6 Things You Didn’t Know About Buying Health Insurance
Post on 16-Jun-2015
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6 Things You Didn’t Know About Buying Health
Insurance
What They Might Not Tell You
Ê Obamacare health insurance plans may look the same at the core, but there are details you should know before you decide on a plan or automatically renew the coverage you have.
Ê When open enrollment begins Nov. 15, 2014, re-‐asses your current health insurance. Like …
The lowest price plan may not be the best for you
Ê A low monthly premium price = high deductible and high out-‐of-‐pocket expenses. Not ideal if you have: Ê an ongoing medical condition Ê tend to be ill and need medical care several
times a year Ê have small children who need to see the
doctor frequently
The lowest price plan may not be the best for you
Ê According to HealthPocket.com, in 2014, the average deductible amounts for individual and family health insurance plans sold on 34 state exchanges were: Ê Bronze plan – $5,081 (individual); $10,386
(family) Ê Silver plan – $2,907 (individual); $6,078 (family) Ê Gold plan – $1,277 (individual); $2,846 (family) Ê Platinum plan – $347 (individual); $698 (family)
The lowest price plan may not be the best for you
Ê Average monthly premiums before any applicable subsidies—for 40-‐year-‐old individuals in the same 34 states were: Ê Bronze plan – $295.51 Ê Silver plan – $319.42 Ê Gold plan – $377.63 Ê Platinum plan – $388.29
The lowest price plan may not be the best for you
Ê Using this data, the 40-‐year-‐old individual could pay $286.92 more each year moving from a Bronze to a Silver plan and reduce the deductible by $2,174.
Ê That’s 8 percent more in premium for a nearly 43 percent decrease in annual deductible.
Deductible Ranges
Ê Reminder: Ê Bronze – the plan pays 60% of covered medical expenses; the
consumer pays 40%
Ê Silver – the plan pays 70% of covered medical expenses; the consumer pays 30%
Ê Gold – the plan pays 80% of covered medical expenses; the consumer pays 20%
Ê Platinum – the plan pays 90% of covered medical expenses; the consumer pays 10%
Some carriers offer low prices the first year, then increase pricing
Ê Enrollment impacts health insurance premiums.
Ê Insurance companies need to ensure there are enough healthy enrollees to balance the cost of sicker enrollees.
Ê When setting their rates in 2014, health insurance carriers had to make predictions about their enrollee demographics.
Ê They based their rates on the projected risk, not actual data.
Ê If companies lost money in 2014, they may need to increase rates in 2015.
Your provider network is always changing
Ê Just because your preferred doctor, clinic, hospital or specialist participates in your health plan’s network does not mean that will always be the case.
Ê Networks change from year to year. Some health care providers and facilities will no longer participate.
Ê Many insurers use narrow networks on exchange-‐based plans to make them more affordable.
Ê Check your network and be sure you still have access to the care you’ve been receiving.
You may need to switch your medication to a different brand or generic version
Ê The medication you take now may not be covered next year, even if your plan currently covers it.
Ê Prescription drug formularies change from year to year.
Don’t pay = no coverage
Ê There have been glitches in the enrollment systems for both state-‐based and federally facilitated health insurance exchanges.
Ê Many people sign up to have their premiums automatically withdrawn from their bank account and then never check if payments are being made.
Unless you are getting a large subsidy, plans on HealthCare.gov or your state exchange may not
be the best option
Ê Health insurance plans sold away from HealthCare.gov or your state health insurance exchange may be cheaper—and they offer the same benefits. You can buy from: Ê HealthCare.com Ê healthinsurance.org Ê eHealthInsurance.com
Ê Only plans sold on the state or HealthCare.gov offer premium tax credits and cost-‐sharing subsidies.
Ê However, if your income makes you ineligible for financial assistance, you should consider checking rates for health insurance plans sold in the private marketplace.
About HealthCare.com
Since 2006, HealthCare.com, a privately-‐held technology company, has been committed to improving online healthcare for U.S. consumers making purchasing decisions. Our goal is to help consumers easily research information and compare health insurance quotes from nearly 200 health insurance carriers using interactive tools and an intuitive search interface. We offer trusted recommendations and a comparison shopping experience to simplify decision-‐making, allowing consumers to find the right health insurance plan that fits their lifestyle. To provide customers a first-‐rate user experience, our technology uses proprietary algorithms and data to advocate the best and most affordable insurance options. We also offer free online calculators and shopping tools to make healthcare buying easier and more efficient. We partner and integrate with industry-‐leading health insurance companies to help consumers enroll into plans. All of HealthCare.com’s leading technology, tools and services are free to consumers. For more information, visit www.healthcare.com.
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