Archives for November 2015

November 1, 2015 was the end of daylight saving time, but on that day open enrollment period for Health Insurance started! With all the festivities happening in the last two months of the year, it is wise to look at this important matter as-soon-as possible.

Who?

People that have a job should get the information for enrollment from their employer. Each company that has more than 50 full time workers needs to offer affordable health insurance. If you want to shop for health insurance on the state’s health insurance exchanges you are not eligible for the premium subsidy.

For those persons that are self-employed or do not work, you do need to buy health insurance for 2016. There are 38 states that use the federal online insurance marketplace at HealthCare.gov. The other states have their own website that offer various plans in all 4 tiers. Besides the official marketplace websites, many insurance agents, non-profit organizations and community centers are offering assistance to consumers that want to buy insurance.

Staying Healthy Through Preventive Care!

When?

First, here are some important dates to remember:

• Enrollment between 11/01/2015 and 12/15/2015                          coverage effective 01/01/2016
• Enrollment between 12/16/2015 and 01/15/2016                         coverage effective 02/01/2016
• Enrollment between 01/16/2016 and 01/31/2016                         coverage effective 03/01/2016

What?

Quite a few states have re-designed their website to make the process easier and better understandable for consumers. All states and their health insurance marketplace have to offer a basic plan that just covers the necessities. These plans often have the lowest monthly premium. But be aware that the deductible for these plans usually is high. People that are very healthy and do not have medical conditions that require many doctor’s visits or expensive treatment can benefit greatly from this kind of plan.

Many families with children, or persons that have a history of health issues, are better off selecting a plan from the next tier. The premiums are higher, but the deductible and out-of-pocket expenses will be lower. On top of that, the government offers a subsidy for plans in this tier only that is based on your household income, number of persons and the cost of a Silver Plan in your area. Below is a table that shows the income limits for 2016.

Income Levels For Subsidy in 2016.

How?

Now, most marketplaces have new tools that will make comparing and shopping easier. Calculators can help in estimating total cost of health plans offered by factoring in premiums, copay and other out-of-pocket expenses and deductibles. It is important to know your family’s health situation and future medical requirements to find the best plan offered. That could mean that you might need to change to a different carrier to get the best deal.

When looking at the different plans keep the following in mind:

• Check that your medication is covered and find out what the cost will be. You find this information on the insurer’s website or call their customer service.
• Look at this year’ and last year’s out of pocket expenses to and see what amount is not covered by the insurance. The maximum amount can be more than $6,000 for an individual. Therefore, it is prudent to think of a way how to pay for any medical emergency.
• Check that your doctor is in the insurer’s network next year. Choosing care and treatment from a doctor and facility from the plan’s list of preferred providers can help save money.
• Consider contributing to a Health Savings Account (HSA) if the deductible is more than $1,300. For family plans the minimum is $2,600. You can use the savings for medical expenses tax free. All contributions stay with you, even if you change plans. Another benefit is that the contributions are tax deductible when filing your annual income tax return.
• Under the Affordable Care Act, many preventive health care services are free.  The website healthcare.gov lists all preventive care services by group such as adult, women and children. Visits to certain doctors, screenings for cholesterol, diabetes (type 2) or Hepatitis B are included. Women can get free mammograms and FDA approved contraceptives. Also, many vaccinations for adults and children are free when provided by a doctor or other provider in the plan’s network. This is true even if you have not yet reached the deductible. Check out the information on the website as some services are limited to certain age groups.

You have many options to enroll. Either online through the federal or the state market place, or an insurance agency website. You also can go in person to enroll at a community center, church or insurance agent that offer free assistance. I advise you to not just think about what happened last year when you and your family were healthy. Instead, I urge you to be responsible and to consider “what if I get sick?”

Health Care is a serious matter for you and your family. Especially, if you have children, you can’t afford to have no insurance. You owe it to those that depend on you and cannot make that decision to do what is best for them and you. It is hard to take care of toddlers or children when you are sick yourself.

If you got value from the information in my post and it did help you making a decision on this important matter, l would like to hear from you. Leave a comment below and share the post with others you know that might benefit reading about this subject.