Understanding how insurance works
Health insurance protects you against unexpected and potentially high costs of medical care.
With a health plan, your insurer, WellFirst Health, pays for specific covered services for you with in-network providers. Health insurance is a contract between your provider and you. Below you can learn more about the various parts of this contract, how to choose a plan and what happens once you enroll.
How do I get health insurance?
The main way to get health coverage depends on various aspects of your life, such as age and employment:
- Individual & family coverage: These health plans are available to anyone age 18 and older who does not receive coverage through their employer but makes too much annually to be eligible for government assistance through Medicaid. Find more information about individual and family coverage.
- Employer or group coverage: This is health insurance paid for by you and your employer. Eligibility may vary depending on your employer, with qualifiers such as how many hours you work each week. These plans generally include an employee’s spouse and dependents under age 26.
- Medicare coverage: This is federal health coverage available to individuals age 65 and older and some younger people who receive Social Security disability benefits. While this coverage helps with the cost of health care, it does not cover all medical expenses or the cost of long-term care. Learn more about Medicare coverage.
- Medicaid coverage: This is federal and state-run health coverage available to people with limited income who do not have coverage through their employer or qualify for Medicare coverage. Learn more about Medicaid coverage.
Understanding Enrollment Periods
Depending on the coverage you are eligible for, there are specific periods in which you can enroll:
- Learn about individual & family plan enrollment.
- Employer coverage enrollment varies by employer. You typically have an initial enrollment period when you start a new job, and each year there is an open enrollment period where you can change the health coverage you currently have. Speak with your plan administrator to determine when that annual enrollment period occurs.
You’ve enrolled in our plan, so what’s next?
Having health insurance through WellFirst Health Plan is more than just saving money on the cost of health care.
We offer members additional benefits based on their plan that help them take control of their health: