What are the different ways
to get health insurance?
There are many ways to get health insurance. Here are a few:
Some people can get health insurance through
a group health plan offered by their employer
or their spouse’s employer. In most cases, the
employee and employer share the monthly cost
of the policy (the premium).
People can buy an individual health
insurance policy on their own.
Some people can buy health
insurance through the Health
Insurance Marketplace, also known
as the health exchange, which is
a website set up by the Affordable
Care Act. Available plans are broken down into 4 health plan
categories, with some available at a reduced cost if certain
requirements are met.
Some people may qualify for government-funded health
insurance, such as Medicare or Medicaid, if they meet certain
eligibility requirements.
Why is it important to
review your plan regularly?
Once you are insured, be sure to review your plan at least once
a year. Many insurance plans change their coverage benefits
and premium costs each year. You will be informed about any
changes as your renewal date gets closer. Check to make sure
that your preferred health care providers are still in your plan
and that the premium is still affordable.
You may decide to switch to another plan that
works better for you. Each year there is an open
enrollment period when people can enroll in a
health insurance plan or change plans. There are
also special enrollment periods that allow people
with a life change, such as a job loss or marriage,
to enroll in a plan outside the open enrollment period.
What happens if your circumstances change?
Life is always changing. If the circumstances in your life
change, you may have to change your insurance plan as well.
For example, if you get married, have a baby, or get health
insurance through your job and later lose or change your job,
you may have to switch to a different insurance plan, depending
on the type of policy that you have. Changing plans because of
certain life events is allowed at any time.
Understanding what your
plan might cover
To learn more about the services covered by a plan, be sure to
read the summary of benefits and coverage (SBC) for each
plan you are considering. The SBC is a short, easy-to-understand
summary of what each plan covers and the associated costs. It
can help you compare the benefits and costs of different plans.
Every SBC includes an example of what the plan covers for a
patient with type 2 diabetes. Everyone’s situation is different.
For a worksheet that can help you choose a plan, see page 40
of this booklet.
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