Different Ways to Get Health Insurance

There are many ways to get health insurance. To put it simply, you can get a Qualified Health Plan that meets ACA minimum requirements or, a non-qualified health plan that does not meet ACA minimum requirements. 

Since 2017, the Individual Mandate has been repealed so you don’t need to worry about having a “Qualified” health plan to avoid a tax penalty. However, some of those plans might not provide as good of coverage in return for lower premiums. Common examples are “HealthShare” plans which have fine print clauses and a lot of limitations and exclusions. Buyer beware! 

 Qualified Health Plans

There are 3 ways to find a Qualified Health Plan for you and your family. 

  1. Independently through the Individual & Family market
  2. Through your or your spouse’s employer
  3. Medicare (65+ years old or individuals with certain disabilities) 

Individual & Family Health Plans

You can find affordable health plans on your own, or work with an Agent. Most of the plans are sold “On-Exchange” via the Health Insurance Marketplace. In WA State, we use the www.wahealthplanfinder.org to find most health plans. If you want to see more options, contact your agent to shop “Off Exchange” Health Plans in your area.  

There are 15 insurance companies available in WA State and you can see what insurance companies Frank Airey and Airey Benefits Company are contracted with here: WA OIC – FRANK AIREY

“On-Exchange” Health Plans 

The easiest way to find a health plan is purchasing a plan “On-Exchange” through the WA Health Plan Finder

Why purchase a plan On-Exchange? There are a few key benefits that you cannot get anywhere else! 

  • Advanced Premium Tax Credits – if your income meets certain income, household size, and geographic criteria, the state will provide you with tax credits to lower your Health Insurance Premiums. I’ve seen policies cost as little as $1 per month for some, and over $1,200 for others. It’s always worth checking
  • WA Apple Health – If your income is too low for tax credits, you’ll be automatically enrolled on WA Apple Health, our state’s Medicaid program. You can think of this as income based single-payer healthcare. 
  • Access to most insurance carriers – most carriers sell On-exchange only so you’ll see most of the plans available 
  • Cascade Care Policies – These are Standardized policies that cost a bit more, but have richer benefits and only available On-Exchange (WA State Only) 

Here are some tips from a pro: 

  1. You can skip all the steps by here by scheduling an appointment! But, if you want to try shopping on your own… 
  2. Before shopping, check and see if you’re eligible. To be eligible, you must:
    1. Shop during Open Enrollment (November 1st – December 15th) for a new plan starting January 1st 
    2. Have a “Qualified Life Event” within the last 60 days
      1. Consider this, a loss of health coverage at no fault of your own in the last 60 days
  3. Browse plans before you create an account
    1. Follow the link above
    2. Click “Browse and Compare Plans” 
    3. Enter your Zip code, Birthday, and expected (if self-employed) or current (if you’re a W2 employee) adjusted gross income for your (tax) household
      1. For help calculating your income – follow this link: Countable Income
      2. Why do you need to enter your income? Find our section on Tax Credits Here 
    4.  DO NOT ENTER IN ANY PROVDIER OR PRESCRIPTION INFORMATION
      1. The site uses that information to find a “smart choice” health plan, but the results are not useful and inaccurate 
  4. Once you’ve found a plan you like, create an account! 
    1. Follow this link to create your WA Health Plan Finder account: CREATE ACCOUNT 
    2. Create account and you’ll be directed to the new account Dashboard
    3. Click “Start Application” 
    4. Enter in all personal details and finish application
  5. After you’ve created your account, next step is to select your plan. 
    1. From your Dashboard, select the green “Shop Plans” 
    2. Click through the next few pages until you see all of the available plans
    3. DO NOT ENTER IN ANY PROVDIER OR PRESCRIPTION INFORMATION
      1. The site uses that information to find a “smart choice” health plan, but the results are not useful and inaccurate 
  6. Which Plan do you pick? 
    1. Schedule an appointment with me to help you decide! 
    2. Here are some topics to consider before you pick your plan:
      1. Do you want to keep your doctors & providers?
      2. How often do you usually see a provider? 
      3. Do you have adequate savings for a catastrophic health event? 
      4. Do you travel outside of the country? Outside Washington? Outside Seattle? How often and for how long? 
      5. How much will your prescriptions cost? 
      6. Do you have and procedures scheduled? 
      7. Will your income change throughout the year? 
      8. Are you moving to a different county this year? 
      9. How many months are left in the year? 
  7. Select your plan
    1. Select your plan by clicking “Add to Cart”
    2. Continue through the pages and add a dental plan if you’d like
    3. Click “Apply Now” on the right-hand side 
    4.  Once you’ve completed the plan selection process, you’ll see your new health plan added to your cart… 
  8. What’s next? 
    1. Pay your premium 
      1. You have 30 days to make your premium payment, but the sooner the better
      2. It’ll take at least 10-14 business days to get your ID card after you’ve paid your premium
      3. The insurance companies won’t send you your invoice in a timely manner – ask Frank what to do to pay your premium
    2. Create your Online Account
      1. Once you’ve paid your premium and you’ve received your ID Card and welcome packet in the mail from your Insurance Carrier, I strongly recommend utilizing their Online Platforms for all billing, claims, coverage, and network questions
      2. If you have questions, ask Frank!

