Affordable Health Insurance
You may be seeking the advice of a health insurance advisor to select a health insurance plan if:
- You are self-employed and are not part of a group plan
- You do not have the option of a group coverage plan at your job or your spouse/partner’s job
- You have turned 26 years old and are no longer on your parents’ insurance plan
- You would like to purchase a plan directly from a health insurance company or through the Health Insurance Marketplace
- You will soon turn 65 years old and quality for the government program, Medicare
Choosing a Health Insurance Plan
It’s important to understand all of your benefits and options and to read the fine print when choosing a health insurance plan. Your health insurance advisor should help you with this. If they don’t, ask questions such as:
- Do I have the right to go to any doctor, hospital, clinic, or pharmacy I choose?
- Are specialists, such as eye doctors and dentists, covered?
- Does the plan cover special conditions or treatments such as pregnancy, psychiatric care, and physical therapy?
- Does the plan cover home care or nursing home care?
- Will the plan cover all medications my physician may prescribe?
- What are the deductibles? Are there any co-payments? Deductibles are the amount you must pay before your insurance company will pay a claim. These differ from co-payments, which are the amount of money you pay when you receive medical services or a prescription.
- What is the most I will have to pay out of my own pocket to cover expenses?
- If there is a dispute about a bill or service, how is it handled?
Major provisions of The Affordable Care Act (ACA), also known as Obamacare, include:
- Expanded coverage for young adults, allowing them to stay on their parents’ plan until age 26
- Access to insurance for people with pre-existing conditions
- The end of annual and lifetime dollar limits on coverage
- Small business tax credits to help companies provide insurance coverage to their workers
- The subsidies are tax credits, which means you can opt to pay full price for your coverage (purchased through the exchange) each month, and then get your tax credit when you file your tax return. But unlike other tax credits, the subsidies can be taken throughout the year, paid directly to your health insurer to offset the cost of your coverage.
- Nearly 85 percent of people enrolled in exchange plans in 2016 are receiving subsidies that average $291 per month.
- Subsidies can lower your premium significantly, but the law also provides subsidies that can reduce your cost sharing. Cost share reductions limit your deductible amount.
- The average after-subsidy premium paid by the millions of enrollees who got premium subsidies in 2016 through Healthcare.gov is only $106 per month. For these enrollees, premium subsidies are covering an average of 73 percent of their total premiums.
- It pays to calculate your subsidy! Let us help you calculate your potential savings.
When is Open Enrollment?
Open Enrollment for 2018 health plans starts November 1, 2017. Here are the important dates:
- November 1, 2017: Open Enrollment starts — first day you can enroll, re-enroll, or change a 2018 insurance plan through the Health Insurance Marketplace. Coverage can start as soon as January 1, 2018.
- December 15, 2017: Last day to enroll in or change plans for coverage to start January 1, 2018.
- January 1, 2018: 2017 coverage starts for those who enroll or change plans by December 15.
- January 31, 2018: Last day to enroll in or change a 2018 health plan. After this date, you can enroll or change plans only if you qualify for a Special Enrollment Period.