Six tips to help you choose the right health insurance policy
You’re in luck if you buy health insurance without a job-based plan this fall. The Biden administration has begun the open enrollment period on HealthCare.gov this week. This is after years of cutbacks, and some even say sabotage, to the Affordable Health Act. Sign up now for a faster process, receive more assistance choosing a plan and are more likely to be eligible to get subsidies to help lower the cost of a health insurance plan that you purchase through the ACA Marketplace.
Even though you have an employer, it can be difficult to choose health insurance. There are many confusing terms and you need to consider your financial situation and your health. Additionally, you must navigate it all on a tight schedule. Often you only have a few weeks to consider your options and make decisions.
You have options. Asking yourself simple questions will help you narrow down your search for the right plan out of all the others on the market.
Tip 1: Know where to look
It is not always easy to find the right place to get health insurance. Sabrina Corlette, co-director of the Center on Health Insurance Reform at Georgetown University, says that “in this country it’s a truly wacky quilt quilt of options.”
Medicare is open to all people 65 and over. It is a federal program that pays for most of your healthcare. Some people may also be eligible, if they have certain disabilities. The open enrollment period for switching your supplemental and prescription drug plans to 2022 is December 7th for Medicare Advantage members or those already enrolled in Medicare.
Corlette said that coverage for people under 65 years old is provided by their employer. The employer will typically cover 70% to 90% of your premium costs. That’s pretty good. To find out if there are any plans available through your job, check with your supervisor.
Medicaid, which is a health insurance program for low-income people, covers almost one in four Americans. Although it is funded by both the federal government and the states, each state manages it. Therefore, eligibility depends on your location.
Tip #2 – Are you overwhelmed with all the options available? You can help yourself by focusing on what you know about your health.
It may not be difficult to pick from one or more plans through your employer if you’re healthy. Perhaps you can ask your coworkers what their favourite benefits are, then sign up via an online portal.
Shopping in the Affordable Healthcare Act marketplaces can be overwhelming. Aaron DeLaO from Foundation Communities, director of health initiatives, said that Austin had 76 plans to review.
DeLaO says even with so many options available, you can still narrow it down by asking some simple questions. Consider the following: Do you want insurance for a catastrophe that could happen? Or are you aware that you may have a health problem now and will need ongoing care?
Sometimes, you can even enter the names of your doctors and medications while searching online for plans. This allows you to filter out plans that don’t cover you. You can also call your insurance company and ask them: Is my provider covered by this plan? Is my medicine covered by the plan’s formulary? This is the list of drugs that an insurance plan covers.
Tip 3: Understand the meaning of some obscure terms associated with health insurance
How much health insurance can you afford each month? You need to understand the terms of several insurance terms. These include premium, copay, cost-sharing, and deductible.
These charges — the premium and the deductible for insurance companies, are similar to dials that help them keep their costs under control. They might sell a basic plan which lowers the monthly premium to make it look more affordable. This plan could have a high, “dialed-up” deductible of $6,000, which means you’ll need to spend $6,000 each year out of your own pockets on health services, before your insurance begins to cover its part. This plan would mean you don’t have any need for many health services. You’d only have to worry about your (hopefully affordable) premiums and the costs associated with a few procedures.
A plan with a higher premium might be better for you if you have a medical condition that is chronic or if you are less risk-averse. Although you’ll pay more each month for the plan, your monthly costs are more predictable because there’s a lower deductible. You can still manage your monthly costs by going to as many appointments as you like and picking up a lot more prescriptions.
You will find that the plans available to you and their affordability vary depending on where and how much you earn, who lives with you, and what insurance policy you have. Congress provided temporary funding for the pandemic to pay more out-of pocket costs. Depending on your income you might qualify for plans with monthly premiums of $10 or lower on HealthCare.gov.
Tip #4 – Get professional, trustworthy help free of charge
Feel overwhelmed by all the ACA options available? You’re in good company. Free, impartial professional assistance is available to assist you in choosing and enrolling in a plan. Just put in your zip code at Healthcare.gov/localhelp and look for an “assister” a person also referred to as a health care navigator on some state websites.”
Aaron DeLaO is one example of such a navigator. He notes that he, along with his fellow guides, don’t work for commission; they are paid by the government. He states that he is not contracted by insurance agencies. “We do this completely independently and impartially. It’s all about what’s best to the consumer.
In 2021 the Biden Administration quadrupled navigators’ numbers ahead of open enrollment. (The Trump administration severely cut funding for the program.
Corlette also believes that insurance brokers are helpful. While brokers may get commissions, I have found that the best brokers desire repeat customers, which in turn means happy customers. She suggests that to find a good broker, you should visit Healthcare.gov or your local department of insurance to locate someone licensed and in good standing.
Tip #5 Beware of online-sold plans that seem too good to be true
The internet can be frightening. Corlette states that she warns people not to enter personal information in interest forms for health insurance on random websites.
While the plans that pop up when you search “I need insurance” may look appealing, they may also be quite expensive and not provide basic coverage such as prescription drugs or annual checks. This type of plan is often not recommended by experts.
Corlette states that “Unfortunately, there is a lot of con people out there who take advantage the fact that people recognize that health insurance should be purchased.” She advises them to simply go to Healthcare.gov. It doesn’t matter where you live, you can use that portal. Any plan you find there will include the ACA’s 10 essential benefits such as free preventive and hospital care.
Tip #6: Know your deadlines
Signing up for HealthCare.gov is usually limited to a few weeks each fall. Sign up for HealthCare.gov’s marketplace plans which will go into effect in January 2022 begins Nov. 1, 2021, and ends on Jan.15, 2022. Signing up for an employer-sponsored Medicare plan or Medicare will have different deadlines, but they are likely to be in the fall. You can enroll in Medicaid any time of year.
DeLaO, a health navigator, states that even though you may be enrolled in a plan that looks good, and it might seem tempting to let it renew automatically, it’s always a smart idea to look at what else is out there.
“Are your premiums eligible for additional subsidies?” He said. “Is there any plan that, with these increased subsidies, you can now get an silver plan rather than a bronze one which lowers both your deductible [and] your monthly copayments?”
According to him, it doesn’t require much time or effort to figure out the best plan for you. His team is able to enroll people in plans in under an hour. Even though appointments are not required to be made in person, customers can receive help by phone and often get all the information they need online.
