Insider tips for enrolling for insurance through the ACA Marketplace

Having the right health insurance is important to ensure you get the care you need at the most affordable price. With several options available through the Affordable Care Act Marketplace, we at Lee Health want to provide a few insider tips to keep in mind when you sign up for health insurance through the ACA Marketplace.

Tip #1: You can sign up through the website or an agent or broker (and it is free to work with an agent or broker).

When choosing an ACA plan, you can opt to sign up directly through the ACA website, or you may choose to use an agent or broker to assist. Many people don't realize that using an agent or broker is free; they are paid by the insurance companies. If you use an agent or broker, please make sure they can offer you all of the ACA options available to you.

Tip #2: Make sure the amount you owe when you go to the doctor or hospital is something you can afford.

Right now, many people qualify to have all or a large portion of their premium paid by the government. Even if you don't have to pay the full premium, please make sure that the amount you will owe when you go to the doctor or hospital is something that you can afford.

Tip #3: Make sure you can get care where you want to get care; don't leave it up to the insurance plan to decide for you.

The health insurance plans on the exchange sometimes don't include the doctors or hospital you need for your care. Some insurance plans force you to use virtual doctors that are not local to you. Here are some ways you can check to make sure you can get care where you want to:

¦ Check the insurance plan's online directory.

¦ Call the plans' customer service.

¦ Check with the hospital and physician's office directly.

¦ Check the benefits to see if you can go to a local doctor or if you have to use a virtual doctor.

Please remember that if you do not see the provider's name, it is most likely not in the plan's network, and you may want to consider a different plan. A hospital or physician may be included in one plan but not another of the same insurance provider.

Tip #4: Check to make sure the plan covers the prescription medications you take.

If you take prescription medications, make sure the plan you're considering covers the drugs you take. You can usually check online which drugs are included in a health plan's formulary.

Tip #5: Sign-up usually happens in the fall, but you can sign up for insurance after the deadline if you experience certain life events.

Your chance to get insurance on the ACA Marketplace usually happens in the fall. However, if you miss the deadline, you may still be able to sign up if you experience certain life events. You also may be eligible to change insurance plans outside of the enrollment period, so if you are not happy with the plan you are in, check with a health insurance agent or broker to see if you can sign up or change outside the open enrollment period.

Lee Health is pleased to be part of several of the plans on the ACA Marketplace, and we encourage you to ask any questions you have about health insurance. We know health insurance can be confusing, and it is worth taking the time to find the option that is best for you. ¦