Health Insurance Frequently Asked Questions (FAQs)

Open Enrollment – Individual and Family

A: It does! Insurance providers are no longer allowed to refuse coverage or charge you more for “pre-existing conditions.”

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Open Enrollment typically happens annually between Nov. 1-Dec. 15

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: These are two very different things. Open Enrollment is when anyone can apply for health insurance. Guaranteed Issue is when you apply during Open Enrollment and cannot be denied coverage.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Anyone can enroll during Open Enrollment and cannot be denied coverage. A Special Enrollment event occurs throughout the year due to life changes that will allow someone currently enrolled to make changes to their policy. Check with an Ark Agent today to see what is the best option for you!

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Open Enrollment after being hired is determined by your employer. Please check with your human resources department.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Yes. Employers are required to notify you of Open Enrollment.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: You can cancel COBRA at any time. However, voluntarily canceling COBRA does not trigger a Special Enrollment period for private insurance.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

Open Enrollment – Group Benefits

A: Yes. Employers are required to notify you of Open Enrollment.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Open Enrollment after being hired is determined by your employer. Please check with your human resources department.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Some carriers will allow this, and others will not. If they will allow you to offer insurance to your 1099’s, there are a few rules. You have to treat them just like your W-2’s. If you are going to offer your W-2 people money towards their health insurance, your 1099’s need it too. You will probably have to provide copies of their 1099 agreements and proof of their pay. It is possible, but it is not the easiest thing in the world to do. So, make sure you’ve got a broker that understands it and can help you find the right carrier.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: You can cancel COBRA at any time. However, voluntarily canceling COBRA does not trigger a Special Enrollment period for private insurance.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

General Questions

A: Health insurance is something that has been around for hundreds of years and is designed at its core to help people get access to care. It provides proof that you will be able to make payments or at least the insurance company will make a payment on your behalf, to give you access to that care. Another reason you buy health insurance is to protect you from a catastrophic financial loss. You do not want to be in a situation where you have a million-dollar claim and all of a sudden you are losing your home. You want to protect yourself from bankruptcy by having health insurance in place for when those unexpected things happen.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: If you are buying a qualified ACA or Affordable Care Act plan, then yes, you are insurable. As long as you buy insurance during the open enrollment, which currently runs from November 1st to December 15th. Now if you are trying to buy other types of plans: partially self-funded plans, short-term plans, supplemental, temporary plans, they can do their underwriting and they can turn you down from enrolling based on what they find and will accept applications all year. One of the best ways to know if it is qualified on the ACA is if they label it with metal levels: Gold, Platinum, Bronze, Silver, or catastrophic. Those plans must take you, but only during open enrollment or if you have a special enrollment event like a birth, marriage, death, divorce, involuntary loss of coverage.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Health insurance brokers and agents in Utah are terms used interchangeably. Brokers are professionals that are required to have licensing to help individuals and businesses navigate their health insurance. They are required to complete a test and maintain continuing education, just like many other professionals you work with. Brokers get paid by the insurance carrier which makes it free for you to work with them. When you work with a broker, you have someone that is licensed, experienced, and can guide you through all of the plan choices in your area and do it without any additional cost to you. You want to make sure that you fully understand which plan you are picking because unless you have a special exception, you will not be able to change until the next open enrollment. Brokers can help you when you aren’t sure what certain things mean or if you need help with questions on a claim and need help getting it taken care of.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A:  Healthcare.gov is a website that helps connect consumers with insurance carriers in their area and then it determines if the consumer qualifies for an advanced premium tax credit with the IRS. Once the advanced premium tax credit is established it will be subtracted from the premium that is listed. This is a very quick process and will show you how affordable insurance can be. Most of the local insurance carriers have their plans integrated with the system. If you need some help please reach out to speak to one of our agents who can help you through this process.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Since health care reform came through, there are only a couple of things that can change your insurance rate. Please see below for a list of the different factors that are considered to impact the insurance rate.

-Location: Depending on where you live the rates will fluctuate. These areas are known as rating areas. In Utah, we have 6 rating areas across the state. The rate someone pays in Salt Lake is going to be different than someone in Davis County or Utah County.

-Age: Older Individuals are going to pay more.

-Tobacco Use: This is super important because if the insurance companies ever find out you lied on your application the insurance company can cancel your policy and not pay your claims due to a fraudulent application. They are allowed to increase their premiums up to one and a half times for any type of tobacco use, including vaping, chewing, and smoking.

