Health Insurance Frequently Asked Questions

• Do I need health insurance?
• Is there a "one-size-fits-all" health plan?
• Is health insurance expensive?
• How can I save money on health insurance?
• What is an insurance agent?
• Will I get quotes directly from health insurance companies?
• What health insurance companies can I choose from?
• What is the difference between individual and group health?
• What is managed care?
• What's a health plan network?
• Why do health insurance prices vary from state to state?
• How do I know what is covered under my plan?
• What is a premium?
• What is a deductible?
• What are copayments and coinsurance?
• What is an out-of-pocket maximum?
• What is a drug formulary?
• Can I get health insurance if I smoke?
• What is a pre-existing condition?
• Are Medical Discount Plans the same thing as insurance?

Do I need health insurance?

Health insurance provides you and your family affordable access to high-quality health care. Accidents and illness can happen without warning, and medical treatments can be expensive. Having health insurance means knowing many of your health expenses will be covered.

Is there a "one-size-fits-all" health plan?

Because we all have different health needs, there isn't one plan that will work for everyone. But there are a lot of health plan options available — and many different companies to choose from.

Is health insurance expensive?

Health insurance isn't cheap, but it’s a bargain compared to the cost of a trip to the hospital. And with GoHealth’s shopping tools, it’s easy to find a plan that works for your budget.

How can I save money on health insurance?

There are plenty of ways to save money on a health insurance plan. To save on premiums, show that you're living a healthy lifestyle by not smoking and eating right. You can also get lower premiums if you choose a high-deductible health plan.

Another way to save on health insurance is to be a smart shopper. There are a lot of different health plans available. Take the time to compare rates to get the plan that fits your budget best.

What is an insurance agent?

An agent is either a direct representative of one insurance company, or an independent seller of health plans. Independent agents can be licensed to sell plans from several different companies.

Will I get quotes directly from health insurance companies?

Quotes are provided both by agents in our nationwide health insurance network and by our automated quoting software. Some agents represent one insurance carrier, while others represent several carriers. When you view plans online with our service, you’ll have the opportunity to apply directly with an insurance company.

What health insurance companies can I choose from?

The health insurance companies quoted by the GoHealth Network include Golden Rule, Humana, Kaiser Permanente, and several of the Blue Cross Blue Shield companies.

Your choice of health insurance companies depends on the state you live in. Some companies offer plans in almost every state, while others only offer plans in one state.

What is the difference between individual and group health?

An individual health plan provides coverage for one person, and can include children and your spouse. Group health insurance is coverage for a group of employees at a company, or members of an organization.

What is managed care?

Managed care health plans create "networks" of doctors, hospitals, and other health care providers. Plan members have the most insurance coverage if they receive care from providers in the network. The most common managed care plans are: Preferred Provider Organizations (PPOs), Health Maintenance Organizations (HMOs), and Point of Service (POS) plans.

What's a health plan network?

A health plan network consists of all the doctors, physicians, hospitals, clinics, and specialists that agree with an insurance company to charge discounted prices for their services — in exchange for patient referrals.

Why do health insurance prices vary from state to state?

Every state has their own department of insurance — and they all have their own price regulations. The variation of prices is because of states' individual laws on health insurance rates.

How do I know what is covered under my plan?

Insurance companies will provide a detailed description of which health care services are covered — and any care that's excluded or has limited coverage. Ask your agent if you have any questions about your coverage.

What is a premium?

The premium is the monthly payment you make to the insurance company to keep a policy in effect.

What is a deductible?

The deductible is the portion of your medical bills per year you must pay before the insurance coverage begins. For example, if you have a deductible of $500, once you pay $500 of your medical bills, your insurance will start covering any remaining health care costs for that year.

What are copayments and coinsurance?

A copayment is the dollar amount of a single medical bill you must pay to receive care. For example, to go to the doctor for a routine check-up, a copayment for the visit may be $30 for the visit. Your insurance will pick up the rest of the bill.

Coinsurance is very similar, but it's expressed as a percentage. For example, an 80/20 coinsurance rate means you pay 20% of the bill and insurance covers 80%.

What is an out-of-pocket maximum?

This is the maximum amount of money per year you'll have to pay out of your own pocket for health care. Once you reach the out-of-pocket max, most insurance plans will cover the rest.

What is a drug formulary?

This is the list of all the prescription drugs that are covered under an insurance plan.

Can I get health insurance if I smoke?

You can find health insurance if you smoke, but your plan will most likely be more expensive than non-smokers. Consider kicking the habit to save money. Many plans require you to be smoke-free for a year to get non-smoker rates.

What is a pre-existing condition?

Any health condition or illness that you had before your insurance coverage begins can be considered a pre-existing condition.

Are Medical Discount Plans the same thing as insurance?

No. They provide discounts for medical services, but they do not offer the same type of protection. Everyone is accepted to enroll in a medical discount plan regardless of health history or pre-existing conditions.