewer can offer Small Business Health Options Program (SHOP) plans to their employees, starting any month of the year. Learn more about small business tax credits to help companies provide insurance coverage to their workers.

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Health Insurance Plans

Learn  About Health Coverage

Health insurance helps you pay for medical services and sometimes prescription drugs. Once you purchase insurance coverage, you and your health insurer each agree to pay a part of your medical expenses--usually a certain dollar amount or percentage of the expenses.

How to get Health Coverage

You can get health care coverage through:

Types of Health Insurance Plans

When purchasing health insurance, your choices typically fall into one of three categories:

  • Traditional fee-for-service health insurance plans are usually the most expensive choice, but they offer you the most flexibility in choosing health care providers.
  • Health maintenance organizations (HMOs) offer lower co-payments and cover the costs of more preventive care, but your choice of health care providers is limited to those who are part of the plan.
  • Preferred provider organizations (PPOs) offer lower co-payments like HMOs but give you more flexibility in selecting a provider.

Choosing a Health Insurance Plan

Read the fine print when choosing among different health care plans. Also ask a lot of questions, such as:

  • Do I have the right to go to any doctor, hospital, clinic, or pharmacy I choose?
  • Are specialists, such as eye doctors and dentists, covered?
  • Does the plan cover special conditions or treatments such as pregnancy, psychiatric care, and physical therapy?
  • Does the plan cover home care or nursing home care?
  • Will the plan cover all medications my physician may prescribe?
  • What are the deductibles? Are there any co-payments? Deductibles are the amount you must pay before your insurance company will pay a claim. These differ from co-payments, which are the amount of money you pay when you receive medical services or a prescription.
  • What is the most I will have to pay out of my own pocket to cover expenses?
  • If there is a dispute about a bill or service, how is it handled?

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Continuation of Health Coverage: COBRA

Learn About COBRA

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families the right to choose to continue group health coverage provided by their group health plan for limited periods of time.

Eligibility

There are three basic requirements that must be met for you to be entitled to elect COBRA continuation coverage:

  • Your group health plan must be covered by COBRA
  • A qualifying event must occur (for example, voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, or divorce)
  • You must be a qualified beneficiary for that event

If you are entitled to elect COBRA continuation coverage, you must be given an election period of at least 60 days to choose whether or not to elect continuation coverage.

How to Get COBRA

Under COBRA, group health plans must provide covered employees and their families with a notice explaining their COBRA rights. Plans must also have rules for how COBRA continuation coverage is offered, how qualified beneficiaries may elect continuation coverage, and when it can be terminated.

For more COBRA information, see An Employee's Guide to Health Benefits under COBRA.

Get More Information or File a Complaint

If you have questions or complaints about your COBRA coverage, contact your plan administrator or the Employee Benefits Security Administration (EBSA).

Note: In some cases, you can change from COBRA coverage to Marketplace health insurance coverage.

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Long-Term Care

Learn About Long-Term Care (LTC)

Long-term care (LTC) is a variety of services that include medical and non-medical care for people who have chronic illnesses or disabilities.

If you are thinking about long-term care needs for yourself or your loved one, these resources can help:

Long-Term Care Insurance

Most health insurance plans and Medicare severely limit or exclude long-term care. If you want coverage, you may need a separate long-term care insurance policy. Read the Guide to Long-term Care Insurance. You should consider the cost of long-term care insurance as you plan for retirement.

These questions can help you evaluate long-term care insurance policies.

  • What qualifies you for benefits? Some insurers say you must be unable to perform a specific number of the following activities of daily living: eating, walking, getting from bed to a chair, dressing, bathing, using a toilet, and remaining continent.
  • What type of care is covered? Does the policy cover nursing home care? What about coverage for assisted living facilities that provide less client care than a nursing home? If you want to stay in your home, will it pay for care provided by visiting nurses and therapists? What about help with food preparation and housecleaning?
  • What will the benefits amount be? Most plans are written to provide a specific dollar benefit per day. The benefit for home care is usually about half the nursing-home benefit. But some policies pay the same for both forms of care. Other plans pay only for your actual expenses.
  • What is the benefits period? It is possible to get a policy with lifetime benefits but this can be very expensive. Other options for coverage are from one to six years. The average nursing home stay is about 2.5 years.
  • Is the benefit adjusted for inflation? If you buy a policy prior to age 60, you face the risk that a fixed daily benefit will not be enough by the time you need it.
  • Is there a waiting period before benefits begin? A 20 to 100 day period is not unusual.

Complaints about Long-Term Care

To report an emergency where there is immediate danger, call 911 or contact your local authorities.

If you have a complaint about a long-term-care facility, read about the long-term care ombudsman program, which investigates complaints.

If you have an elder abuse complaint, contact your long-term ombudsman or local elder abuse resources.

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Health Insurance and Health Resources for People with Disabilities

Health Coverage for People With Disabilities

If you have a disability, you have a number of options for health coverage through the government. 

Health Resources for People With Disabilities

Federal, state, and local government agencies and programs can help with your health needs if you have a disability. 

Visit USA.gov’s Government Benefits page to learn more about government programs and services that can help you and your family.

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