Household Size: The size of your family can affect your premium, as the rates are charged per person. Kids are charged per child up to three per family under the age of 19. After the age of 19, you pay for them as an adult and there is no limit.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Subsidies are all based on income and family size. If your employer is offering you affordable insurance (affordable is 9.12% of your income going to the premium for a single rate in 2023). If you have an affordable plan offered by an employer you can’t get a subsidy. Starting in 2023, family members may still be able to get a subsidy if an employer plan is affordable for the employee only.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: When healthcare reform first came out, they decided it would help the American consumer if they made an easy way to identify which plans covered what. They came up with a metal tier system that covers different percentages of the cost. You typically see bronze, silver, gold, and platinum. Many states have chosen not to offer platinum plans out on the market unless you receive a cost-share reduction subsidy. Catastrophic plans are going to be available for people under the age of 30 years old. The catastrophic plan is included in the tier system but is not named after a metal. Please see below what each tier covers:

-Catastrophic plans are going to cover 50% of expenses.

-Bronze plans are going to cover 60% of your expenses.

-Silver plans are going to cover 70% of your expenses.

-Gold plans are going to cover 80% of your expenses.

-Platinum plans are going to cover 90% of your expenses.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Your deductible can range from zero to $9,100 in 2023. It is an important piece of your plan that you need to understand. It is the amount that you pay before the insurance company starts paying. Similar to your auto insurance, if you have an accident in your car and you have to pay the first thousand dollars, then the insurance kicks in. That’s how it works in health insurance as well. In traditional style plans, the deductibles tend to be lower and before the deductible happens, you have things like co-pays. You will only have to pay towards the deductible if you need expensive scans or treatments such as MRI, CT scan, emergency room, etc. The next plan is the high deductible health plan which is required by law to have everything (except your preventative care) come after the deductible has been met. There will be an individual and family deductible that will need to be met before the insurance starts paying towards anything. As you can probably tell by the name, these tend to have a high-deductible which you can use a Health Savings Account (HSA) to cover the costs of those medical expenses.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Your out-of-pocket maximum is the most you will pay in one calendar year for any person in your family and anything that’s covered on the plan goes towards that out-of-pocket maximum. The most you legally will pay out-of-pocket for 2022 is $9,100/individual or $18,200/family. On a traditional plan, often, the out-of-pocket maximum or your total liability is higher than on an HSA, even though you are paying more in premium. In an HSA plan, often they’re lower, and your premiums are also lower and you get tax incentives. So, when you are looking at a health insurance plan, keep in mind if everything goes horrible this year, can I pay this number? That’s the one you’ve got to watch.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: If you go to an in-network provider, then the insurance company will give you a fixed amount that you pay at the time of service. Most co-payments are going to range between $30-$75 and instead of going to an office visit and paying $120 or $160, you would just pay that co-payment amount. When you are looking at a summary of a plan, it will show you the co-payments, typically listed just below the out of pocket maximum. In a traditional plan, they will usually just have a fixed dollar for primary care, which are generally a pediatrician, an internist, a general family practitioner, and OBGYN’s. Then they will list a specialist co-pay, which is almost everyone else with an “ologist” in their name. On an HSA plan, they cannot have co-pays before the deductible. You will see an AD or an after the deductible on most of your plan summaries. What that means is after you have paid this high deductible amount, then you can start having a co-pay when you visit your physician. Co-pays are nice because if you have to take a child to the doctor that’s sick you would only have to come up with a fixed amount instead of paying the full bill.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: HSA stands for Health Savings Account. These were established over 20 years ago to try and get people to be better consumers with their medical plans. With an HSA, you put the money in pre-tax and the money grows tax-free. At the end of the year, your funds will roll over! You are only allowed to contribute a certain amount each year. This money is yours forever and once you reach the age of retirement you can either leave the money for medical expenses, or withdraw it and pay your current tax bracket. If you pull the funds out before the age of retirement, you have to pay a 20% tax penalty on the amount you pull out. You can only utilize an HSA if you are enrolled in a qualified high deductible health plan.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Flexible Spending Accounts can also be called a cafeteria plan or section 125. These plans were designed to give people the option to run some of their expenses for their medical, dental, and vision through a plan, pre-tax. The important part to understand is this money does NOT roll over year to year. At the beginning of the year, you have to choose how much you are going to put into the account. As soon as you select how much you want in the account they will divide that amount by the number of paychecks you will get that year. You instantly have access to that money as soon as the plan year is effective. If you do not use this money by the end of the year it will no longer be your money. It will have defaulted to the company and they get to keep it.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: If you fall within certain portions of the federal poverty level table, you may qualify for some help inside of your plan, in addition to your advanced premium tax credit. The government realized that individuals could not afford to pay the monthly premiums and their deductible for their health insurance. When you receive a cost-sharing reduction, it can change your plan from being a silver-level plan to a gold plan or a platinum plan. What that means is that the highest benefit, you may have a plan that has no deductible, $10 copays, and a $1200 out-of-pocket maximum. It is a really big deal. This type of subsidy can only be applied to silver-level plans.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: There is a possibility that you can get a subsidy if the insurance your employer offers is deemed unaffordable. If the insurance premiums are going to cost more than 9.12%(for 2023) of your income, then it is not considered affordable and you still can get a subsidy. There are major changes for 2023 that may allow your family members to get a subsidy, even if a work plan is affordable for you, so make sure you check for 2023!

