Good morning! There are a million questions about Open Enrollment with the Affordable Care Act, so I thought I’d bring in an expert, my brother, Jason of My Choice Insurance, to help you navigate Obamacare and provide an easy-to-understand explanation and advice.
I’m excited to share some information with the Itz Linz crew about choosing the right health insurance for you and your families as we’ve reached Open Enrollment with the Affordable Care Act, or Obamacare, for the second time. In the past year, my team and I have helped over 500 new clients get coverage on and off the exchange, so we have the knowledge and experience to streamline this process and lower your frustration. How do we do this? We listen to you and your needs and provide access to every single plan in your state. We maximize your coverage, decrease your overall costs and lower your risk by giving you the things that are most important to you: the doctors in your network, the lowest possible premiums, and the highest benefits available.
As a general rule of thumb, you may even be eligible for subsidies to offset the costs of your plan if your employer doesn’t offer coverage and your income falls in the following ranges:
- Single: $46,500 or less
- Married: $63,000 or less
- Family of 4: 95,000 or less.
I’ll be honest, Obamacare is not a perfect system. There are many shortcomings and it remains to be seen if it’s going to be around forever, but it’s here now and for the foreseeable future, so let’s focus on maximizing the best parts of it and be honest about the challenges that certain individuals will have in obtaining affordable coverage.
Obamacare may not be perfect, but my Puerto Vallarta Wedding sure was!
Starting this year, insurance companies could no longer deny people or change their rates based on their health or medication needs and this is GOOD NEWS! In addition, all qualified health insurance plans now cover wellness and preventive visits at 100%. This means that annual physicals, the lab and blood work associated with them, annual pap smears and mammograms, children’s school physicals and immunizations, and even colonoscopies are all covered without a copay or deductible. The health insurance companies realized that regardless of the plan chosen, if they could get people to their doctors more regularly instead of reactively when there was a problem, they could get out in front of the serious illnesses and save both lives and money in the process. This is one of the 10 essential benefits that insurance must offer today, and all 10 have an expense associated with it, so it’s natural to expect that the cost of coverage must go up, especially because the insurance companies can’t pick and choose only healthy people to cover anymore. We’ll cover this increase in costs shortly, but let’s focus on the positive aspect of the government subsidies.
When the government decided to revamp our healthcare system, they realized that covering everyone at the same premium without regard to their health would be expensive. So the government set some guidelines for how they would offset the cost of that coverage by paying premiums to the health insurance companies directly based on your estimated annual income according to the guidelines above. On a side note, even if you fall in one of these categories, it doesn’t guarantee that you’ll receive subsidies. Every situation is different and the best advice I can give you is to call an insurance agent you trust and spend 5-10 minutes discussing your particular situation.
For most people, we look for a company that offers affordable copays that sit outside their deductible for their day-to-day needs, such as doctors visits, medications, and urgent care visits. We’ll also look at deductibles and worst-case scenario situations. One of the things we often do a little differently than others is combine a major medical policy with a supplemental health insurance policy. While most plans today have a deductible of at least $1,000 (up to a max of $6,000), the supplemental coverage pays you directly for injuries, trips to the emergency room, hospital stays, and critical illnesses. When faced with a catastrophic loss or an unexpected accident, the supplement can provide the cash exactly when needed to offset some, or even all, of your out-of-pocket expenses. In the same way you diversify your retirement funds, this is the least expensive way to manage your risk and build a complete health insurance portfolio. While none of us expect it to happen to us, we’ve all been impacted by someone that is fighting cancer, heart disease, or stroke, to name a few. Imagine if they had an extra $10,000, $20,000, or even $50,000 to help them cover their deductible, pay their monthly bills, or help make up lost income.
We’re going to cover some of the challenges in choosing the right plan in part two of this post, but in the meantime, please don’t depend on the hourly workers at Healthcare.gov that are helping you get your application completed. They are not licensed agents and are literally reading from a script. Because the premiums for insurance are fixed by law, it doesn’t cost you any extra to work with an insurance broker like me.
The bottom line is that purchasing individual health insurance today is more difficult and can be more expensive than ever before, but there are resources to help you understand your options and potentially make it more affordable. If my staff or I can help you in any way, from asking questions to getting enrolled to proactively helping you manage your renewals, please don’t hesitate to reach out to us. I can be contacted directly by phone at 314-828-3371, by email to Jason@mychoiceinsuranceco.com, or through the contact-us form on our website at www.MyChoiceInsuranceCo.com. Thanks for reading!