Frequently Asked Questions

Check out some of the most frequently asked questions we receive about medical insurance, health coverage, and the Shoreline team.

Can I qualify for health coverage with pre-existing conditions?

Yes! Due to the Affordable Care Act, all health insurance plans are now guaranteed issue with no pre-existing condition limitation. However, you must enroll during the Open Enrollment Period or have a qualifying event if outside of OEP in order to acquire a private health plan.

Do I have to purchase coverage through MNSure?

No. However, if you qualify for a subsidy and would like to pursue that option, then you would need to purchase your “Qualified Health Plan” through MNSure. If you don’t qualify for a subsidy, then you may find the process to acquire private health coverage much easier by purchasing direct with the insurance carrier.

Are there differences in the plans available through MNSure vs. Off Exchange?

Most health plans available on MNSure can be purchased directly through the insurance carrier; the benefits and rates would be the same regardless of how you apply (unless you qualify for a subsidy/Advance Premium Tax Credit). However, there are some additional plan options that can only be purchased outside of MNSure and vice versa.

*More changes to come in 2015

How far in advance should I start looking for private health coverage?

Ideally, you should start searching for private health insurance coverage 2-3 weeks in advance as there is processing time once your application is submitted. In some cases, your application would need to be in by the 15th of one month in order to have it start the 1st of the next month.

What is a Special Enrollment Qualification?

A Special Engrollment Qualification is a loss of minimum essential coverage. For example, coverage ends because a job is ending or a dependent is turning 26. This does not include loss of coverage due to failure to pay premiums, including COBRA premiums.

Other situations that may qualify include:

  • Marriage.
  • Divorce – if losing benefits as a result of the divorce.
  • Birth of a child, adoption, or placement for adoption or foster care.
  • Gain citizen, national, or lawfully present status.
  • Change in circumstances causing new eligibility or ineligibility for advanced premium tax credits or cost-sharing reductions.
  • Change in enrollee’s permanent address
  • Being an enrolled member of a federally recognized tribe.
  • MNsure determines that an error was made by MNsure which resulted in an error with the consumer’s prior enrollment.

When is the next Open Enrollment Period?

The specific dates for Open Enrollment Period have varied since the ACA has rolled out in 2014. Typically, Open Enrollment runs from Nov – Feb with plan changes going into effect as early as Jan 1st of the following year.

Can I make a change to my plan outside of Open Enrollment?

No, unless you have a qualifying event. See list of SEP qualifications above.

Can I have a Health Savings Account with any high deductible plan?

No. You must have a qualified H.S.A. plan. Some high deductible plans have copays or first dollar benefits which will exclude them from being eligible to use a Health Savings Account.

Will I lose the money in my H.S.A. at the end of the year if I don’t use it?

No. That money is your money and it will roll over from year to year.

Can I use my H.S.A. to pay for premiums?

No. It can be used for medical, dental, and vision related expenses, but it can’t be use to pay your health insurance premiums (unless they are Medicare premiums).

Is the deductible on a plan year or a calendar year?

The deductible runs on a calendar year, so it will reset on January 1st regardless of your effective date.

Is there an additional cost to having an agent?

No. In fact, if you have a good health insurance agent, you will most likely save money. The premiums are the same no matter if you use an agent or go directly to the carrier, so you might as well have someone with expertise walk you through the process and service your policy going forward.