22 Things You Don't Know About Your Health Insurance Policy

LOS ANGELES - Jan. 28, 2025 - PRLog -- First 5 myths in full article, link at end

Myth #6: You Are Not Covered if You Go Out of Network
Am I covered if I choose a specialist or doctor who is not in my health insurance network?
If the treatment or visit is medically necessary and you decide to go with an out-of-network provider, and you have a PPO plan, you'll still be covered for the service, just not as much as if you go to an in-network provider. EPOs and HMOs have tighter network restrictions, however.

You'd be best off securing approval from the insurance company before going out-of-network to see if you qualify for coverage. If you're approved, your insurer would only cover what your policy would have covered for the equivalent in-network provider.

Myth #7: Health Insurance Covers International Travel
Am I covered by my health insurance plan while traveling abroad?
Some health insurance plans may cover emergency care while traveling abroad. Most health insurance plans are only covered within a certain zone, usually in-state, but each policy varies. It's a good idea to contact your insurer to ask about coverage because you may need to buy travel medical insurance if you need health care or medications during your trip.

Myth #8: You're Not Covered Out of State
Am I covered by my health insurance policy in another state?
Most ACA plans are exclusive to that state because they are state subsidized. However, this is not true for all private health insurance plans. It's best to call your insurance company and ask if you'll be covered at your destination. Otherwise, you may only be covered for emergencies.

Myth #9: You're Not Eligible for an ACA Plan if Offered Insurance at a Job
Can I buy an ACA plan instead of a job-sponsored health insurance plan?
You're not legally or ethically bound to your work's health insurance options, and there is no law against buying a marketplace plan instead. In fact, it's a good idea to see if you qualify for a low-cost policy based on income requirements.

Myth #10: You Can Only Buy Health Insurance During Open Enrollment
If you miss the open enrollment deadline, you are still able to buy health insurance during a special enrollment, which is unique to each individual. Common life changes make you eligible for special enrollment, like losing your health insurance coverage, having a baby, changing jobs or losing a job, getting married or moving.(3)

Full article: https://smartfinancial.com/health-insurance-myths