This article was last updated on May 6, 2021.
If you’re new to navigating the world of health care and health insurance, it’s natural to have a lot of questions. Like, how do I sign up for health insurance? When do I sign up? And, why is health insurance so important, anyway?
Don’t worry: You’ve come to the right place. Here, we’re answering some of the most common questions about health insurance.
Why is health insurance so important?
Health insurance helps pay for medical care and medications, which can vary widely in terms of cost. Even if you’re relatively healthy, you don’t want to skip the financial protection that health insurance provides. Accidents happen, and health insurance can help protect you from high, unexpected medical costs.
Plus, having a health insurance plan for you and your family members provides access to preventive care and services External Site at little to no out-of-pocket cost for you External Site. Depending on your age, preventive care includes:
- Tests for blood pressure, diabetes, and cholesterol levels
- Screenings for some cancers, like mammograms for breast cancer and colonoscopies for colon cancer
- Annual well-baby and well-child exams up until age 21
- Screenings for pregnant people
- Routine vaccinations against diseases like measles, polio, meningitis, HPV, or chicken pox
- Annual flu and pneumonia shots
How do I get health insurance?
There are several different ways to get health insurance. You may have employer-sponsored coverage through your job or your spouse or partner’s job, or if you’re under the age of 26 External Site, you can still be on your parent’s health insurance plan. You may also receive health insurance through a government program like Medicare or Medicaid.
If none of the above options apply to you, then it’s time to shop around for an individual and family plan. These plans can cover just you or your spouse and kids. You can purchase an individual and family plan from a private health insurance provider or through the federal Health Insurance Marketplace. You can check out our plan options and enroll online Opens New Window or call a Wellmark-certified agent Opens New Window to help you find a plan that fits your needs and budget.
When is open enrollment for health insurance?
Though there are several different ways to get health insurance, there is generally only one time to get it and that’s open enrollment.
Open enrollment usually happens at the end of the year (but may happen at a different time if you have coverage through an employer) and is the one time when you can update your health insurance coverage, like selecting a new plan or re-enrolling in your current plan (which you’ll need to do each year).
However, you can also make changes to your health insurance plan if you experience a qualifying life event that opens up a special enrollment period. Qualifying life events Opens New Window include:
- Getting married or divorced
- Adding a new dependent child to your family
- Moving to a new state
- Losing other coverage (like employer-sponsored coverage or aging out of your parents’ plan)
- Policyholder death
Special enrollment periods are only open for a limited time, and if you miss that window you may have to wait until the next open enrollment period to get coverage. You can generally cancel your health insurance coverage at any time, but you may not want to do that unless you have other coverage lined up.
What does health insurance cover?
As we mentioned already, health insurance covers a wide range of medical expenses, from basic doctor visits to longer hospital stays, plus prescription drugs and durable medical equipment. So, what doesn’t health insurance cover? Most plans will not cover elective or cosmetic procedures, beauty treatments, and services or prescriptions determined as investigational or experimental.
To find out what your health insurance covers — including things like mental health care, inpatient and outpatient services, chiropractic and dental care — check your Coverage Manual. If you have a Wellmark Blue Cross and Blue Shield health plan, you can do this online through myWellmark®. Sign up for free Opens New Window in minutes or simply log in today.
How has my coverage been updated for COVID-19?
Most insurers have updated their policies over the last year to help cover treatment costs related to the coronavirus pandemic. Wellmark is committed to supporting our members, and we are continuing to offer no-cost COVID-19 testing and in-network inpatient care related to the diagnosis of COVID-19 when prescribed by your doctor. To learn more, visit Wellmark.com/Coronavirus Opens New Window.
Turning 65 and have questions about Medicare?
Medicare plans work a little differently than health insurance offered through your employer, a private health insurer, or the federal Health Insurance Marketplace. Learn more about the basic parts of Medicare, how to enroll if you plan on working past age 65, important enrollment periods you need to know, and four steps to get retirement-ready.
Get even more Medicare-related content here in the Medicare section of Blue.