Quick Pointers on How to Shop for Insurance
NEW YORK ( MainStreet) Shopping for health insurance can be a confusing task. Gold? Bronze? Deductible? There seems to be no guide to shopping for these products. Many consumers are left wondering, "Can I afford what I need?" Carrie McLean, director of Customer Care at ehealthinsurance, gave a quick list of pointers for shoppers to make the process a little easier.
- Understand that the true cost of a plan is about more than just your monthly premium: you also need to look at how costs are shared when you actually receive medical care. Look at your annual deductible, copayments, and coinsurance and your annual out-of-pocket maximum. A plan with a low monthly premium is not worth much if it requires you to pay more than you can afford out-of-pocket before your coverage really kicks in for non-preventive care.
- Subsidies are great, but they can get complicated: The ACA allows some people earning less than 400% of the federal poverty level (about $46,000 per year for a single person or $94,000 for a family of four) to qualify for government subsidies designed to help offset the cost of coverage. This is great for many people though applying for a subsidy can take a while and require you to provide additional personal information. However, your eligibility for a subsidy is also based on the cost of coverage in your area, and costs in many cases are lower than expected. That means that even if you earn less than 400% of the federal poverty level, you may not actually receive a subsidy. Also, it is worth mentioning that your eligibility is based on your projected earnings for 2014, not on your past earnings. If your income fluctuates or changes during the year, your eligibility for a subsidy may also change. If you end up earning more than expected in 2014, you may have to repay all or a part of any subsidy you received from the government when you complete your 2014 federal tax return.
- There are more options available off the exchanges than on them: Government exchanges are designed to provide subsidy-eligible consumers with access to plans specifically qualified for purchase with a subsidy. Not all plans are. Some major health insurance companies have opted not to sell plans through the government exchanges. However, all major medical plans sold in 2014 meet the coverage requirements of the law. Consumers who want to choose from the broadest selection and find the best match for their needs and budget should shop around. Shoppers should consider plans available off the exchange through licensed online agents like eHealth.com.
- Pay attention to provider networks in 2014: People who might already have had self-purchased coverage in 2013 may find that their list of network providers is different in 2014. Just because your favorite doctor accepts "Blue Shield," for example, does not mean that he or she is a preferred provider for all Blue Shield plans. Provider networks may have changed as of January 1, and some plans limit your access to providers to help keep costs in check. Make sure that the doctor or hospital you like best is still a preferred provider under your new health plan in 2014. Contact your doctors before you purchase anything.
Written by Leigh Held for MainStreet