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How to buy Health Insurance
have becoming first-time health insurance buyers for medical policies with the
dawn of Obamacare. But how do you avoid confusion and find the best health
insurance? Here are some top tips:
Research – Be sure your insurance policy
will cover your healthcare needs. Don’t forget about medications, as different
plans pay different amounts for prescription drugs.
Shop for Best
Pricing – What is more important – low monthly you need, what you can
afford, and shop different carriers for similar plans.
Network – If you have a specific doctor you want to see, ensure your
doctor is in the plan’s network. If you don’t have a doctor, make sure the
network is broad enough so you have a choice of providers.
Reputation – Does the insurance company have a reputation for paying
claims quickly and standing behind its members when they need them?
Buy – Once you have chosen a plan,
fill out an application form and provide payment information.
If you’re buying health insurance
on the individual market for the first time, you may discover there are
hundreds of plan options to choose from. That’s why it’s important to shop
around for the best plan that meets your budget and lifestyle.
What is the Healthcare Marketplace?
By now you‘ve
probably heard terms like Obamacare, the Affordable Care Act, and “the
marketplace”… or at least you heard a lot of buzz about those phrases in the
past months. But do you really understand the healthcare marketplace and why or
if it matters to you? It‘s that time of year again, when health insurance and
Obamacare are in the news, so here‘s a quick rundown of the basics.
In a nutshell,
the healthcare marketplace, or health insurance exchange, is a program meant to
connect uninsured people with private or government-regulated health insurance
options. These plans are made affordable by the regulations placed on
providers, by federal subsidies, or both. The Affordable Care Act (ACA), which
is the same thing as Obamacare, allows for states to create their own
exchanges. States can band together to create a multi-state exchange, or opt to
let the federal government manage the exchange for their state. Your state may
be part of the “federal exchange” (opted not to create a state exchange) or a
more customized state exchange.
If you have health insurance
through your employer and are happy with your coverage and costs, you likely
don‘t need to visit the marketplace. If you‘re uninsured or don‘t have
insurance coverage at work, it‘s important to understand your options and what
the marketplace has to offer. You can purchase individual or family insurance
independent of your job, and the private marketplace is often the best place to
start when shopping for health insurance.
Important Health Insurance Definitions
Tax Subsidy: A tax subsidy is defined in the
Affordable Care Act as cost assistance. In other words, if your income is
between 100 and 400 percent above the national poverty level, you may receive a
Financial reduction to better match your income level instead of paying the
full cost of your healthcare insurance.
Penalty for Not
Buying Health Insurance: If you have not purchased health insurance under the
Affordable Care Act, you will be assessed a tax penalty. This went into effect
January 1, 2014 and is unavoidable. The penalty in 2014 is $395 or 1 percent of
your income, unless you qualify for an exception. You may only go up to three
months without health insurance before you are assessed the penalty.
Obamacare: Officially known as The Patient
Protection and Affordable Care Act, it is a health care reform signed into law
on March 23, 2010, which aimed at making healthcare insurance accessible for
each and every American family. The Act provides a number of new benefits,
rights and forms of protection. Some of the favorite new benefits include the
elimination of pre-existing conditions as a reason to deny someone from
receiving coverage and subsidies to assist others who may not otherwise be able
to afford the program.
Health Mandate: The health mandate, also known
as the Obamacare Mandate, states that everyone needs to purchase health
insurance. If a person chooses not to purchase insurance, they will have to pay
a tax penalty. There are exemptions for those who fall into certain specified
groups, but the majority of the population is required to purchase insurance.
What is the Health Insurance Exchange?
Care Act, also known as Obamacare, went into effect on January 1, 2014. All
Americans must now have health insurance coverage or face paying a tax penalty.
If you do not have health insurance through your employer, you are required to
purchase an Obamacare plan. Don’t think you can afford health insurance? If you
are worried about the affordability of a healthcare plan, you may qualify for a
Insurance Marketplace or Insurance Exchange means U.S healthcare consumers can
gain access to information that will help during the shopping process:
Find out whether you qualify for a tax subsidy or not based on
Discover different plans available in your state
Find out if your current plan is a qualified health plan
Apply for a health insurance plan online
If you don’t
qualify for a subsidy or Medicaid, don’t worry! You can purchase an individual
health insurance plan on the private marketplace; and the affordability might
actually surprise you.
considerations when thinking about buying health insurance:
Determine if you qualify for a tax subsidy or Medicaid
Find a plan that fits your healthcare needs and budget
If you can afford a larger monthly premium, find a plan that
will work with a larger network of providers
Finding the Best Health
you buy individual health insurance, you want to make sure you‘re going with an
insurance carrier who will be there when you need them. A.M. Best Company, an
independent rating service, provides scoring on insurance company financial
standings, and offers its database of health carrier ratings online to help you
make the right choice.
shopping for health insurance, look for each company‘s A.M. Best rating. This
scoring system provides not only ratings of insurance carriers, but determines
a company‘s ability to meet contract obligations to its policyholders. As an
informed consumer, it‘s important for you to understand a carrier‘s:
Best will help you find an individual health insurance company that will:
claims quickly and appropriately
you the customer service you deserve
an ethical partner in your healthcare
that indicate the insurance company is secure are:
Best is a great resource to remember when you start looking for a health
insurance plan that will work for you and your family
What Happens if I don’t buy Health Insurance
most Americans would probably prefer to have health insurance to cover their
medical and healthcare needs. However, it‘s not just a wish any longer. In
recent years having health insurance has become the law. All U.S. consumers are
required to have health insurance, either through their employer or purchased
on their own. If you decide to forgo buying healthcare insurance, you can be
penalized with an additional tax for not having insurance coverage. It‘s called
an "individual mandate penalty," and is intended to encourage
everyone to get insured.
for 2015 are increasing from 2014. You can now be penalized up to 2% of your
income or $325 per adult and $162.50 per child, whichever is higher. Make sure
to take this tax into account when determining whether you can afford to be
insured. If you are insured for only part of the year, you can deduct a percentage
from your penalty. That means even if you gained health insurance right now for
2014, you could deduct some of the tax for the current tax year.
These tax penalties are expected
to keep increasing each year with the 2016 penalty already set at $695 or 2.5%
of income. Some situations may decrease your penalty, but it‘s important to
research your health insurance options to see what could be most affordable for
you to avoid paying the tax penalty.