Connecting with patients through shared experience
Art Bowie, a physical therapy aide at Sharp Grossmont Hospital, draws on his own hip replacement journey to inspire patients.
You’re almost 26. But before you cut your birthday cake, don’t forget to check your health insurance plan.
If you’re currently enrolled in your parent’s plan and will be turning 26 this year, you’ll need to enroll in your own health plan soon. Waiting too long could be costly, so get a head start on your search with these helpful tips.
6 tips for getting insurance
Know when your coverage will end. The Affordable Care Act lets you stay on your parent’s health insurance plan until age 26. After that, you’ll need to enroll on your own.
Typically, you can only enroll in a health insurance plan during certain times of the year. Special enrollment periods are exceptions to these dates. Losing coverage under your parent’s plan is considered a qualifying event, which signals the start of a special enrollment period. Most special enrollment periods last for 60 days after a qualifying event.
If your parent gets health insurance through their employer, the date you’ll need your own plan may depend on your parent’s insurance provider. Most likely, coverage under their plan will end on the last day of the month that you turn 26, but it could end as soon as your birthday.
Additionally, if you are disabled, you may be able to stay on your parent’s plan. Check with the health insurance company to be sure.
Learn how health insurance works. Before you decide which health plan you’ll need, it’s important to know how health insurance works. Brush up on key terms, such as premium, deductible, coinsurance and copay. Being familiar with what is or isn’t covered can help you save time and money after enrollment.
Consider your health needs. If you don’t need to visit the doctor often, or only for yearly wellness visits, a low-premium, high-deductible plan might be best. Your monthly premium is usually lower, but you pay more health care costs yourself — your deductible — before the insurance company starts to pay its share.
However, if you know you’ll need to use your insurance benefits frequently, a high-premium, low-deductible plan may be ideal. You’ll pay more each month, but you’ll also meet your deductible faster, meaning your insurance carrier will contribute sooner.
It’s also important to recognize that your doctor could change when you get new insurance. Most health plans allow you to search their provider directory to see which doctors are in their network before signing up for benefits.
Review your health insurance options. Before your coverage ends, do some research to find the plan that’s best for you. You have three main options:
• Insurance through your employer: If your employer offers health insurance, you will most likely be allowed to enroll in a plan when your coverage ends. Contact your employer’s human resources department for more details.
• Insurance through the Health Insurance Marketplace: If your employer doesn’t provide health insurance or if you’re unemployed, Covered California™ is a good place to start. Covered California is the state’s marketplace — a free resource that can help you enroll in health, dental and vision insurance. Covered California offers financial help, and Sharp Health Plan’s options are available for as low as $0 per month, based on eligibility. You can use the Shop and Compare tool to find out if you qualify for financial help.
• Insurance through Medi-Cal: Medi-Cal offers free or low-cost health insurance to those with low incomes. Applications are accepted all year.
Shop for a plan based on quality. Not all health plans are created equal. Check out a plan’s ratings before deciding, which can help you determine the quality of care you’ll receive.
Don’t wait to get covered. Health insurance is a requirement in California. If you don’t enroll in a health plan, you could face steep fines when you file your state income tax return. Try to start your application sooner than later to avoid any penalties.
Learn more about finding a health plan
You can sign up for a free health insurance enrollment lab, where you’ll learn how to choose the right plan and find out if you’ll qualify for financial help. Sharp Health Plan’s certified enrollment specialists are also available to guide you through enrollment.
Learn more and connect with a Sharp Health Plan certified enrollment specialist.
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