How to Buy Affordable Health Insurance in 2014

Kelley-Jensen2Author:  Kelley Filice Jensen

Covered CA, the state run marketplace created from health care reform, just issued an actuarial study about the impact of health care reform on health insurance rates for 2014.  The results? Rates are going up somewhere between 20% and 30% or going down between 40% and 75%, depending on your income levels.  So what do you do?  Shop wisely.  The actuarial report highlights the importance of being a smart shopper of health insurance. Being well informed on the plans available, and whether you qualify for subsidy, is critical for getting the best value from the new insurance plans available in 2014.

Where do you start?  Start with the steps below, and if you have questions, consult a health insurance agent that represents multiple carriers and is certified to sell for a health care exchange  California’s is called Covered California. Health care reform may be new, but health insurance is not, and health agents have the most experience with health plans, health insurance carriers and health insurance terms.  They can also help determine subsidy amount available, and their services are free to consumers because they are paid by health insurance carriers, regardless of subsidies.

And, what if you already have individual health insurance?  How to Buy Affordable Health Insurance in 2014? Should you shop for new health insurance because of health care reform?  YES.  You may now qualify for premium assistance credit (subsidy) that was unavailable prior to reform.  And, most health plans are being revised as a result of health care reform’s essential health benefits requirements.  Those that do not meet the new requirements of health care reform will disappear, so your existing health plan may not be available in 2014, if it is an individual plan, meaning one that you do not have through work.

How to Buy Affordable Health Insurance in 2014:

Step 1:  Do you qualify for premium assistance or subsidy

Factors that determine whether you qualify are found on your prior year tax return, or can be estimated for the year 2014:

1)    Modified adjusted gross income for your household

2)    Whether or not you or anyone in your household is eligible for employer-sponsored health insurance that does not exceed 9.5% of your income

Step 2:  Estimate what you pay for health care now.  This includes:

–       Doctors, specialists or other health care professionals that you visit regularly

–       Monthly prescriptions, treatments and appointments

–       Health care expenses for your kids, spouse or other dependents

–       If you have health insurance already, the amount for deductibles, copays, and premiums

Step 3:  Think about you and your household’s health and lifestyle

–       Do you get sick easily

–       Do you have a chronic condition

–       Do you travel frequently or participate in activities that have elevated risk of accidents

–       Are you fit and in generally good health

–       Can you use the services of a health care professional with weight loss

–       Do you want to go to any doctor, any time; or is it fine to use one doctor that refers you to a specialist if that ever becomes necessary

Step 4:  Determine, based on step 2 and 3, how much you want to spend on premiums, deductibles and copays.

Premiums are the amount you will pay monthly to keep a health insurance plan.  Premiums can be subsidized, if you qualify.

Deductibles are the amounts you pay for health care before the insurance company starts to pay, the higher your deductible, the lower the monthly premium.  An affordable health plan might have a $5,000 deductible, meaning that you will pay $5,000 for your care before insurance starts to pay.  This is something important to consider if you think that you will mostly keep health insurance for emergency services or if the essential health benefits offered without regard to deductibles will suffice for your care.

Copays are the amount you will pay every time you visit a doctor, in addition to the amount your insurance carrier pays.  Typical copays are $10, $20, or $40, and similar to premiums, the higher the copay, the lower the monthly premium.

Step 5:  Get quotes on a few different health plans.  You can do that in a few ways:

–       Go directly to your State’s Exchange:  online at the state exchange’s website or in a local government office, such as a county facility, that has an health plan exchange assistor or navigator to help you.

–       Go directly to an insurance carrier’s website, such as Anthem or Blue Cross.  This is generally not a smart or efficient way to shop, because at each Carrier website, you will only be able to see the health plans that they offer, making comparisons between carriers more difficult.  And there is no price savings going directly to a carrier.

–       Go to a licensed health agent: online, or in person.  Make sure that the agent is licensed to sell health insurance, represents multiple insurance carriers, and is certified to sell for the exchange in your state.

Step 6:  Go over the quotes with someone that can explain them to you and help you decide which plan fits your budget and meets your needs.

Once you have picked a plan, use your insurance!  Get annual physicals, screenings and updates from your doctor.  It is important because the overwhelming majority of health issues are much more manageable when caught early.  An ounce of prevention is worth a pound of cure, that is the real value of health insurance, and the real reason that you should not stay uninsured.


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