“Off-Exchange” Health Plans

Why purchase a plan Off-Exchange?

  • Streamlined enrollment – eliminating the Exchange can make your life easier because you reduce the number of parties processing your enrollment
  • Looking for a specific plan – Want an HSA plan with a deductible lower than $6,000? They’re out there but you need to know where to look Off-Exchange, sometimes there are better options for a specific person or family that is only available Off-Exchange

What carriers offer Off-Exchange plans in WA State? Check them out here: 

Regence Blue Shield 

Asuris NW Health 

Kaiser Permanente

PacificSource (not contracted)

Providence Health

United Healthcare of OR

Dental & Vision

So… you’ve spent the time to find the best health plan for needs but what about covering a root canal? Or new prescription glasses? Dental and vision policies are a great way to save money on big expenses that you cannot predict. 

Do you need more than your 6 month dental cleaning? I recommend one of the policies through Delta Dental Off-Exchange using the link below. Be careful! If you haven’t had dental insurance in the last 60 days you might have a waiting period before certain services are covered! The Clear plan and the Ascent plan don’t have any waiting periods. 

Delta Dental 

Still have questions? ask Frank

There aren’t many options for vision plans on the Individuals & Family market. Luckily, VSP is a great option that won’t break the bank. Save money easily from your annual exam to a new set of frames with either of the policies offered through VSP in the link below. 

VSP Vision Plans 

Still have questions? ask Frank

Life Insurance

WAYS TO GET HEALTH INSURANCE 

There are many ways to get health insurance. To put it simply, you can get a Qualified Health Plan that meets ACA minimum requirements or, a non-qualified health plan that does not meet ACA minimum requirements. 

Since 2017, the Individual Mandate has been repealed so you don’t need to worry about having a “Qualified” health plan to avoid a tax penalty. However, some of those plans might not provide as good of coverage in return for lower premiums. Common examples are “HealthShare” plans which have fine print clauses and a lot of limitations and exclusions. Buyer beware! 

 Qualified Health Plans

There are 3 ways to find a Qualified Health Plan for you and your family. 

  1. Independently through the Individual & Family market
  2. Through your or your spouse’s employer
  3. Medicare (65+ years old or individuals with certain disabilities) 

Individual & Family Health Plans

You can find affordable health plans on your own, or work with an Agent. Most of the plans are sold “On-Exchange” via the Health Insurance Marketplace. In WA State, we use the www.wahealthplanfinder.org to find most health plans. If you want to see more options, contact your agent to shop “Off Exchange” Health Plans in your area.  

There are 15 insurance companies available in WA State and you can see what insurance companies Frank Airey and Airey Benefits Company are contracted with here: WA OIC – FRANK AIREY

“On-Exchange” Health Plans 

The easiest way to find a health plan is purchasing a plan “On-Exchange” through the WA Health Plan Finder

Why purchase a plan On-Exchange? There are a few key benefits that you cannot get anywhere else! 

  • Advanced Premium Tax Credits – if your income meets certain income, household size, and geographic criteria, the state will provide you with tax credits to lower your Health Insurance Premiums. I’ve seen policies cost as little as $1 per month for some, and over $1,200 for others. It’s always worth checking
  • WA Apple Health – If your income is too low for tax credits, you’ll be automatically enrolled on WA Apple Health, our state’s Medicaid program. You can think of this as income based single-payer healthcare. 
  • Access to most insurance carriers – most carriers sell On-exchange only so you’ll see most of the plans available 
  • Cascade Care Policies – These are Standardized policies that cost a bit more, but have richer benefits and only available On-Exchange (WA State Only) 

Here are some tips from a pro: 

