The Affordable Care Act, while still in place, was significantly amended in December, 2017 when the individual mandate was removed from the plan. By eliminating the tax penalty, the government has essentially allowed for consumers to choose the health insurance options and plans which are best for them, whether or not they purchase from the marketplace exchanges.
Don’t Forget! If you are looking to purchase insurance through the government exchange, the open enrollment window for 2019 is November 1, 2018 through December 15, 2018.
Factors to Consider When Choosing Health Insurance
- The first thing to evaluate is the amount any plan under consideration will pay to cover your expenses. The best option is generally a plan with no lifetime benefit maximum, as limits can be reached very quickly should you have a serious injury or disease. If no lifetime benefit maximum is available to you, opt for the highest available maximum – both annual and lifetime – which your budget will allow. This out of pocket maximum will be the most you will be expected to pay, and therefore gives you an opportunity to budget appropriately.
- Keep a close eye in the differences in deductibles. A deductible is the amount that you will have to pay out-of-pocket before your health insurance provider will begin to pay benefits. The amount of the deductible is important, but so are the terms. For instance, some plans may make you pay 100% for your office visits until a deductible is met, while others may offer a co-pay option which may or may not be applied to your overall deductible.
- A co-payment is the amount of the doctor’s visit or emergency room visit which you are responsible for. These can be as low as $20 0r less, but can also be significantly more. It is important to understand your possible out-of-pocket in order to budget for regular visits, as well as be prepared for unexpected incidents.
- Co-insurance is often confused with a co-payment, but it reflects a different responsibility. Your co-insurance amount is the portion of the entire medical bill which you are responsible for. In other words, if you had a hospital stay and your co-insurance is 70-30, you will still be responsible to pay 30% of the total invoiced bill. Given the high cost of some treatment and procedures, this number can become intimidating quickly.
- Consider all your options based upon your situation. IF you are a younger person in excellent health, you may wish to pay lower premiums and have higher deductibles. Conversely, if you are older or in poor health, you may wish to pay more in premiums, but have lower costs should anything occur. By calculating the maximum amount of money you will likely have to shell out should the worst occur, you can understand each plan better. Remember, the cheapest plan may not be the best plan over the long run, so make sure to do the math!
Once your coverage is in place, you still will want to make sure you are getting the most for your money. If urgent care visits are costing you significantly more money, you may wish to find a doctor with extended or weekend hours, for instance. By doing your best to limit those scenarios which cost you more, you can use your plan for maximum benefits coverage. Always check your medical bills, and review for accuracy. If you have any questions or disputes, bring them up immediately.
If you have any questions as to which plan is best for you, call a Florida health insurance advisor who has your best interest at heart. At Anderson and Associates Insurance Group, we work hard to keep up with the changing landscape of healthcare coverage, as well as to bring you the best insurance products and plans available.
