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Buyer Beware

Posted on July 18, 2016 at 11:15 AM

Buyer Beware

Here are some commonly asked questions by consumers purchasing Health Insurance through Access Health CT.

 

When I purchase Health Insurance through Access Health CT can I purchase ancillary products such as: AD&D, cancer, critical illness, dental, vision, or disability plans to include as a package with one monthly payment?

No, you are only able to purchase health insurance plans and separately some dental plans through Access Health CT. If you are interested in adding other insurance products to make your health insurance coverage a more complete package you are able to purchase these plans separately. These plans are not offered through Access Health CT and are not part of the National Health Care Act. Most of these plans are offered through insurance carries other than the carries offering health insurance on the exchange. Contact us for more detailed information and a list of ancillary products at 860-436-9522.


What benefits are included in the Health Insurance Plans offered through Access Health CT?

All Access Health CT plans offer the same set of minimum essential Health Benefits. The varying factors for these plans are the carrier’s networks as well as the cost of the premium and benefits.


Essential Health Benefits included:

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)

• Emergency room coverage

• Hospitalization (such as surgery)

• Maternity and newborn care (care before and after your baby is born)

• Mental health and substance abuse services, including behavioral health treatment (includes counseling and psychotherapy)

• Prescription drug coverage

• Rehabilitation and Habilitation services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)

• Laboratory service coverage

• Preventive and wellness services and chronic disease management

• Pediatric services


Are dental and vision benefits included in the market place health plans available for purchase through Access Health CT?

Only Health Insurance Coverage is available for adults in any commercial plan on or off the Access Health Market Place. The Affordable Care Act treats dental coverage differently for children versus adults. For children, dental and vision coverage is an Essential Health Benefit, which means it must be made available either as part of a health plan or a stand-alone plan. However, insurers do not have to offer adult dental or vision coverage as part of their health plans. All of the plans offered through Access Health CT provide preventive pediatric dental and vision coverage as a benefit. Dental and Vision products for adults are available as a separate plan. Please contact us at 860-436-9522 to learn more.

 

If my employer offers insurance, am I still eligible to purchase a plan through Access Health CT?

Yes, but if you buy an individual plan through Access Health CT, you may not be able to qualify for an affordability program, such as an Advanced Premium Tax Credits (APTC). Your eligibility for APTCs depends on your income as well as whether or not the insurance from your employer was affordable and met certain other requirements. An employer plan is declared “affordable” if the price the employee is required to pay for “employee-only” coverage would cost no more than 9.66% of the employee’s household income.


Please also be aware that if a plan is declared affordable for the employee, any member of the employee’s household who could have also joined that plan will also be declared to have had access to affordable coverage, even if the cost to add that person would result in a total plan price over the limits above. This may result in all members eligible for that employer plan not being eligible for Advanced Premium Tax Credits (APTC) or Cost Share Reduction which can help people enrolling through Access Health CT afford their coverage.

 

How do I pay my Health Insurance premium and when is it due?

About 3 days following the selection of your health insurance plan through Access Health CT, Access Health CT will send you a letter confirming your enrollment and information such as if you enrolled in a Qualified Health Plan, and what coverage provider and plan you chose. Please note that if your application was incomplete or if additional eligibility verification is needed, you may receive a letter requesting additional information to either validate or complete your enrollment.


About 10–14 days after your enrollment is complete, your insurance provider will send you a bill with directions on how to make your first payment and when it is due. You will receive your Member ID Cards shortly after.

 

Am I able to purchase insurance from Access Health CT at anytime during the year?

No, you are only able to enroll during the Open Enrollment Period, but you may be able to apply for coverage if you have a Qualifying Life Event or if you are eligible for Medicaid (HUSKY A and D) or the Children’s Health Insurance Plan (CHIP), are an American Indian or Alaska Native.  For more information on qualifying events contact Access Health CT.


 

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