What every caregiver needs to know about health insurance

woman at the doctor


You may know that every American is required to have health insurance by law. But what exactly does that entail? How do you go about finding the right policy and how much it will cost?


Whether you're a full-time nanny, a part-time senior caregiver or an occasional babysitter, it’s important for caregivers to understand what the law requires you to do, and how to go about finding and signing up for the right health insurance policy. It’s also important to remember that health insurance is for you: Having the right protection in place in case of emergency can save you a whole host of problems, both financially and in terms of your well being.


Here are answers to seven common questions people have about health insurance:


  1. Am I eligible for health insurance?

“Anyone who needs health insurance is eligible under the Affordable Care Act,” says Nick Moriello, president of Health Insurance Associates in Newark, DE. "That is one of the positive pieces of the law." Before the Affordable Care Act, you could be denied coverage for a pre-existing condition. But now, you are free to shop for the policy that best fits your personal and financial needs.  


  1. Do I have to purchase a health insurance policy?

Everyone is required to have health insurance of some kind under the law. If you're covered under a spouse's plan or are under 26 and covered by your parents' insurance, you don't need to apply for more insurance. In previous years, you could be fined for not having coverage, but this is going away in 2019. Even without a monetary penalty, it’s still a good idea to have health insurance so an injury or illness doesn’t significantly impact your financially.


  1. When do I sign up for health insurance?

Open enrollment begins November 1st for plans taking effect next year. The cutoff date for enrollment is December 15. You should enroll before the deadline approaches to avoid any potential headaches in trying to obtain a policy. If you're already enrolled in a policy, it will expire at the end of the year. When open enrollment begins, it's important to renew your policy to make sure you're covered. Take the time to compare your current coverage to a few new policies and see if there’s a better fit for you.


  1. What If I don’t sign up in time?

If you miss the Open Enrollment period, you can't purchase coverage until next year’s open enrollment. The only exception is if you incur a “life changing event,” such as the birth of a child, getting married or beginning a new job. You’ll then have a 60-day period to be able to purchase a policy.


  1. How do I purchase health care coverage?

Begin by comparing plans. Check online markets like Stride Health or the federal marketplace. You can choose from different levels (often called "metallics") of cost and care services provided. All plans have universal coverage for wellness visits, emergency care and maternity care. Make sure you are shopping for a plan that lets you see the doctors you want, go to your preferred hospitals, get the deductibles that fit your budget and also covers your prescription drug needs.


  1. How much will my health insurance policy cost?

The different so-called "metallic" levels are named for the types of coverage offered, with the most basic coverage listed as bronze level. Catastrophic insurance is also available for individuals under 30 years of age. You should figure out what you can afford for coverage, but prices are regulated by the Department of Insurance. That means the same plan, even if it's offered in three different places, is always going to be the same.


  1. Are there ways to lower the cost of my policy?

If your income is no more than 400 percent above the poverty level (currently under $100,400 for a family of four or under $48,560 for an individual), you may qualify for government subsidies to help pay for part of your insurance. State exchanges and some online markets can administer those subsidies. To get an unofficial idea of health insurance costs and if you qualify for subsidies, use the Kaiser Family Foundation Subsidy Calculator.


"It's important to remember that your wages must be documented in order to qualify for a subsidy," says Tom Breedlove, Sr. Director of Care.com HomePay. "That means your employer has to be paying you on the books."



Your Next Steps:


* The information contained in this article should not be used for any actual caregiver relationship without the advice and guidance of a professional advisor who is familiar with all the relevant facts. The information contained herein is general in nature and is not intended as legal, health, tax or investment advice. Furthermore, the information contained herein may not be applicable to or suitable for your specific circumstances and may require consideration of other matters.


Join the conversation

Photo of Akpeyedze G.

Akpeyedze G.

People can barely afford everyday meal the government should buy insurance and sell it cheaper for us who earn a minimum wage instead of punish us with some fine...raise first the minimum wage .who doesnt want to be cover with health insurance ? We want but cannot simple..
January 27, 2015 at 8:19 PM
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Patty A.

Interesting about the 10k cut off. I had no idea. I've always worked part time and in 2014 had to give up my 5k a year retail "job" because my husband's insurance wouldn't cover me if I could "buy" my own...did I just lose a year of pay? My 23 yr old HR boss told me I had opportunity to purchase...I called my (husband's) insurance company and they said I would not longer be covered if I kept my job...
January 27, 2015 at 5:32 PM
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Tom B.

Hey Priscella. If you can get on your husband's insurance policy through his employer, you'll be just fine.
January 19, 2015 at 3:58 PM
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Tom B.

Hello Mary. If you are under a Medicare or Medicaid program, that will satisfy the requirement for health insurance.
January 19, 2015 at 3:57 PM
Photo of Lelia N.

Lelia N.

If u go to the Harris county Health clinic would u still need to get Health isurance u pay to see the doctor u pay for ur meds and still can go to the hospital so can someone answer this for me?
January 19, 2015 at 3:34 PM

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