When you turn 26, you can no longer stay on your parents' insurance plan. What should you look for when shopping for coverage. Craig Wiseman explains in this video.

Wiseman Insurance

Here's a transcript of the video:


"I'm getting ready to turn 26 and my parents have just told me that I'm gonna have to get my own health insurance. Not even sure what I'm supposed to do."

My name's Craig Wiseman and I'm here to help you out.

Who Do I Go To?

You can give us a call at the agency at (801) 377-3060 and we can walk you through this process that can be very difficult, depending on your circumstances.

What Am I Buying?

When you're purchasing health insurance, you are purchasing full medical insurance. It's going to include coverage for the hospital, coverage for the doctor, coverage for prescription drugs. It's going to include maternity coverage, if you need that, and a lot of other ancillary coverages that come with health insurance.

What Is A Deductible?

When you buy health insurance, your plan is going to come with a deductible. Some plans have a lower deductible, and a lot of plans nowadays have a very high deductible. The deductible is the amount that is going to apply on a per calendar year basis that you are gonna be responsible before the health insurance kicks in. Now, there are certain things that are covered before the deductible. If you have a physical exam, preventative healthcare, a women's exam, that type of thing, those are all covered 100 percent — regardless of what health plan you're on.

What Is A Co-Pay?

After you've met your deductible, lots of plans have what's called co-insurance. And co-insurance is usually stated in, like, a 80/20 or a 70/30 or a number such as that. That means the first number after your deductible's met is the percentage that the insurance company is gonna be paying and the second number is the amount that you're going to be responsible for. And that tracks all the way through claims up until you have reached an out-of-pocket maximum, which is a maximum amount in any one policy year that you would be responsible for.

Is Health Insurance Expensive?

Health insurance can be pretty expensive. However, there are premium subsidies that are available, depending on income level for the household, that you might be able to participate in. If your household income is within the 100 percent to 400 percent of the federal poverty level, you may qualify for a premium subsidy through the government, through the Affordable Care Act.

What Is The Affordable Care Act?

The Affordable Care Act is something a lot of people will know as "Obamacare." And that was enacted in 2010. And it is there to assist people that have lower incomes to be able to purchase health insurance. Otherwise, it would be very cost-prohibitive. And the premium tax credits that are available are on a scaled basis depending on your income, and can offset your costs substantially.

Would I Qualify For A Discount On My Health Insurance?

If you give us a call, we can help you to determine what your actual annual household income is and try and get you every possible discount that's available to you.

Can I Buy Health Insurance At Any Time?

Health insurance has an open enrollment period that lasts from November 1st through December 15th of each year. And that becomes effective January 1st of the following year. That's when everybody can go in and purchase health insurance. You can change plans. If it's some other time during the year and you're trying to buy health insurance, you have to have a special enrollment period.

What Is A Special Enrollment Period?

A special enrollment period is basically triggered by what's called a life event. And that would be getting married or having a baby or losing other coverage. So if you'd been working for a company and you leave the employ of that company, you lose coverage. That would open an enrollment period for you to be able to purchase health insurance whatever time of the year. You only have 60 days to make that election, so it's important that you don't wait.

We're available to help you secure health insurance whenever you need it. If you'll just give us a call, we can walk you through the process and we can help you apply for the subsidies. And we can explain coverage that's available through the Affordable Care Act — because it's also a little different or can be different, depending on your income level. Give us a call and let's see if we can help you.


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