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Often employer plans include up to a 90 day waiting period before their insurance coverage begins for a new hire. There are policies called short term or temporary policies that will give you coverage during that time you are waiting for the insurance to become effective with your employer. Temporary policies can go up to one year which covers a limited amount of dollars. These plans are very inexpensive because they exclude a lot of pre-existing conditions. Be aware that anything you’ve been seen for, treated for, or have been seen or treated for in the last 5 years will be completely excluded from coverage in this plan. These plans are designed to protect you from something unexpected during a short period.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: After you are seen by the doctor, you will receive two things in the mail: the bill and the explanation of benefits (EOB). Please take this as a time to make sure the EOB and the bill have a matching total listed. If the total isn’t correct please reach out to your doctor’s office as it may not be an accurate billing. Most of the time you can find your EOB on your insurance carrier’s portal or you may receive a physical copy in the mail.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: This is something you are going to get every time you go to the doctors, have a lab, or when you visit a hospital, and you will also get a bill. These will detail every single thing that happened inside of your visit and it is important to double-check them. They all look a little bit different. The first thing you are going to see is the billed charges. You will always have some kind of a discount and that is listed under the allowed amount column. This is what the insurance company is contracted with that provider to pay. You will see a total of what you are responsible for so please make sure you use these to match the total on your bill before you pay.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

Q:  People have a perception that you have to have 20 employees before you can start offering health insurance and that is incorrect. You can have a plan that is as small as one person enrolling but you do have to have two people inside of your business. For some carriers, those two people can be you and your spouse if you both work inside of the business. The benefits are a little bit richer in a group plan and generally, if you are not getting a subsidy, they’re less expensive. Running the insurance through your business also allows you to take the money out pre-tax, which lowers the tax burden for both you and your staff.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: If you were on insurance before the baby was born or the child was adopted, you can add the child to your insurance within 60 days of the birth. If you have not had insurance before the baby is born, you can’t use the birth of the child as an event to get insurance for you. Adding a child will generally increase your premiums, unless it qualifies you for additional subsidies based on your income.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: ACA Qualified plans are the best plans for pregnancy. With the healthcare reform, it is now required to be covered inside of the plans. If you are on an ACA qualified plan, it does cover maternity like any other illness. For insurance purposes, it is not an accident, no matter how accidental it may seem, it is covered as an illness, which means it will go to your deductible, coinsurance and then hits your out of pocket maximum. In addition, you can add some extra policies that may help with your out of pocket expenses.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: CHIP is the Children’s Health Insurance Plan that is administered by the state and it is subject to your income qualifications. Generally, you are going to be between 133%-200% of the federal poverty level to qualify for CHIP. You will be allowed to select a network that will best serve their needs. We have a variety of networks here in Utah: University of Utah, Select Health, Molina and they will cover medications, preventative care, office visits. Usually, there is cost-sharing available, so you will have a copay or you may also have to pay a partial premium. For example, commonly we hear people say that they pay $75.00 a quarter for all of their children to have insurance.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: The co-insurance is the amount after the deductible and before the out-of-pocket maximum that you split with the insurance carrier.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: That depends. If you have perfect teeth, and all you are doing is paying for a visit every year, then it might not be. But for most Americans who have to have a cavity filled every once in a while, maybe get a crown, it probably is a very good value. Dental insurance plans are interesting because sometimes they are capped, they’ll pay a thousand dollars per year per person where other dental plans have no cap at all. Dental is pretty inexpensive; it ranges between $18.00 and $40.00 a month per person. You can get your cleaning covered and then if you have to have something major done, it is paid on a coinsurance. Some dental insurances will help pay for braces, which are so expensive. Make sure you look at your family situation. If you need help looking into the costs please reach out and we can give you a quote!

