Frequently Asked Questions

Health insurance helps cover the cost of medical expenses, including doctor visits, hospital stays, and prescriptions. It ensures you’re protected from high out-of-pocket costs in case of unexpected medical needs.

Deductible: The amount you must pay out-of-pocket before your insurance starts covering certain services.

Co-Insurance: After meeting your deductible, co-insurance is the percentage of costs you share with your insurance company. 

Out-of-Pocket Maximum:  This is the most you’ll pay in a year for covered healthcare services, including your deductible, co-pays, and co-insurance. Once you hit this limit, your insurance covers 100% of the costs for the rest of the year.
 

• Type of Coverage: Different policies have varying costs.
• Age & Health History: Older age or pre-existing conditions may increase costs.
• Lifestyle: Smoking or other habits can raise premiums.
• Location: State regulations and healthcare costs matter.
• Coverage Amount: Higher limits or lower deductibles mean higher premiums.

 Most health insurance plans do cover pre-existing conditions, but coverage can vary depending on the specific condition and the treatment required. Some plans may have limitations or waiting periods, so it’s important to review your policy details carefully. At Clear Choice Coverage, we help you navigate these options to ensure you’re fully covered. 

If you miss a payment, your insurance company may provide a grace period to pay. If not paid within the grace period, your policy could lapse, leaving you without coverage. 

Typically, dental and vision insurance are separate from health insurance. They cover services like dental cleanings, eye exams, and glasses. You can purchase them as add-ons or standalone policies. 

HMO: Requires a primary care physician (PCP), referrals for specialists, and only covers in-network providers. Lower costs but less flexibility.

PPO: No PCP or referrals needed, covers both in-network and out-of-network providers, but has higher costs.

EPO: No referrals needed, only covers in-network providers, offering a balance of cost and flexibility.

 Yes, but coverage depends on your plan. Some plans, like PPOs, offer nationwide networks, while others, like HMOs, may only cover emergencies outside your service area. Always check with your provider before traveling. 

 Yes, you can cancel your health insurance at any time. However, if you cancel outside the Open Enrollment Period without a qualifying life event, you may not be able to enroll in a new plan until the next enrollment period. 

 If you lose your job and health insurance, you may qualify for a Special Enrollment Period (SEP) to get coverage through the Public & Private Marketplace. You can also consider COBRA, which allows you to keep your employer’s plan temporarily, though it can be more expensive. Reach out to us, and we’ll help you explore your options. 

Supplemental insurance provides additional coverage for expenses not covered by your primary health insurance, like dental, vision, critical illness, or accident coverage. It’s especially helpful if you want extra financial protection for specific needs. 

While the federal penalty for not having health insurance was removed in 2019, some states still impose penalties like  California,  Massachusetts,  New Jersey,  Rhode Island,  Vermont,  Washington, D.C.  Even if you don’t live in a state with penalties, going without health insurance can leave you vulnerable to high medical bills in the event of an illness or accident. Health insurance provides financial protection and access to preventive care, ensuring you’re covered when you need it most.