  1. You can skip all the steps by here by scheduling an appointment! But, if you want to try shopping on your own… 
  2. Before shopping, check and see if you’re eligible. To be eligible, you must:
    1. Shop during Open Enrollment (November 1st – December 15th) for a new plan starting January 1st 
    2. Have a “Qualified Life Event” within the last 60 days
      1. Consider this, a loss of health coverage at no fault of your own in the last 60 days
  3. Browse plans before you create an account
    1. Follow the link above
    2. Click “Browse and Compare Plans” 
    3. Enter your Zip code, Birthday, and expected (if self-employed) or current (if you’re a W2 employee) adjusted gross income for your (tax) household
      1. For help calculating your income – follow this link: Countable Income
      2. Why do you need to enter your income? Find our section on Tax Credits Here 
    4.  DO NOT ENTER IN ANY PROVDIER OR PRESCRIPTION INFORMATION
      1. The site uses that information to find a “smart choice” health plan, but the results are not useful and inaccurate 
  4. Once you’ve found a plan you like, create an account! 
    1. Follow this link to create your WA Health Plan Finder account: CREATE ACCOUNT 
    2. Create account and you’ll be directed to the new account Dashboard
    3. Click “Start Application” 
    4. Enter in all personal details and finish application
  5. After you’ve created your account, next step is to select your plan. 
    1. From your Dashboard, select the green “Shop Plans” 
    2. Click through the next few pages until you see all of the available plans
    3. DO NOT ENTER IN ANY PROVDIER OR PRESCRIPTION INFORMATION
      1. The site uses that information to find a “smart choice” health plan, but the results are not useful and inaccurate 
  6. Which Plan do you pick? 
    1. Schedule an appointment with me to help you decide! 
    2. Here are some topics to consider before you pick your plan:
      1. Do you want to keep your doctors & providers?
      2. How often do you usually see a provider? 
      3. Do you have adequate savings for a catastrophic health event? 
      4. Do you travel outside of the country? Outside Washington? Outside Seattle? How often and for how long? 
      5. How much will your prescriptions cost? 
      6. Do you have and procedures scheduled? 
      7. Will your income change throughout the year? 
      8. Are you moving to a different county this year? 
      9. How many months are left in the year? 
  7. Select your plan
    1. Select your plan by clicking “Add to Cart”
    2. Continue through the pages and add a dental plan if you’d like
    3. Click “Apply Now” on the right-hand side 
    4.  Once you’ve completed the plan selection process, you’ll see your new health plan added to your cart… 
  8. What’s next? 
    1. Pay your premium 
      1. You have 30 days to make your premium payment, but the sooner the better
      2. It’ll take at least 10-14 business days to get your ID card after you’ve paid your premium
      3. The insurance companies won’t send you your invoice in a timely manner – ask Frank what to do to pay your premium
    2. Create your Online Account
      1. Once you’ve paid your premium and you’ve received your ID Card and welcome packet in the mail from your Insurance Carrier, I strongly recommend utilizing their Online Platforms for all billing, claims, coverage, and network questions
      2. If you have questions, ask Frank!

“Off-Exchange” Health Plans

Why purchase a plan Off-Exchange?

  • Streamlined enrollment – eliminating the Exchange can make your life easier because you reduce the number of parties processing your enrollment
  • Looking for a specific plan – Want an HSA plan with a deductible lower than $6,000? They’re out there but you need to know where to look Off-Exchange, sometimes there are better options for a specific person or family that is only available Off-Exchange

What carriers offer Off-Exchange plans in WA State? Check them out here: 

Regence Blue Shield 

Asuris NW Health 

Kaiser Permanente

PacificSource (not contracted)

Providence Health

United Healthcare of OR

Dental & Vision

So… you’ve spent the time to find the best health plan for needs but what about covering a root canal? Or new prescription glasses? Dental and vision policies are a great way to save money on big expenses that you cannot predict. 

Do you need more than your 6 month dental cleaning? I recommend one of the policies through Delta Dental Off-Exchange using the link below. Be careful! If you haven’t had dental insurance in the last 60 days you might have a waiting period before certain services are covered! The Clear plan and the Ascent plan don’t have any waiting periods. 

Delta Dental 

Still have questions? ask Frank

There aren’t many options for vision plans on the Individuals & Family market. Luckily, VSP is a great option that won’t break the bank. Save money easily from your annual exam to a new set of frames with either of the policies offered through VSP in the link below. 

VSP Vision Plans 

Still have questions? ask Frank

Life Insurance

Curious if you’re Life Insurance policy still meets your financial needs? We can take a deep dive into your personal Life Insurance policy so your whole family is well protected. Download my personal Pre-Screening form here and schedule a free consultation to get the ball rolling. 

Disability Insurance 

Download and complete my Pre-Screening form and schedule a free consultation to get started.  

Curious if you’re Life Insurance policy still meets your financial needs? We can take a deep dive into your personal Life Insurance policy so your whole family is well protected. Download my personal Pre-Screening form here and schedule a free consultation to get the ball rolling. 

Disability Insurance 

Download and complete my Pre-Screening form and schedule a free consultation to get started.  

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