Having ongoing health care is a concern in every household in America, thanks to the Affordable Care Act, which requires every American to acquire and maintain health insurance. To ensure every man, woman and child has access to health care, Obamacare rolled out the Marketplace, which featured low-priced insurance policies that were only available for individuals that qualified. This is the alternative option for low-income families that don’t qualify for Medicaid or Medicare.
If you’re on the search for health insurance, whether it’s in or outside the marketplace, you need to keep in mind the total costs, the health care needs for you and your family, and the network of doctors included in the plan. Here are some quick tips to help you get the best health insurance plan possible.
Find Insurance ASAP
If you know you need health coverage from the marketplace, you should begin your search right away. There is a deadlines for enrollment, and once it closes, you’ll be out of luck until the following year. A lot of people wait until the last minute to shop around for health coverage, which means customer service and websites will be a lot slower. This will make it more difficult to get a good plan since you’ll be racing against time to find a policy before the deadline. You need sufficient time to browse your options and carefully select a plan that would benefit you and your family the most.
Scrutinize the Networks in Each Plan
This is especially important if you are looking for specific types of doctors for your health care. For instance, if you have spinal issues, a physical handicap or another problem that requires a specialist, you’ll want to have specific types of doctors covered in your network. If you want a particular doctor, you can look them up and see which insurance policies they accept. On the other hand, if you don’t have specific doctors you want or just recently relocated, you should still look for a network that is extensive so you will have more options available to you.
Explore Your Options
If you’re employed, you should first check with your employer to see if there are health insurance options available to you as part of your compensation and benefits package. If so, you won’t need the health insurance marketplace as employer sponsored healthcare is generally the most cost effective option available. However, if you don’t like the plans available, you can search for an individual plan in the government insurance exchanges.
Do keep in mind that you may not qualify for premium subsidies if your employer does offer health insurance options. Premium subsidies are tax credits that help lower your health plan expenses.
If you need to shop for your own insurance because your employer doesn’t offer plans, you can check to see if your state offers it owns marketplace or if you have to search through the Affordable Care Act federal marketplace. You can find out by simply going to HealthCare.gov and typing in your zip code.
A private exchange or insurer’s website are other options to consider. But again, you won’t qualify for the premium subsidies.
Put Together a Premium Budget
It’s important to know how much you can afford each month on premiums before you start shopping around. To find this out, you need to first determine what your monthly expenses are and how much you have left over. Subtract your typical monthly expenses from your monthly income and then calculate how much your medical expenses are. This is important for determining the deductible to choose. For instance, going with a lower premium and higher out of pocket costs wouldn’t be ideal if you obtain a lot of health services in a given year.
One way to determine this is to look over your health expenses from the previous year. Make sure to include the cost for premiums and out of pocket expenses. If your next year will be similar, then it’s a good idea to choose a policy that is the same as or better than your previous health plan. You can go with a higher premium and lower deductibles if you are worried about out of pocket costs. This is recommended for individuals and families with planned future medical expenses, such as:
- Surgery, such as a hip replacement or spinal surgery
- Additional care for a new illness
Of course, it’s impossible to predict the future, so you’ll have to factor in potential emergencies, like a family member falling ill. If this worries you, you can go with a comprehensive policy (the best you can afford).
If your funds are limited and are unable to afford a high premium, you can opt for a policy that includes a health savings account, or HSA. This will help drive down the costs for medical expenses. It acts like a savings account, which you can withdraw from whenever you need to pay for medical bills. This money is untaxed. However, in order to get one, you need to have a plan that has a high deductible. The upside is that the premium is normally lower. The savings you witness can be placed into your HSA.
Determine Out of Pocket Costs
This is just as important as the deductible and premium. This is what you’ll have to spend out of your own pocket from day one. You can find this out by looking at the health plan. It should list which services have out of pocket costs and what they will be. When you shop in the federal marketplace, you will find a snapshot of cost comparisons, so you have a better idea of what to expect.
You should go after a plan with a low out of pocket cost if you’re regularly seeing a doctor or specialist, you require emergency care frequently, you take medications that are expensive, you plan to have a baby or have little children, you have an upcoming surgery and/or you have a chronic condition, like cancer or diabetes.
On the other hand, you can opt for higher out of pocket costs if you’re in good health and rarely go to the doctor, you’re unable to pay for a higher premium with low out of pocket costs and/or you don’t get involved in activities that increase your chances of injury.
As you’re shopping around for health insurance, keep these tips in mind. Make sure you understand the terms and the exact benefits you’ll receive before signing any paperwork.