Help Me
Need Help? Call or Text your Licensed Agent
Patrick Hackenberry (Licensed in GA & SC)
The best way to enroll is with the help of a licensed agent. You can enroll on your own - but please consider calling us when it comes time to finalize which plan you want to enroll in.
📧 email: patrick@onwardshield.com
Easy Guide to enrolling in your new Health Insurance Plan
Before you start - it's helpful to have the following information.
your Zip Code
What County you live in (need help click here)
your Email
your Cell Number (optional)
your Age (must be under 65)
the date-of-birth for everyone in your household that is applying for insurance
Explore these questions before you apply
You will want to answer these questions for the upcoming year. So, if it's November/December 2024 - you are projecting what your household size and income will be for 2025.
How many people are in your "tax" household?
This is the number that you use when you file your taxes. You want your Insurance Application to match your tax return.
If you live alone then your household is one.
If you live with your spouse (and file a joint tax return) then your household is two.
If you live with your spouse and your 3 kids then your household is five.
If you life with your 2 kids and your cousin (that pays their own taxes) then your household is three.
Do you have affordable coverage available at your job ?
If the health insurance that you are being offered at work costs more than 9.02% of your pre-tax household income to insure just you. In some cases if you have affordable coverage at work- you must enroll at work - but your spouse and kids can enroll on an ACA plan - to save you money.
What is your estimated household income (before taxes)?
Include the taxable income of anyone you're claiming or filing taxes with - even if they're not applying for new health insurance coverage. This can be an estimate for now. Your income determines if you're eligible and how much savings you're eligible for.
If your income increases or decreases significantly during the year please let your health insurance know so that they can adjust your plan. If you don't, you could end up owing a large tax bill.
Do you have any preferred doctors, pharmacies, or hospitals?
Make a detailed list if you want to keep seeing a certain doctor. The plans offered have strict networks. If you see a doctor that is NOT in the network - you could be stuck with the entire bill. Know your network. Check your network. If you are not sure - call your agent (Patrick Hackenberry) 706-699-2301 for help - before you go to a doctors appointment or before you have a surgery or procedure done.
If you don't have a regular doctor - don't worry. You can search for a doctor that is in your new plans network.
Do you take any prescription drugs?
This will help you to find a plan/carrier that will help cover some (or all) of the cost of your medicine.
Some key terms and concepts
A Carrier is an insurance company - for example UnitedHealthcare is a "carrier"
Your Monthly premium is the amount that you will pay each month. Depending on your income and household size you might qualify for a variety of discounts. You will see a monthly premium crossed out (that's the full price) and then you will see your price. Your price is based on your previous answers regarding your tax household and your estimate income.
Deductible. Your deductible is the amount that you must pay before the plan starts paying. Some services don't require you to pay the deductible first. For example a basic check up at a doctor that is in network usually only requires the doctor visit co-pay. However, if you have a major issue, procedure or surgery - you will most likely need to pay the deductible amount before the insurance company will pay any amount. You can have a $0 deductible and sometimes you can have a separate deductible for health and for prescription drugs (Rx). If your deductible is $7,500 and you have a $50,000 surgery - then you will have to pay $7,500 before your insurance will start paying their portion.
Out-of-pocket max This is the most you will have to pay within a year for health care services.
Specialist visit. When you have a doctors appointment many plans require you to make a co-pay at the doctors office. If you are seeing your primary care provider (pcp) then you have one copay amount. If they send you to a specialist - then you have a different copay amount. For example. You visit your primary care doctor and you have to pay a $30 co-pay. They send you to a bone doctor (orthopedic surgeon) and you have to pay a $75 specialist co-pay.
Co-insurance. This is a percentage amount that you must pay. For example if your coinsurance is an 80/20 plan - then the insurance company pays 80% (like a gold plan) and you pay 20%. In general you probably don't want a plan that shows you paying a large percentage after deductible. It's normally better to have a plan that charges a co-pay. ACA plans work like this:
The metal levels, or tiers, are based on how costs are split between you and your health insurer. Bronze and Catastrophic plans generally have lower premiums but require you to pay more out of pocket should you need to use the insurance. Platinum and Gold plans generally have higher premiums and lower out of pocket costs, with Silver plans somewhere in between.
Generally plans are Bronze 60 / 40 - the insurance company pays 60% and you pay 40%. This is after you have paid your deductible.
Silver 70 / 30
Gold 80 / 20
Platinum 90 / 10
Need Help? Call or Text your Licensed Agent Patrick Hackenberry (Licensed in GA & SC)
The best way to enroll is with the help of a licensed agent. You can enroll on your own - but please consider calling us when it comes time to finalize which plan you want to enroll in.
📧 email: patrick@onwardshield.com