The HealthCare.gov website got off to a shaky start, to put it mildly. Fortunately, however, it's doing a lot better.
Beyond allowing many more people to sign up for plans, a key upgrade is the new plan comparison tool. With it, you can now browse plans without creating an account. Yes, this option was available before, but it was incredibly unhelpful to users who didn't fit the two standard ages provided -- 27 and 50.
When using this tool, you'll want to keep a few important tips in mind to ensure a smooth process. Here are five tips that will ensure you get the most value out of your health insurance shopping experience.
1. The Price May Not be Right
Keep in mind that the quoted price may be above what you'll actually pay, because you may qualify for subsidies.
Qualification for subsidies depends on your annual income, and the number of people living in your home. The following are the income ranges that qualify for a subsidized premium, based on total household members:
•One: $11,490-$45,960
•Two: $15,510-$62,040
•Three: $19,530-$78,120
•Four: $23,550-$94,200
•Five: $27,570-$110,280
•Six: $31,590-$126,360
In addition to a subsidized premium, you could also qualify for lower, out-of-pocket costs if your income falls within the following ranges, based on the number of people in your home:
•One: $11,490-$28,725
•Two: $15,510-$38,775
•Three: $19,530-$48,825
•Four: $23,550-$58,875
•Five: $27,570-$68,925
•Six: $31,590-$78,975
Note that income thresholds are higher in Alaska and Hawaii. Also, the prices you see are for non-smokers.
2. Essential Health Benefits Are Not Necessarily Free
The site mentions that essential health benefits must be covered by insurance plans wishing to be certified in the Health Insurance Marketplace. Some assume this to mean that those benefits are free, but it is important to clarify that "covered" does not mean "free." Essential health benefits include things like maternity and emergency care -- which are by no means free under these plans.
The amount you will pay for this type of care depends on your plan. For example, some bronze plans will not cover any part of an emergency room visit until you've exceeded your deductible -- at which point, you will pay a percent coinsurance (which can still be thousands for a large bill). On some higher tier plans, on the other hand, you will only pay a set amount for such a visit, regardless of reaching your deductible or not.
3. You Get What You Pay For
Some lower-tier plans offer no charges on generic prescriptions and office visits after you meet your deductible. However, the deductible for these plans can be over $6,000 per person. With a $6,000 deductible, you'll pay for most things (excluding free preventive care, which is required of all plans) in full, until you reach that amount.
According to TransUnion Healthcare, the average American's annual, out-of-pocket healthcare tab is just over $2,000. Evaluate your own health status to come in below this figure. If you are in good health, and you go with a lower-tier plan with a health savings account (HSA), you will save money in premiums and be eligible for tax advantages -- as long as you don't fall sick or get in an accident that requires extensive medical care. However, if you have high medical expenses, a higher-tier is likely worthwhile. For a few hundred dollars extra in premiums per year, you can trim thousands from your deductible.
4. Read the Fine Print
Healthcare is a very important component of your wellbeing, and insurance is an important part of making sure that your bank account is also healthy -- so you'll want to read the fine print. To do so, click "Details" on the plan you're considering. Then, choose either "Summary of Benefits" or "Plan Brochure," which will take you directly to the company's website. Read this information carefully to ensure you're signing up for an adequate plan for your healthcare needs.
5. Keep Your Doctor
You may have heard the horror stories of patients who, despite promises otherwise, have been unable to keep their doctor. That's not a crowd you want to join.
To determine whether your doctor is included in a given plan, click "Details." Then, choose "Provider Directory." This will take you to the provider's website, where you can verify your doctor is on the plan.