Top 10 Reasons to Sign Up for Health Insurance

12/4/2014

Even if you’re young, you’re not invincible. Accidents can happen to anyone. Be prepared. Get health insurance. The health professionals at Commonwealth Health offer these top 10 reasons for enrolling for health insurance.

10. Without health insurance, you may not be able to afford medical care when you or a family member needs it.

9. People with health insurance are more likely to see their doctor before their condition worsens and becomes more expensive to treat. Individuals who have diabetes and do not have health insurance have a higher mortality (death) rate than those who have diabetes and health insurance.

8. If you don’t have health insurance and experience a serious illness or medical emergency, you will be responsible for all of your medical costs. Health insurance helps protect you and your family from financial hardships that may result from health care expenses.

7. Some colleges, universities, and international programs require proof of health insurance to enroll.

6. You cannot be denied coverage because of a pre-existing condition, such as having diabetes or having a previous cancer diagnosis.

5. All Health Insurance Marketplace plans must cover the following essential health benefits. These benefits are minimum requirements for all plans in the Marketplace.

• Emergency services
• Hospitalization (such as surgery)
• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Pregnancy, maternity, and newborn care
• Mental health and substance use disorders
• Prescription drugs
• Lab services
• Pediatric services
• Rehabilitative and habilitation services and devices (help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Preventive and wellness services and chronic disease management

4. Marketplace health plans must cover a set of preventive services like screenings, tests, and vaccinations to keep adults and children healthy. Depending on your age, gender and other risk factors, your doctor may tell you it’s time for a mammogram, colonoscopy or other screening that can detect disease in its earliest, most treatable stages. Or, it may be time to screen for high blood pressure or high cholesterol to give your doctor information that can help prevent a stroke or heart attack. Best of all, these preventive services are free of charge – no copays or deductibles.

• Preventive care for all adults: 15 preventive services
• Preventive care for women: 22 preventive services
• Preventive care for children: 25 preventive services
• Medicare preventive care: 23 preventive services

3. You may qualify for lower costs on a health plan. Depending on household income and family size, you may qualify for financial assistance from the government – or subsidies – towards the cost of the premium and other financial obligations like copays or deductibles.

2. Some individuals and families may qualify for low-cost coverage through Medicaid. In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. And in some states, the program covers all low-income adults below a certain income level. Pennsylvania has chosen to expand Medicaid coverage which increases the eligibility limits for adults. However, citizens must enroll in the program; it’s not automatic.

1. If you can afford health insurance coverage in 2015, but don’t sign up, you may have to pay a penalty ($325 per adult, $162.50 per child – up to $975/family or 2% of family income, whichever is higher). Penalty example: Family of four with household income of $40,500, 2% of income = $810, penalty = $975; Family of 4 with household income of $65,000, 2% of income = $1,300; penalty = $1,300.

Peace of mind comes from knowing you and your family has the medical services needed to keep you healthy, as well as health coverage in the event of an unexpected illness or injury. 

If you need help reviewing the health insurance options on the Health Insurance Marketplace, the application coordinators at Commonwealth Health can help. Through Feb. 15 (the enrollment deadline for 2015), call these numbers to make an appointment:

• Wilkes-Barre General Hospital at 570-552-1648
• Regional Hospital of Scranton at 570-340-4942
• Tyler Memorial Hospital at 570-966 – 1240
• Moses Taylor Hospital at 570-770-5167
• Berwick Hospital Center at 570-759-5036

Change isn’t always easy, but in this case it can bring a wealth of health benefits.

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