To find the best value, do your due diligence and compare plans.
I’ve said this before and I’ll say it again: Obamacare is working, in many of the ways in which it was intended. Millions more Americans have health insurance than they did before the Affordable Care Act (ACA) was passed and overall healthcare costs are going down. And although it’s true there is still a long way to go before insurance coverage becomes affordable for everyone (single payer, anyone?), it’s a heck of a lot better than it was before.
You’ve probably heard about how much insurers are hiking rates for 2017, and it’s true. The fact is that insurers still have way too much power, so many are either retreating from the marketplace altogether or raising rates to cover what they consider losses — even though insurance companies are still plenty profitable.
There’s one thing you can do to make sure insurance companies aren’t taking advantage of you: Do your homework. Take the time to shop for the best plan for your needs. Make sure it covers all the services, doctors and hospitals you want and need. Compare premiums, deductibles and out-of-pocket costs. You simply can’t make a good purchase without knowing what you’re buying.
You can sign up for coverage through HealthCare.gov from November 1 through January 31, 2017, and you can start perusing and comparing plans right now. Everyone should comparison shop every year, even if they love their current plan. New options come on the market every year, and you can’t know what’s available until you look. You might find a plan with a lower deductible or better prescription coverage. You won’t know until you shop.
Here are some basics on shopping for the right plan.
A great place to start is this five-minute video created by Kaiser Family Foundation (KFF). It covers the most important insurance terms you need to know when buying and using insurance.
Still want to know more? Our friends at Enroll America have put together a host of health insurance literacy resources from trusted sources like Consumer Reports.
When you’re comparison shopping, remember that the monthly premium is only one aspect of choosing an insurance plan. You should weigh that against a plan’s out-of-pocket costs, deductibles, prescription costs and the out-of-pocket maximum you’ll have to pay each year.
In general, Bronze plans have a lower monthly premium but higher deductibles and out-of-pocket costs. This may be a better choice if you’re young or don’t have any health issues. Silver, Gold and Platinum plans have incrementally higher premiums and lower out-of-pocket costs, which may make them more attractive if you have a chronic condition like asthma, diabetes or arthritis. You’ll pay more every month, but will have lower additional costs. For 2017, there will also be “Simple Choice” plans in some areas. These plans cover basic health services without a deductible, addressing the concerns many consumers have about high deductibles and making it easier to compare plans within the same category, such as Silver.
Once you’ve narrowed it down to a few plans, make sure your favorite doctors and nearby healthcare facilities like hospitals are covered. Checking on this before you enroll will save you a lot of hassles — and possibly money — later.
When you visit Healthcare.gov, in addition to comparing insurance plans you can see if you’re eligible for financial assistance to help pay for your coverage. Although premiums are going up this year, subsidies to help pay for coverage are increasing accordingly. So you may find you’re not actually paying more even though the “list price” of your plan is higher. Keep in mind, though, that some types of financial assistance require you to buy a Silver plan.
If you bought insurance through the insurance Marketplace last year, your insurance company should let you know if you need to take any steps to renew your coverage. Either way, it’s a good idea to check out these tips for keeping or changing your existing plans. If you want to change plans — or if you’re buying for the first time — you need to sign up by December 15 to have your coverage start or renew on January 1, 2017.
In addition to enrolling online through Healthcare.gov, you can call 1-800-318-2596 and a trained representative will walk you through the process of enrolling by phone.
What’s more, there are trained in-person enrollment assisters across the country who will sit down with you, answer your questions, and help you choose and enroll in the plan that’s right for you. The easiest way to find an assisters near you is through the Get Covered America Connector. Because Get Covered America is an independent non-profit organization dedicated solely to helping people sign up for insurance, you can trust that they’re looking out for your best interests as a consumer.
Are insurance premiums going up for 2017? Yes, for most people who buy through HealthCare.gov, they are. But the fact is that things are still better for millions of people like me than it was before the ACA. As I wrote back in 2013, I was paying nearly $1,400 a month for my coverage — a rate that had been increasing by $100 a month year after year. In 2014, thanks to the ACA, that rate dropped to $530 for the exact same coverage. Have my rates gone up since then? Yes, because that’s how insurance has always worked. Insurers also make money by eliminating plans they don’t consider profitable, like the one I have had all this time.
Earlier this month, I got “the letter” telling me my plan was being discontinued and replaced by a similar plan. My monthly premium will go up in 2017 from $670 to $886, with a slightly higher deductible but a lower maximum out-of-pocket cost. My co-pays will be identical and so far, the coverage looks exactly the same. Unlike 85 percent of Americans who buy insurance through HealthCare.gov, I do not qualify for any financial assistance to pay for coverage.
Don’t get me wrong. I felt the pain of sticker shock when I got that letter. But $886 is still much less than $1,400 a month — a rate that would undoubtedly be closer to $1,700 or $1,800 a month by now if not for the ACA and the protections it affords to people like me who live with pre-existing conditions. I have diabetes and I’m a woman, which used to be considered a pre-existing condition that insurers could charge more for before the ACA.
But the thing is, I don’t have to just accept the plan my insurer is offering me. I can go on HealthCare.gov and shop all of the available plans to find the one that’s right for me. I personally like to pay for most of my healthcare through my monthly premiums with very low out-of-pocket costs, which my current and proposed plan do for me. It works out to be more cost-effective for me in the long run. But that’s not true for everyone. That’s why there are options.
I fully intend to do plenty of homework at HealthCare.gov to make sure I’m getting the best value for the coverage I need. I encourage everyone to do the same.
[Image credit: HebiFot via Pixabay.]
