9 Best Queens, NY Health Insurance Agencies | Expertise.com (2024)

Providers

FAQs

• Introduction

  If you're looking for health insurance for yourself or your family, an agent can help you save time, understand your options, and manage your costs. Insurance agents must be licensed in the state where they operate. They can provide information about on- and off-exchange plans to help you weigh all of your options, and they can see if you qualify for tax credits that can lower your monthly premiums. There's no cost to work with an agent, and they can help you save quite a bit by recommending the best plan for your needs. Here's what you should know before you get started.
  

• What are some of the most important factors Queens residents must consider when looking for health insurance?

  When Queens residents are selecting health insurance, they need to verify whether their healthcare providers fall within the network. Visiting an out-of-network physician could result in significantly higher expenses than staying within the network. Individuals in good health may want to explore health plans with lower premiums. It is also important for applicants to understand that health insurance operates as a binding contract, meaning they cannot request changes in coverage from their insurance provider mid-year.

• Can private health plans like Medicare Advantage work alongside the Original Medicare plans of Queens and Queens County residents?

  Yes. Private options such as Medicare Advantage serve as an alternative to Original Medicare, and Part D plans can complement the benefits provided by Original Medicare. In Queens County, there are over 45 private Medicare plans accessible, all of which are administered by Medicare-approved private companies. Medicare Part C can provide extra benefits that are not part of the Original Medicare package.

• What types of health insurance plans are available to Queens residents?

  Residents of Queens can avail themselves of personal health insurance options, including HMOs, PPOs, and EPOs. Family health insurance, on the other hand, provides comprehensive coverage for all family members, safeguarding their well-being. Additionally, employers have the option to provide group health insurance plans to their employees, ensuring collective coverage for the workforce.

• What are the different types of group health insurance plans in Queens?

  Residents of Queens can choose from a variety of group health insurance options, including HMO and POS plans. HMO plans present lower out-of-pocket expenses like copayments and deductibles in comparison to alternative plan types. Typically, HMOs mandate that their members secure referrals from their primary care physicians prior to consulting specialists or receiving non-urgent medical treatments. Conversely, POS plans blend attributes of both HMOs and PPOs, though they extend partial coverage for services rendered outside their network.

• What healthcare services must all Queens residents with health insurance receive under the Affordable Care Act of 2014?

  In accordance with the provisions of the Affordable Care Act of 2014, individuals holding health insurance policies in Queens are entitled to ambulatory patient services. Policyholders are guaranteed access to emergency and comprehensive hospitalization services, and diagnostic tests and laboratory procedures must also be provided.

• How can you find affordable health insurance?

  Affordable insurance is available through employers, Medicare, Medicaid, and the federal Health Insurance Marketplace, which offers subsidies in the form of tax credits. You can also purchase coverage through private insurance companies and independent agents. Nearly half of all Americans have employer-sponsored health insurance, and about 10% of the population is uninsured.

• What is health insurance?

  Health insurance policies are contracts that require an insurer to pay some or all of a beneficiary's health care expenses in exchange for a premium and deductible. Plans cover preventive care and emergency medical services arising from an injury or illness. They may also offer optional coverage for dental and vision.

• How do health insurance companies make money?

  Health insurance companies make money by collecting premiums from consumers and reinvesting the funds. Federal law requires insurers to put approximately 80-85% of collected funds toward claims, and 15-20% is used to pay for administrative expenses.

• What is subsidized health insurance?

  Subsidized health insurance is available exclusively through the Health Insurance Marketplace. This system applies federal tax credits that can reduce or eliminate premiums. Tax credits are available to consumers who earn up to 400% of the federal poverty level based on household size.

• What is a health insurance deductible?

  A deductible is a fixed amount you must pay out-of-pocket before normal copays or coinsurance rates apply. Under the Affordable Care Act, some services, such as annual physicals and wellness screenings, must be covered at no charge.

• Is it illegal to not have health insurance?

  No. Starting in 2019, the federal government eliminated the penalty that applied to individuals who could afford health insurance but chose not to purchase it. Financial penalties still apply in California, Massachusetts, New Jersey, Rhode Island, Vermont, and Washington, D.C.

• Does health insurance cover therapy?

  All Marketplace plans must cover behavioral health care services, including counseling, inpatient care, and substance abuse treatments. However, there are coverage limits, and preauthorization may be required.
  

• What is a copay?

  A copay is a fixed price that you pay at the time of service after your deductible is satisfied. Insurance companies set specific rates for primary and specialty care and other services, such as emergency room visits and X-rays. Alternatively, plans may have coinsurance rates that require beneficiaries to pay a certain percentage of covered charges.

• What is the Health Insurance Marketplace?

  The Health Insurance Marketplace is a federal service designed to help consumers compare and purchase subsidized health insurance plans that comply with the Affordable Care Act. A number of states operate their own insurance marketplaces, including California, Colorado, New York, and Pennsylvania.
  

• How can you find health insurance without a job?

  Individuals who don't have access to health insurance through their job can purchase ACA-compliant plans through the Health Insurance Marketplace. Off-exchange plans are also available through private insurers and independent agents. The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives certain individuals who are losing their coverage the right to maintain the same plan for a limited time period.
  

• Can you cancel health insurance at any time?

  Consumers can cancel their health coverage at any time. Cancellations may be effective immediately or at a specified date. However, you must wait until Open Enrollment to sign up for a new plan unless you qualify for a Special Enrollment period.

• Can you have more than one health insurance policy?

  It's possible to have primary and secondary health insurance. This is most common with Medicare and Medicaid beneficiaries, including dual enrollees and individuals who purchase supplemental plans. Secondary plans can cover some additional expenses, but you're still responsible for premiums and deductibles.

• Is health insurance pretax?

  Premiums for employer-sponsored health plans are generally deducted from the worker's pretax income. The same is true for voluntary contributions made to Flexible Spending Accounts and Health Savings Accounts that are paired with a qualifying high-deductible health plan.

• How long can a child stay on a parent\'s health insurance policy?

  Children can stay on their parents' health insurance plan until their 26th birthday. There's a 60-day special enrollment period following this date. Exemptions allow disabled adult children to remain on their parents' policy beyond this age.

• Do you have to pay a health insurance deductible upfront?

  In most cases, out-of-pocket expenses for approved services count toward your deductible. However, it's increasingly common for hospitals to request all or part of the deductible upfront when scheduling major services, such as CT scans and surgeries.

• Do employers have to offer health insurance?

  The Affordable Care Act requires companies with at least 50 full-time employees to make essential health benefits available to 95% of their workforce. Companies that choose not to offer such benefits may have to pay a penalty.

• Is there a tax credit for having health insurance?

  The Advance Premium Tax Credit is a federal tax rebate designed to lower the cost of health insurance plans purchased through the Marketplace. Eligibility is based on income and household size. Consumers can decide how much of their tax credit to put toward their premiums.

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