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Vision insurance can be very important when you and your family need glasses/contacts. The cost usually runs around $8.00 – $15.00 a month. It will typically cover your eye exam once a year and an allowance towards glasses/contacts. It is very important to get your eye exam yearly as they can tell many different health issues from your eyes. If you do not wear glasses and you do not wear contacts and all you want to do is pay for your exams, it might not be the best value. You have to sit down and look at your situation and decide. Many insurance plans will include an eye exam as a preventive benefit, so make sure to check that before you buy an additional policy.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: While moving is included in the list of events that allow you to change your insurance, it does have some caveats. If you had insurance previously and you move outside of the service area, then it gives you a special enrollment period-to-enroll of 60 days. However, if you were living somewhere else and didn’t have insurance and then moved, that’s not considered a qualifying event. You have to have had prior insurance for it to open a special enrollment event to enroll. If you move within the same area (for example, a new house in the same neighborhood) that would NOT open an event where you can change your insurance.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: If you make a commission, and your income changes every single month, do you need to call in every single month and adjust it? In general, the guideline that we have been told from healthcare.gov is that if you think your adjusted gross income will change more than $5,000 in either direction, that’s when it needs to be reported. As soon as it gets reported, it will adjust your subsidies and decrease any liability you may have on your taxes related to subsidies. If your income decreased, then you want to report it quickly so you can benefit from that cash during the year.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: You lost your job, now you want to know if you can qualify to get insurance. If you had insurance at your prior job, then yes you are eligible to get another plan outside of open enrollment. You will have 60 days to enroll. If you did not have insurance at your job, then no you are not eligible to get another plan outside of open enrollment as it is not a qualifying event. Make sure you do not miss the 60-day window to get enrolled. Just because you have 60 days to do it, doesn’t mean you want to wait that long because it can create a gap in coverage if you do not enroll right away. If you lose your job during open enrollment (November 1 to January 15), it will not matter if you had previous coverage.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Preventative care helps you to detect or prevent serious diseases before they can become major problems. Immunizations, annual check-ups, and birth control are all examples of preventative care. All carriers have a list of items that are classified as preventive care.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Medicaid is available to people who are either low income or disabled. You have to be under 138% of the federal poverty level in income to qualify for Medicaid and these plans are administered by the state. There may be some cost-sharing involved, and they will determine that based on your income. You will go to jobs.utah.gov to apply for Medicaid. If you do not qualify, please come back and we would be more than happy to help you.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: -First Tier: This will be generic low-cost type prescriptions.

-Second Tier: This will be moderately expensive medications that will have a pretty inexpensive co-pay.

-Third & Fourth Tier: These are going to be the most expensive medications in general. The final tier tends to include injectables and/or medications for chemotherapy.

Some carriers will even have five and six tier medications now. All tiers are determined by an internal panel and they vary carrier by carrier so make sure you check with each carrier you are considering before you make a move!

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: When you turn 65 you may be able to qualify for Medicare. Medicare is a plan that is administered by the government and it can give you 100% coverage if you design it correctly. You qualify for different parts of Medicare and they are all designated by letters. We have agents here at Ark that are certified to help you enroll in Medicare. You can start the Medicare process no more than three months before your 65th birthday. Medicare may also be available in other situations such as disability. We recommend connecting with a certified Medicare specialist.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Individuals that are currently incarcerated are covered by the system inside the jail or prison. They do not need to stay on an insurance policy outside of that plan. You are unable to keep them on your policy if they are incarcerated and it is an underwriting question. However, once somebody gets out of jail, that does count as a qualifying special enrollment period. You have 60 days after they are released that you can either add them back to your plan or help them get a plan of their own.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: The only way you can enroll due to a divorce is if you had insurance before the divorce. For example, if you are on your spouse’s plan at their work and you need to come off their plan, you can enroll in a special enrollment period on the marketplace. You have 60 days to complete this but please do not wait until the end because we do not want you to have a gap in coverage.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

A: Open Enrollment goes from November 1st To January 15th for individual policies. You will have to qualify for a special enrollment period to get enrolled outside of these dates. Some of the special enrollment periods are: an involuntary loss of coverage, birth or adoption of a child, death of a family member, moving out of the area, changing your income so that it changes your subsidy amounts, etc. If you do not have one of those, we are going to have to look at other alternatives. Those may include getting a group policy in place if you are an employer and you have got an employee. If you’ve missed the open enrollment period, give us a call and we will try to figure something out.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.