If you don’t get health insurance through your employer, your spouse’s employer, or a parent if you’re 26 or younger, you can start enrolling yourself and your baby in health insurance offered through the Affordable Care Act (ACA), a.k.a. “Obamacare.”
“Health care reform is awesome. It’s the first federal oversight of a completely non-federally regulated industry in 100 years,” says Katherine Woodfield, an insurance expert and author of Don’t Buy THAT Health Insurance: Become an Educated Health Care Consumer. New insurance marketplaces or “exchanges” will be available in every state. “The ACA is going to give self-employed people access to a lot more plans,” Woodfield says. And small companies will be forced to offer their employees health insurance or pay a penalty. Shopping for health insurance is going to be like walking into a giant shoe store, Woodfield says. She offers these quick tips for simplifying the health care shopping process:
- Focus on health plans with the highest deductible. Obamacare will offer four plan types: Bronze (60 percent of health care costs covered, with the lowest premium), followed by Silver (70 percent covered), Gold (80 percent) and Platinum (90 percent of costs covered, with the highest premium). To save money, Woodfield suggests choosing health plans in the Bronze plan category. “As consumers, we often think that if we pay more for insurance, more stuff will be covered,” Woodfield says. “It rarely works that way. Usually you just pay more.” Here’s why: Plans with lower deductibles typically cost more in terms of a monthly premium. That’s money that automatically goes right out of your pocket. If you’re otherwise healthy, however, you may not necessarily use your health insurance enough to justify paying a hefty premium, especially given that all well-child care and preventive visits, such as mammograms are immunizations are free. Under Obamacare, there’s no copay or deductible for them. And even if you’re not as healthy as you’d like to be, all Obamacare plans have a $6,350 out-of-pocket annual maximum for an individual or $12,700 for a family, with the exception of the Platinum plan, which has an out-of-pocket annual maximum of $4,000 for an individual and $8,000 for a family.Instead of buying the highest premium plan, think less is more. Woodfield suggests putting what you’d otherwise pay in a monthly premium into a health savings account or personal savings account, then pay for health care as you go, just like you do for groceries or gas. With a lower-premium plan, you’ll still be covered for major medical expenses, with a cap of $12,700.
- Choose a health plan with providers you currently use. In other words, don’t pay more for a health insurance plan with a wider network of doctors you don’t need yet. “I’ve heard people say, if I get cancer, I want to be able to go to such and such a hospital,’” Woodfield says. That’s not a good use of your health care dollars. “You don’t need to buy insurance for a disease you don’t have, for providers you haven’t even contacted yet,” Woodfield says.
- Be prepared to shop around. Policy prices can vary greatly among insurers for essentially the same coverage. Don’t assume that a low price automatically means lesser coverage, or that all carriers within a plan type offer the same coverage.
There’s a lot to know about the ACA, so be sure to visit www.healthcare.gov. Consumer Reports also has a really helpful website, www.HealthLawHelper.org. Check out Woodfield’s site, too: http://healthcare-insurance-education.com.