The Affordable Care Act (ACA) provides individuals and families greater access to affordable health insurance options including medical, dental, vision, and other types of health insurance that may not otherwise be available. Under the ACA:
Visit HealthCare.gov to apply for benefits through the ACA Health Insurance Marketplace or you'll be directed to your state's health insurance marketplace website. Marketplaces, prices, subsidies, programs, and plans vary by state.
If you have questions about specific parts of your insurance plan, you must contact your insurance company to get answers. Only your insurance company can answer specific questions about doctors, medications, treatments, medical equipment, and what is and is not covered under your plan.
Businesses with 50 employees or fewer can offer Small Business Health Options Program (SHOP) plans to employees, starting any month of the year. Learn about small business tax credits to help companies with the equivalent of fewer than 25 full-time employees provide insurance coverage to their workers.
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. These questions can help you evaluate long-term care insurance policies.
Medicare provides medical health insurance to people under 65 with certain disabilities and any age with end-stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant). Learn about eligibility, how to apply and coverage.
If you have lost health insurance or no longer qualify for NJ FamilyCare, you may be able to get health coverage through GetCoveredNJ. Compare health plans, costs, and learn how much financial help you may qualify for now. Nine out of 10 residents enrolling qualify for financial help.
All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico.
Under the federal Affordable Care Act (ACA), companies with 50 or more employees will be assessed a penalty starting in 2015 if they do not offer group health insurance to fulltime workers. Companies with fewer than 50 employees are exempt from the penalty.
For those without affordable group insurance, another option might be one of the health care plans offered by the Minnesota Department of Human Services. These plans have very low, if any, enrollee cost sharing and in Minnesota will cover low income adults as well as children. An individual looking for insurance on MNsure will be screened for eligibility for the Minnesota health care plans. Those deemed eligible will be directed to DHS. Go to Minnesota Department of Human Services to learn more about the Minnesota Health Care Programs available to eligible Minnesotans.
Grandfathered plans are plans that were in effect on March 23, 2010 when the federal Affordable Care Act (ACA) was signed into law. The intent was to allow individuals, families and employers to keep the coverage they had. Grandfathered plans are subject to some of the reforms contained in the ACA: no annual dollar limits on coverage; no preexisting conditions exclusions; no waiting period of more than 90 days; no lifetime limits on coverage; dependent children are covered to age 26. Grandfathered plans are not required to offer the essential benefit set or limit cost sharing or provide preventive care with no cost sharing. Grandfathered plans will lose that status if there are significant changes in benefits, copayments, coinsurance, employer contributions or change in insurance companies. Should this occur, the plan will be subject to all of the requirements of the ACA and Minnesota law.
Help shopping and choosing a health plan is available via navigators, in-person assisters, certified application counselor and licensed insurance agents/brokers, and via the MNsure customer call line at 1-855-366-7873. For more details about MNsure, go to MNsure.
Individual and small group health insurance called Qualified Health Plans (QHPs) will be sold on MNsure. For those with lower incomes but not eligible for Minnesota health care programs, MNsure will determine if they quality for a subsidy to help pay for the insurance. Subsidies are only available for shoppers using the MNsure website. A subsidy will be used to discount your insurance premium.
Medicare coverage is not subject to these market reforms. Go to Minnesota Board on Aging or Minnesota Department of Commerce - Insurance or Medicare.gov for more information about Medicare health plans and Medicare supplemental insurance.
You may be able to get short-term health coverage. This temporary coverage can last for up to six months. Preexisting health conditions are not covered. This may be an option to consider if you are between jobs, just graduating from college, or waiting for your group coverage to start. Be sure you understand what is covered and what is not covered. For more information about short term coverage go to Minnesota Department of Commerce.
COBRA, or the Consolidated Omnibus Budget Reconciliation Act, was passed in 1986 and contains provisions which allow employees to continue health coverage for themselves and their dependents after they leave their jobs. COBRA and state law require that if your employer provides you and your dependents with group health coverage, your employer must also allow you and your dependents to continue that coverage at your own expense, should you or your dependents lose your coverage. In most cases, both you and your dependents may elect COBRA or state continuation coverage for up to 18 months, but the time frame varies depending on how you became eligible for continuation coverage. You will most likely have to pay the entire cost of coverage yourself.
Connect for Health Colorado is the only place you can apply for financial help to lower the cost of private health insurance. The financial help you can get to lower your monthly payment is called a Premium Tax Credit.
Note: Subsidies are only available if you buy a plan through the Exchange (wahealthplanfinder.org). Non-Exchange plans are plans you buy through an insurance agent, broker or directly from a company.
Get more from your health plan coverage for less. Enjoy plan benefits like $0 preventive care, access to walk-in clinic care* with extended hours and weekends and virtual care through MinuteClinic.**
*For a complete list of participating walk-in clinics, log in to Aetna.com and use our provider search tool. Walk-in appointments are based on availability and not guaranteed. Online scheduling is recommended. Includes select MinuteClinic services. Not all MinuteClinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventative MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates. This benefit is not available in all states.
For TX/GA: Includes select walk-in clinic services. Not all walk-in clinic services are covered. Please consult benefit documents to confirm which services are included. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventative walk-in clinic services at no cost-share.
**Applicable cost-share may vary based on services and providers. Please consult benefit documents for more details. Members enrolled in qualified high-deductible health plans must meet their deductible before receiving covered non-preventative MinuteClinic services at no cost-share. However, such services are covered at negotiated contract rates.
The Applied Behavior Analysis (ABA) Medical Necessity Guide helps determine appropriate (medically necessary) levels and types of care for patients in need of evaluation and treatment for behavioral health conditions. The ABA Medical Necessity Guide does not constitute medical advice. Treating providers are solely responsible for medical advice and treatment of members. Members should discuss any matters related to their coverage or condition with their treating provider.
You, your employees and agents are authorized to use CPT only as contained in Aetna Clinical Policy Bulletins (CPBs) solely for your own personal use in directly participating in healthcare programs administered by Aetna, Inc. You acknowledge that AMA holds all copyright, trademark and other rights in CPT.
Telehealth benefits are available on all plans either from Blue Cross NC or through the provider network. Blue Cross NC provides the telehealth program for your convenience and is not liable in any way for the goods or services received. Blue Cross NC reserves the right to discontinue or change the program at any time without prior notice. Decisions regarding your care should be made with the advice of a doctor. Depending on your plan, selected programs may not be available to you at this time. Check with Blue Cross NC Customer Service to determine your eligibility. Blue Cross NC has contracted with a third-party vendor independent from BlueCross NC to bring you telehealth benefits.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
Individual/family coverage is another type of health coverage. You can buy health insurance in the individual/family market if you do not get health insurance through your employer and you do not qualify for Medi-Cal or another public program.
Remember, cost is not the only thing to think about when you buy health coverage. The quality of health care covered by an insurer is impo