How to Choose Health Insurance: 5 Steps to Pick the Best Plan
The type of insurance plan affects your costs and access to medical care. Through the online portal, you can see all of the plans offered in your ZIP code to start comparing companies, coverage and costs. Search each plan’s provider network picking the best health insurance for 2015 for primary care providers, hospital services and specialists in your area so you can get a sense of your options. If you would rather see specialists without a referral, you might be happier with an EPO or a PPO.
Also, you’ll want to keep in mind that companies usually pay a portion, if not all, of their employee’s monthly health-insurance premiums, so if you go with a marketplace plan instead, you’ll be responsible for covering all of that yourself. Some companies state in this clause that the policy expires once the insured reaches a specified age. This could leave you without health insurance when you probably need it most. Health insurance will be valuable at any age, so it’s sensible to choose a policy that offers coverage for a lifetime. The biggest health insurance mistake you can make is not choosing a plan during open enrollment. You may not be able to sign up for health insurance after open enrollment, which could mean you’d have to pay the full cost of your medical bills and prescriptions, and miss important benefits of health insurance like free preventive care.
When can you sign up for health insurance?
- Premiums for employer health insurance averaged $16,834 for family coverage in 2014, which is a 69% increase over the past 10 years, according to the Kaiser Family Foundation.
- After a year of huge changes in the health care world, now is your opportunity to step back and figure out whether you made the right choices.
- Every company will do what it can to put its best foot forward, but you will want to know about all the negatives before you decide to sign up for one of their policies.
- Pay special attention to clauses regarding pre-existing conditions, such as diabetes.
- The best option for 2015 may be different than it has been in the past.
You might just ask your coworkers what they like, sign up through an online benefits portal, and call it a day. This may influence which products we review and write about (and where those products appear on the site), but it in no way affects our recommendations or advice, which are grounded in thousands of hours of research. Our partners cannot pay us to guarantee favorable reviews of their products or services. If you buy your health coverage on the exchanges, take these steps to make sure you get the best possible policy in 2015. You could get extra money (as much as $500 or more) by participating in a wellness program. You may get some cash for taking a health assessment or biometric screening (which measures things such as cholesterol and blood pressure).
Higher premiums, more coverage
It’s funded by both the federal and state governments, but run by each state, so whether you’re eligible depends on where you live. More provider options and a primary doctor who coordinates your care for you, with referrals required. And because it’s easy to change policies during open enrollment, regardless of your health, you can reassess your needs from year to year. “If you had a bronze plan and are anticipating surgery in 2015, you may want to go to a gold plan, but then move back to the bronze plan the following year,” says Wayne Sakamoto, a health insurance broker in Naples, Fla. This year, you can analyze your expenses to see what kind of plan works best for you.
How can I find out if I can save on a Marketplace plan?
Maybe you’ve found that the deductibles and copays that you thought would be manageable are far from it. Or maybe you’ve discovered that the doctors and specialists your family members prefer to see aren’t covered by your plan. Or the prescription drugs you need to take for a chronic illness costs more than you expected them to.
Do you regularly take any particular prescription medications?
UnitedHealthcare, for example, sold policies on four exchanges but plans to sell on as many as 24 for 2015; Cigna is entering three more states. For marketplace plans, you may also qualify for a premium tax credit to help with the costs of health insurance, regardless of the plan tier. If you don’t have access to health insurance through a job — or the plan that’s offered isn’t affordable — you can purchase coverage from the federal or state marketplace, depending on where you live. Start at HealthCare.gov and choose your state to determine where you’ll shop. Health insurance plans will have a list of in-network doctors and hospitals.
- The Affordable Care Act requires plans to have an out-of-pocket maximum in 2015 of no more than $6,600 for single coverage or $13,200 for family coverage.
- For example, compare the cost of each of you staying on your own employer’s plan and choosing one of the plans for the kids versus the entire family being on one employer’s plan.
- If you still want to go with one of these companies, you should conduct extensive research and background checks on them to make sure they are trustworthy.
- There are a lot of confusing terms, and the process forces you to think hard about your health and your finances.
- Plus you have to navigate all of it on a deadline, often with only a few-week period to explore your options and make decisions.
- There are also two major different types of plans to consider.
If you have insurance at work, don’t let inertia take over during open enrollment. Employers have been struggling to find creative ways to rein in rising costs. Some are giving their health coverage a major overhaul; others are introducing stealth changes that can boost your costs significantly. People whose income is lower than a certain amount may be eligible to receive a subsidy that will help them buy a health plan on the federal or state exchanges. And if you’re on the opposite end of the spectrum, you may want to focus on plans that have higher premiums.
Decide how much coverage you need
The company you select can affect how easy it is to use your insurance, the quality of the customer service and how much you pay. On HealthCare.gov or a state marketplace, coverage options are grouped into different levels called metal tiers. This can make it easier to choose a health insurance plan because you can tell roughly how much coverage each plan has.
The subsidy is based on the cost of the second-to-lowest-cost silver policy in your state. If the price of that policy changes in 2015, your subsidy will change, too — even if your income remains the same. You get an extra subsidy to help with deductibles and co-payments if your income is below 250% of the federal poverty level, but only if you buy a silver policy. Ask both the insurer and your doctors whether the doctors are covered by your plan.