Frequently Asked Enrollment Questions

Answers to frequently asked enrollment questions.

How long can I stay on my parents' insurance?

You can stay on your parents’ plan until you turn 26 years old. If you consider getting a plan on your own, depending on your household size and income, you may qualify for premium tax credits to reduce your monthly premium and/or lower out-of-pocket costs.

Contact us at Sales@AveraHealthPlans.com for a free quote and answers to all of your questions.

What types of plans are available for me to choose from?

Comparing plans is easier now that all the plans are placed into categories (bronze, silver, gold, platinum and catastrophic). The difference between the plans is the percentage your plan will pay for the total cost of care.

For example:

  • With a bronze plan, you'll pay more for health care services; however, your monthly premium will be less.
  • With a platinum plan you'll pay less for health care services; however, your monthly premium will be more.

Tip: Look at your budget and identify how often you went to the doctor last year to determine which plan works best for you.

Contact us at Sales@AveraHealthPlans.com for a free quote and answers to all of your questions.

What type of plan do you recommend for a 20-something with no dependents?

Consider a bronze plan with affordable co-pays so you know exactly how much you'll pay when you do go to the doctor. Plans with a higher deductible will have lower monthly premiums. Make sure you understand plans that have you pay a co-insurance at the doctor’s office as this will be a percentage – and sometimes this is hard to predict.

Contact us at Sales@AveraHealthPlans.com for a free quote and answers to all of your questions.

If I'm planning on getting married or starting a family, what should I be looking at for coverage?

Congratulations! This is an exciting time in your life and you're taking an important step by looking for health coverage.

First of all, identify your monthly budget and how much you can afford to pay each month for your premium.

Note: If you have an annual income of less than $96,000 for a family of four, you may be eligible for tax credits and cost reductions.

Contact us at Sales@AveraHealthPlans.com for a free quote and answers to all of your questions.

How much of a penalty will I have to pay if I don't have insurance?

If you don’t have coverage in 2015, you’ll pay a fee that is the higher of these two amounts:

  • 2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
  • $325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.

We have many resources available to help you select the best plan and avoid a penalty. You can trust us to be educated on the latest updates regarding the Affordable Care Act.

Contact us at Sales@AveraHealthPlans.com for a free quote and answers to all of your questions.

What is the average price difference of a broken leg with and without insurance?

Without health insurance, non-surgical treatment for broken leg typically costs up to $2,500 or more for a fracture that requires a cast. X-rays average $210 according to health.costhelper.com. If you need surgical treatment for a broken leg, it will typically cost you $17,000 to $35,000 or more.

If you have health insurance, coinsurance and the rest will depend on where you are at with your year-to-date deductible and your annual out-of-pocket cost. (This is where having a low-deductible plan is beneficial. Yet the cost will be significantly less than without health insurance.

Contact us at Sales@AveraHealthPlans.com for a free quote and answers to all of your questions.

How can I sign-up for insurance?

First of all, view pricing and identify if you qualify for financial assistance online. Be prepared, here is a checklist to save you time.

Then, check out our list of insurance agents or sign up to meet with anyone at our office by contacting us directly. We'd love to talk with you and are available from 8 am to 8 pm, Monday through Friday and Saturday mornings from 8 am until noon.

I've heard there were problems with the Federal Insurance Marketplace during the initial rollout. Should I be concerned now when enrolling?

Healthcare.gov has improved a great deal since its initial rollout. You can get a quote or see if you qualify for tax credits within a few clicks. Keep in mind, when it comes to the deadlines mid-December, high utilization of Healthcare.gov may slow down the website and cause delays so it is smart to start looking in October and enroll early November and avoid last minute shopping. Be prepared, here is a checklist to save you time.

You always have the option to contact us directly at Ask@AveraHealthPlans.com early on so we can help you through the process over the phone or in person.

What if I do have few questions or just want someone to enroll for me?

If you have questions, contact a local agent or one of our licensed agents on staff. You can always email Ask@AveraHealthPlans.com or stop at one of our locations.

We can’t stress enough how important it is to shop for health insurance, find the right plan for you and understand what you're paying for. We have a lot of experience and can walk you through plans while highlighting the benefits. We're here to answer your questions and walk you through the process as needed. Be prepared, here is a checklist to save you time.

Is there anything else I should know?

We recommend not waiting. Don’t let a question, lack of time or financial resources hold you back from getting health insurance. Our services are free and we're ready to help. Be prepared, here is a checklist to save you time.

Once you have a health plan, make sure you understand the benefits and what it covers when you go to the doctor. We're here to help you from the moment you start shopping for insurance to the day-to-day process of navigating your health care.

How do I find out if I can get help with my monthly premium?

You're only a few clicks away from finding out if you qualify to reduce your monthly premiums based on your annual salary. Check out this chart from healthcare.gov to find out.

Contact us at Sales@AveraHealthPlans.com for a free quote and answers to all of your questions.