Health insurance faq

how can you help me with my health insurance?

As a licensed a local insurance agent, I have the health insurance knowledge, experience and expertise to answer your questions, help you determine what plan will best fit your needs and assist you with enrolling in that plan.

why did rates go up so much for 2017?

The individual health insurance market in Minnesota is literally on life support at this juncture, and individual health insurance is in desperate need of reform to make it sustainable for future years.  The Minnesota Commerce Commissioner reported that his department had to engage in emergency negotiations with the few remaining health insurance companies to keep them from pulling out of the market completely.  What arose from these negotiations were severe rate increases in excess of fifty percent, caps on how many new members would be enrolled, and carriers pulling back geographically and/or in what plans they offered.  Much of this can be blamed on the pool of people in the individual market being higher health care users than what the premiums coming in can support.  To learn more about this situation, read the Commerce Department's report, especially pages 2, 6 and 7.

why can't i purchase insurance whenever i want?

The individual health insurance marketplace changed drastically with the implementation of Obamacare.  One of the changes is that you can only buy a new individual or family major medical policy during open enrollment, unless you are eligible for a special enrollment period due to a life change (such as moving or losing other health coverage).  For 2017 health plans, open enrollment begins 11/1/16 and ends 1/31/17.

should i buy my health insurance through mnsure?

Many middle and lower income individuals and families will qualify for reduced premium (via an advance tax credit) when buying insurance through MNsure. Upon your request, I can help you determine if you are likely to qualify for this subsidy and, if so, direct to MNsure. If you obviously don’t qualify for a subsidy, I can save you a lot of time and trouble by avoiding MNsure and enrolling you directly with an insurance company.  (Note, however, that enrolling outside of MNsure makes you ineligible for a tax credit at the end of the year, which could come into play if your income unexpectedly dropped mid-year.)

why should i buy from you instead of buying direct?

Your health insurance plan will cost the same whether you purchase it through us or directly from the insurance company.  But I can help you understand your options, pick the right plan to fit your needs and provide you personal, local service now and down the road. 

how much do you charge for your services?

Because we receive compensation from your insurance company, we won’t charge you any fee for the service we provide.  Please also note that your insurance rate will be the same, regardless of whether you purchase a given insurance plan through us or directly from the insurance company.

WHY ARE CHOICES SO LIMITED FOR 2017?

The individual health insurance market is frankly on life support.  (See my answer on rates going up above.)  There is talk about signficant reform both at the state and federal level, and this will be necessary, or the individual market may cease to exist entirely, leaving people with no choices at all.  I have my fingers crossed that choices will hopefully be better for 2018, but time will tell.

do lower priced plans cover fewer types of health treatment?

Because all new major medical plans now being sold are required to include federally mandated essential health benefits, the largest difference in plan pricing has to do with how much of the cost of your covered healthcare you will have to pay (via deductibles, so-insurance, and/or copays).  There are also differences in provider networks and coverage features.

will i pay more if i have a pre-existing condition?

As part of health reform, you will pay the same regardless of your medical history or current health condition.  However, tobacco users will pay more, and older people will pay more than those who are younger.  You can no longer be refused insurance because of poor health.

will my pre-existing condition be covered?

The Affordable Care Act requires all new major medical plans being sold to cover all pre-existing conditions the same as if the condition arose after the plan was in place.  Keep in mind, however, that in most cases you can only start coverage during annual open enrollment.

since i can't be turned down, can i wait and buy insurance when i need it?

No.  In addition to the IRS penalty if you don’t carry insurance, most people can only buy insurance during the annual open enrollment period, unless you qualify for a special enrollment opportunity due to a current life event.  

what if i don't want to enroll in obamacare?

Obamacare is not so much a plan to enroll in as it is regulations which drastically change the health insurance and healthcare industries.  All major medical insurance policies are now regulated by the Affordable Care Act (aka Obamacare).  However, some people refer to buying a private insurance policy through MNsure as “enrolling in Obamacare”.  If this is your concern, I can help you avoid MNsure altogether and buy your health insurance directly through an insurance company.  (No financial assistance will apply.)

can you assist me in signing up through mnsure?

Assuming you don't qualify for government assistance and don't want to leave the door open for a tax credit at the end of the year, I can save you a lot of time and frustration by skipping MNsure and enrolling you directly with an insurance company.   If you do need to sign up through MNsure and need more assistance, I will redirect you to someone who can help.  (We have made a business decision not to affiliate with MNsure any longer.)

i still have questions.  what is my next step?

Click here to get started so that I can answer all your other questions and discuss your situation.  Or call me at 214.444.9360.  Or visit my office at 507 Beltrami Ave, Downtown Bemidji.  I look forward to talking to you!

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Agent Ken Cobb, CIC
ken@pinecountryinsurance.com