Individual Health Insurance in West Virginia:
Is health coverage purchased by an individual or a family and is not tied to a job or a group of policyholders?
Many people get health insurance in West Virginia through their employers. However, if you do not currently participate in your employer’s health plan, or if your employer doesn’t offer coverage, obtaining Individual health insurance Insurance in West Virginia is an excellent route to go to ensure that you and your family will receive affordable routine health care and will be protected from very high costs in the event of a medical emergency.
1. Get Individual Health Insurance in West Virginia in the Individual Market
Obtaining an individual policy can be expensive. Before purchasing, shopping around for the best plan with the lowest premium is essential. Generally, a low premium means higher out-of-pocket costs when you need care; a high premium means lower out-of-pocket costs. You’ll also want to ensure you are covered in case of a significant medical accident and preventive care.
2. Shop for Coverage Using the Health Insurance Marketplaces
The Health Insurance Marketplaces (also known as Exchanges) are a new way to buy health insurance and apply for Medicaid. Created by the ACA, the Marketplaces are designed to help you quickly find health insurance that fits your budget.
Eligible individuals can shop for coverage using the Marketplaces. Qualified health plans in the Marketplaces are sold and run by private companies. Every plan covers a core set of 10 essential health benefits, which include emergency, prescription drugs, and mental health services. Additionally, all plans offered in the Marketplace must provide free preventive care, with 100% of the costs paid for by insurance companies.
3. Get on Your Parent’s, Spouse’s, or Domestic Partner’s Plan
If your spouse or domestic partner has an employer-sponsored plan open to family members, consider joining and enrolling your children. The ACA extended coverage for young adults up to age 26 on plans offering dependent coverage, regardless of marital or student status.
4. Secure Insurance Through COBRA and State-sponsored Programs
Suppose you recently left your job or had your hours reduced and were subsequently dropped from employer-based coverage. In that case, you may be able to obtain coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA).
After you leave your job, your former employer no longer pays for any of your insurance costs. Therefore, when you have COBRA coverage, you usually have to pay the entire premium plus a small administrative fee. As a result, COBRA coverage can be costly.
5. Insurance Through Protections Under HIPAA
Under the Health Insurance Portability and Accountability Act (HIPAA), at least one private insurer must sell you a policy if you meet all of the following conditions:
• You previously had 18 months of coverage without a break for more than 63 days
• The last day of your coverage was through your former or current employer
• You do not have a COBRA or mini-COBRA option available
6. Determine Whether you are Eligible for Medicaid or Other State Programs
Medicaid provides individual health insurance in West Virginia and coverage for some low-income individuals, including families and children, pregnant women, the elderly, and people with disabilities. People not qualify for full Medicaid benefits may still be eligible for breast cancer and cervical cancer screenings or assistance with specific treatments.
With all the different health plans available, it can be challenging to select the plan that best meets your and your family’s needs and, ultimately, your budget. While picking the plan with the lowest premium can be tempting, you don’t want to be surprised by high out-of-pocket costs or network restrictions when seeking medical care. Contact Songer Benefits, Inc. today for more information about your coverage options or for help selecting the best health plan for you.