If you haven't yet enrolled in an individual health insurance plan through former President Barack Obama's health care law, act fast: The deadline to sign up is Jan. 31.
The
might be repealed or changed in coming months, but right now, federal law says that you must have
or you'll pay a tax penalty. If you qualify for tax subsidies, shopping on the federal or a state exchange is the only way to receive them. Exchange plans can be found:
- At Healthcare.gov or your state's exchange website.
- Through health insurance comparison sites.
- Through a health insurance broker.
If getting a subsidy isn't a concern, you can also shop for plans directly through health insurers.
Here's how to make a quick decision before the open enrollment window closes.
Look closely at costs
Many people choose a plan based on the monthly premium. That's an important factor, but there are other out-of-pocket costs to consider:
- Deductibles: The amount you pay upfront for medical care each year before your plan pays. Some plans cover certain services, such as primary physician visits, before you meet the deductible; others don't.
- Copayments: A flat fee you pay at the time of a medical service, such as $25 for a doctor visit or $10 for a prescription.
- Coinsurance: A portion of the cost of a medical service, which you typically pay even after you've met your deductible, such as 20% of the cost of an X-ray or 30% of a laboratory fee for bloodwork.
- Out-of-pocket spending limits: The most you'll pay each year for copays, coinsurance and deductibles before the plan pays 100% of your medical bills.
The health plan with the lowest monthly premium likely has some of the highest out-of-pocket costs. In other words, if your family frequently uses medical services, you have a surgery coming up, or you plan to become pregnant, "maybe a plan with a higher premium and lower deductible is a better choice," says Ellen FitzPatrick, vice president of partnership development at Copatient, a medical cost consulting firm.
Pick a tier, then compare choices
Plans on the exchanges are grouped into "metal tiers" based on the average amount they pay for care:
- Bronze: Plans pay 60% of charges.
- Silver: Plans pay 70% of charges.
- Gold: Plans pay 80% of charges.
- Platinum: Plans pay 90% of charges.
Bronze plans generally have the lowest premiums and the highest deductibles, copays and coinsurance. Use the metal tier system to compare costs of the available plans and pick a few to look at more carefully.
Examine the provider network and benefits you want
Before you choose any plan, "know what's covered -- and what's not," FitzPatrick says. Make sure the plan you select pays for your doctor visits, as well as services and medications you regularly use.
- If you have one or more doctors you want to keep, check that they're listed in your plan's provider directory before you buy. You'll often find a link to the directory near the plan's details on comparison sites and on the insurer's website.
- If you use specific health services due to a chronic condition, such as diabetes, make sure they're covered services in the plan's summary of benefits.
- If you take medications, look them up in your plan's formulary and find out how much you'll pay. Search for the generic names, not the brand names. For example, if you take Synthroid for a thyroid disorder, search for the active ingredient "levothyroxine" instead.
If you're unsure whether the insurers you're considering will pay for your drug or doctor visits, call sooner than later. Customer service phone wait times will likely increase as the Jan. 31 deadline gets closer.
Even if you don't have questions, avoid signing up on the last day in case of any last-minute website glitches due to high demand.
Lacie Glover is a staff writer at NerdWallet, a personal finance website. Email: lacie@nerdwallet.com. Twitter: @LacieWrites.
Our 2024 Coverage Needs You
It's Another Trump-Biden Showdown — And We Need Your Help
The Future Of Democracy Is At Stake
Our 2024 Coverage Needs You
Your Loyalty Means The World To Us
As Americans head to the polls in 2024, the very future of our country is at stake. At HuffPost, we believe that a free press is critical to creating well-informed voters. That's why our journalism is free for everyone, even though other newsrooms retreat behind expensive paywalls.
Our journalists will continue to cover the twists and turns during this historic presidential election. With your help, we'll bring you hard-hitting investigations, well-researched analysis and timely takes you can't find elsewhere. Reporting in this current political climate is a responsibility we do not take lightly, and we thank you for your support.
Contribute as little as $2 to keep our news free for all.
Can't afford to donate? Support HuffPost by creating a free account and log in while you read.
The 2024 election is heating up, and women's rights, health care, voting rights, and the very future of democracy are all at stake. Donald Trump will face Joe Biden in the most consequential vote of our time. And HuffPost will be there, covering every twist and turn. America's future hangs in the balance. Would you consider contributing to support our journalism and keep it free for all during this critical season?
HuffPost believes news should be accessible to everyone, regardless of their ability to pay for it. We rely on readers like you to help fund our work. Any contribution you can make — even as little as $2 — goes directly toward supporting the impactful journalism that we will continue to produce this year. Thank you for being part of our story.
Can't afford to donate? Support HuffPost by creating a free account and log in while you read.
It's official: Donald Trump will face Joe Biden this fall in the presidential election. As we face the most consequential presidential election of our time, HuffPost is committed to bringing you up-to-date, accurate news about the 2024 race. While other outlets have retreated behind paywalls, you can trust our news will stay free.
But we can't do it without your help. Reader funding is one of the key ways we support our newsroom. Would you consider making a donation to help fund our news during this critical time? Your contributions are vital to supporting a free press.
Contribute as little as $2 to keep our journalism free and accessible to all.
Can't afford to donate? Support HuffPost by creating a free account and log in while you read.
As Americans head to the polls in 2024, the very future of our country is at stake. At HuffPost, we believe that a free press is critical to creating well-informed voters. That's why our journalism is free for everyone, even though other newsrooms retreat behind expensive paywalls.
Our journalists will continue to cover the twists and turns during this historic presidential election. With your help, we'll bring you hard-hitting investigations, well-researched analysis and timely takes you can't find elsewhere. Reporting in this current political climate is a responsibility we do not take lightly, and we thank you for your support.
Contribute as little as $2 to keep our news free for all.
Can't afford to donate? Support HuffPost by creating a free account and log in while you read.
Dear HuffPost Reader
Thank you for your past contribution to HuffPost. We are sincerely grateful for readers like you who help us ensure that we can keep our journalism free for everyone.
The stakes are high this year, and our 2024 coverage could use continued support. Would you consider becoming a regular HuffPost contributor?
Dear HuffPost Reader
Thank you for your past contribution to HuffPost. We are sincerely grateful for readers like you who help us ensure that we can keep our journalism free for everyone.
The stakes are high this year, and our 2024 coverage could use continued support. If circumstances have changed since you last contributed, we hope you'll consider contributing to HuffPost once more.
Support HuffPostAlready contributed? Log in to hide these messages.