INSURANCE HEALTH INSURANCE 101-TIPS FOR YOUNG ADULTS

Becoming an adult can be intimidating. There's paying bills, living on your own, and setting up your own health care for the first time. After years of going to a doctor chosen by your parents, it can be confusing to know what to do when it is time to take charge of your own health. If you are looking at signing up for health insurance through an employer or looking for a plan on your own, the amount of options can be overwhelming.

First, let's discuss some terms. The following terms will be important to know when comparing plans and prices. Deductible-the amount you owe for health care services before your health plan starts to pay.

Premium-the amount you pay for your health insurance every month. Copay-a fixed amount you pay for a covered health care service. Coinsurance-is the percentage you will pay for covered health services after you have met your annual deductible. Provider-a licensed health care facility, program, agency, doctor or health professional that delivers health care services. In-network providers-are providers that have a contract with your insurer to provide services for plan members at a certain cost. Out of network providers-are providers that are not contracted with your insurer to accept negotiated prices. This means that you may have to pay more or the full amount for services received from an out of network provider.

Out of Pocket Maximum-is the total amount of deductibles/coinsurance that you will be responsible for before the plan pays 100% of eligible charges. Affordable Care Act (ACA)-The ACA was a law enacted in 2010 to increase health insurance coverage for the uninsured. Marketplace-the Health Insurance Market-place, is a federal government service that helps people, families and small businesses compare and enroll in ACA health insurance plans.

Qualified Health Plan (QHP)-is an insurance plan that meets the requirements of the ACA and is certified by the Health Insurance Marketplace, provides essential health benefits (EHBs), follows established limits on costs sharing, and meets other requirements outlined within the application process. Major Medical Plans-are plans that are typically offered through the Marketplace or employers. This type of insurance covers the majority of health care services and procedures you might encounter in a given year. It includes preventive care, emergency room and urgent care.

Supplemental Care Plans-are plans that can help pay for healthcare costs that aren't covered by your primary health insurance. Some examples of supplemental plans would be vision, dental, disability, long-term or short-term care. Supplemental plans must provide a disclosure saying it is not major medical and will not cover all health costs.

Now, how do you find the right coverage? You may have an employer that offers health care coverage. In these instances, meet with your Human Resources Representative to discuss what is offered. You should specifically ask about coverage related to the terms above. For instance, what will be your deductibleft What is the monthly premium? Do they have a list of in-network providers? A lower deductible may result in higher premiums, so can you afford a higher deductibleft Your employer HR representative can help you with all of these questions. Maybe you are turning 26, and no longer qualify for coverage under your parent/guardians plan and you don't have the option of an employer plan. In this situation, it is good to discuss options with an individual that specializes in health insurance. In Wyoming, you can reach out to Enroll WY. They can help you understand what marketplace insurance is and why it is the best solution for those who qualify. They can also help you get a quote on what insurance will cost and navigate the marketplace application process. https://enrollwyo.org/Perhaps Medicaid is an option. Medicaid is based on your household income, family size and other factors. You can reach out to the Wyoming Department of Health for more information on the Medicaid program. Call 1-855-294-2127 to apply for these benefits.

Other health insurance options maybe coverage directly from an insurance company. There are many agents and brokers in Wyoming that could assist you with finding coverage. The Department of Insurance has a health insurance shoppers guide and a "what to ask when shopping for health insurance" guide. You can find these at https://doi.wyo.gov/consumers Most importantly, not all plans are the same. Do not assume that all insurers offer the same coverage. There are many different plans that cover many different health issues and situations. The most important thing you can do is READ THE PLAN. Ifyou do not understand the plan, ask questions and keep asking until you are sure you understand the coverage. You may also come across information that sounds like a health plan, but it is not insurance. An example would be Health Care Sharing Ministries. They offer coverage through membership. When health care expenses arise you can request that the ministry or other members share part of the cost. However, the ministry is not legally obligated to pay for your health care costs. Finally, going for the cheapest plan may seem like a good idea, but if it doesn't cover what you need, it can be premium payments wasted. If you have a high deductible you should be prepared and able to pay that amount. The shoppers guide at the DOI link above can help you walk through and determine what you need for healthcare coverage.

Shopping for insurance can be a bit overwhelming. However with some help from the resources available to you, you can find a plan that will provide the right coverage when you need it.

This public service announcement is presented and paid for by the insurance companies licensed to do business in Wyoming in cooperation with the Wyoming Insurance Department. For more information on the state's insurance companies, including financial information, visit the Insurance Department website's "Company Financial Information" section.

Wyoming Department of Insurance http://doi.wyo.gov 1 (800) 438-5768