It’s easy to see how it can be daunting to shop health insurance when you don’t know what you’re looking for, but with these tips you’ll be able to find the plan that works best for your family, without spending hours sorting through the different options and plans available.
Remember, it’s worth spending the time shopping, because if you don’t you could end up paying much more later on! Here are six steps to follow when shopping health insurance.
Do you qualify for Medicaid
You can check with your state’s health insurance department for information about Medicaid and its various provisions, but know that most states make Medicaid available only to pregnant women, parents of children younger than a certain age (usually 18 or 19), caretakers of dependent children, people with disabilities and those who are aged, blind or disabled.
If you don’t qualify for any of these groups but meet income requirements in your state, then you may be able to purchase coverage under Obamacare—if you can get through an often difficult enrollment process.
Beyond that, if you aren’t on Medicare or have employer-sponsored health insurance and make too much money to qualify for Medicaid coverage, it may be difficult—or even impossible—to find affordable private health insurance.
Do you qualify for the Affordable Care Act?
Are you a United States citizen or legal resident? Do you earn less than $46,680 per year? If so, then congratulations—you’re eligible for some coverage under the Affordable Care Act.
To find out what kind of coverage options are available in your state and whether or not you qualify for subsidies and aid to offset your insurance premiums, visit healthcare.gov.
The site also has handy calculators that will help you determine how much it would cost for each level of coverage based on your age, location and marital status.
It’s important to be prepared before meeting with an agent, as many ask questions about your health history and make recommendations based on that information; however, there is no wrong answer when it comes to applying for health insurance under the ACA.
Choose a Bronze, Silver, Gold or Platinum plan
While every insurer has its own complex formulas for rating plans, it’s safe to say that gold, silver and platinum are better than bronze.
Bronze-level plans will be more limited in benefits and higher in deductibles.
Silver plans cover 60 percent of an average member’s medical expenses with a $1,250 deductible; gold covers 70 percent of an average member’s costs with a $3,000 deductible; platinum covers 80 percent of an average member’s costs with a $5,000 deductible.
Both silver and gold options typically have lower premiums than platinum.
Know your deductibles, co-pays and co-insurance
Deductibles, co-pays and co-insurance all factor into how much health care you can receive without paying for it out of pocket.
If you don’t have medical insurance, your medical bills are likely to be deducted from any money that’s left over from other sources of income such as wages or disability payments.
When shopping for new health insurance, keep in mind that your costs could go up if you choose a plan with higher deductibles, co-pays and/or co-insurance.
(For related reading, see: Know Your Deductibles.) For example, imagine if you make $3,000 per month and choose a health plan with a $1,000 deductible.
Understand out of pocket maximums
The Affordable Care Act requires all health insurance plans sold on its exchanges in 2018 to have an annual out-of-pocket limit of $7,350 for individuals and $14,700 for families.
This refers only to your maximum exposure when you receive medical care—not including premiums or what you pay on prescriptions or dental visits.
If you’re buying a plan off of an exchange like Healthcare.gov, it should be pretty easy: These numbers are listed right there on your comparison tool.
You can also find out your individual maximum by calling your provider’s customer service line.
If you buy a plan outside of an exchange (this is called being assigned risk), you may not get those figures until open enrollment starts again in November 2019.
Don’t forget about your prescription drug coverage
Part D offers drug coverage to older adults.
It is a program of prescription drug coverage available through Medicare.
The Part D program may be offered by private insurers, known as Medicare Advantage plans.
This can be advantageous if it will allow you access to more affordable or specialized prescriptions that are not covered under original Medicare.
But keep in mind that different plans cover drugs differently and some may not cover prescriptions you regularly use, so it’s important to compare before deciding on one.
It’s also possible to buy your own insurance plan, which could save you even more money than Part D does (but could also come with additional costs).
You may have other options for lowering prescription drug costs through any supplemental health insurance or short-term insurance policies you have access to.
What if my income fluctuates?
When you go to compare health insurance policies, you’ll need to decide whether or not your income will fluctuate throughout a given year.
If it does, then you may need a policy that accounts for that. Some insurers offer policies based on annual income and others allow you to submit your salary on a more continuous basis (usually weekly or monthly).
However, there are also many companies that do not offer such plans at all—meaning if your income changes, so will your monthly premium.
If that’s important to you, shop around and make sure it’s available in addition to any plans and quotes you see online or over the phone.
Adding on riders can help too
A rider on your health insurance policy can be a great way to make sure you have what you need.
For example, adding a mental health rider may ensure that your insurance covers therapy.
Adding on extras like maternity care or vision coverage can help cover those potential expenses too! If you already have an idea of how much these might cost, it’s easy to calculate how much a rider will run you.
Riders are also commonly referred to as endorsements and add-ons, so keep an eye out for those words as well when shopping around for health insurance.
You’ll probably want at least one or two riders added onto your policy once it’s all said and done! ( Source )
Renewal letters will show your costs next year
When your health insurance carrier sends you a renewal notice, it will have estimated premiums for next year.
If you shop around between then and when open enrollment starts (which is generally in October), you can usually get a better deal.
The best deals are usually offered between July and September of each year.
If you choose not to renew with your current carrier and don’t have an alternative plan in place by early November, you may have to wait until next year’s open enrollment period starts.
However, if your existing plan isn’t covering all of your needs or costs more than competing plans would, some states will allow you to purchase new coverage before Open Enrollment begins — often with additional services such as preventive care covered at no cost at all.
how to pick the best health insurance plan
1) Understand Your Personal Needs. The first step in deciding what health insurance plan is best for you is determining your personal needs.
If you’re young and healthy, a good health savings account (HSA) or high-deductible plan with a low premium may make sense; if you have a family, on the other hand, it might be wiser to invest in a more expensive plan that offers greater coverage.
While there’s no substitute for sitting down with an insurance professional or doing your own research, these are some things you can think about: How much money will I need? A higher deductible means lower premiums; however, if you want prescription drug coverage or mental health benefits, you may have to trade off a lower deductible for higher monthly payments.