Private care providers can refuse non-emergency care, public hospitals can’t. Insurers can refuse to pay claims after 30 days of non-payment of premiums.
When you move whether or not you keep your coverage depends upon your plan type and if you have more than one residence.
When you move back to the US use the 330 day presence test to claim an exemption the 12 months before you move back, then use special enrollment to make sure you are enrolled in a plan
When you move you’ll switch your coverage at that point using special enrollment, don’t enroll in the new state until you are ready to move.
An employee can reject employer health coverage, but can’t get cost assistance on the Marketplace if coverage is offered. The employer mandate only applies to employer responsibility
If a child has been a citizen for more than 5 years, they may qualify for CHIP based on income. If a family member has access to the Marketplace they can join a family plan
Your insurer uses a drug schedule (drug formulary) to determine what tier a drug is on and it’s price. They can change these without notice.
Every legal US resident is eligible for health insurance, either through ObamaCare or private coverage. However, cost assistance is based on income.
Meridian health insurance is a physician-owned and operated group of health plans and companies. They service Medicare and Medicaid in low-resource environments. In some states, in some regions, they really let insurers (of all types public and private) get away with some B-S. Essentially the insurer is offering a network that is so tight that your coverage becomes lackluster (to be fair you coverage was also probably cheaper than other offers)
An allowed amount is the maximum amount an insurer will pay for a covered health service, the remainder owed by the insured is called “balance billing”. Allowed Amount Versus No Dollar Limits No lifetime or annual dollar limits means there is no limit to what an insurer will spend on all care as a whole,…
You can switch between health plans, including ObamaCare, but you’ll lose your cost sharing. Also claims made during coverage gaps could be denied.
You can’t retroactively sign up for any health insurance type aside from Medicaid.
Anyone in the US can go the hospital without insurance. In an emergency anyone will be treated, but without insurance you may be billed full price.
Health insurance is required for students and is based on household income. The person who files a tax return takes on the responsibility for the fee.
Health insurance premiums aren’t regulated, they are just subsidized based on income, but cost sharing and benefits are regulated by the ACA.
If you know your going to move, get a multi-state health plan. If you don’t have a multi-state plan moving qualifies you for special enrollment.
If someone is in the middle of treatment they can avoid a gap in coverage by enrolling special enrollment at HealthCare.Gov.
If your medical treatment extends over two policy periods you’ll have to meet the deductible twice, even if it’s for the same condition.
When you get out of prison you qualify for a special enrollment period in the Health Insurance Marketplace, or may qualify for Medicaid based on income.
In a Health Maintenance Organization (HMO) you’ll typically need a referral from a primary care physician (PCP) to see a dermatologist.
You can only apply for coverage in a state you reside in. You can however get a multi-state plan if you want coverage outside your state.
Generally you can only get cost assistance through ObamaCare’s Health Insurance Marketplace if you don’t have other coverage options.
If you have coverage, but don’t have your card yet, call your insurer and get the information. You’ll need your member ID, group number, and insurer at least.
A dependent can be added to coverage during open enrollment or a special enrollment period, this is the same for a spouse.
Only multi-state plans cover you outside of your state. Other than that only emergency services and drugs are covered.