Health Insurance 101


Article Source: http://virtuale-ssistance.com/2014/10/18/health-insurance-101/



It’s that time again…open enrollment. Americans are shopping for health insurance plans in droves, and taking to the Marketplace to find a plan that fits their family’s evolving health needs. It can be a frustrating process, much like shopping in a real marketplace. However, we have your “weekly ad” here, which includes tips for finding the best (affordable) health plan.

So what are the key things that you need to know when shopping for a plan?

1. Know the terms (and the math).

Sounds simple right? Everyone should know what a co-pay or premium is…but what about the generic name for your cholesterol medication, or your child’s allergy pills? Have this information in front of you when shopping for coverage; it will help you find a plan that best meets your family’s prescription needs. This information can also be given to your doctor when he/she prescribes medication, which will help keep your out-of-pocket costs down. Also, consult the glossary that each insurer provides: find out how they define “emergency” hospital visits. Some plans may only cover out-of-network ER visits that deal with symptoms of heart attack, or have a different definition of exactly how long an “extended hospital stay” should be.

While you’re at it, do some practice bill calculations. If a plan will cover a certain percentage after your out-of-pocket costs, grab an old hospital bill from the last year or so and see how the new plan would cover the same ER visit, or surgery (in theory, at least). It won’t be exact, but will give you a good enough idea to know whether or not the plan you’re looking at is in your budget.

2. Get acquainted with the Marketplace System.

Around 158 million Americans will be choosing a health plan provided by their employer, so this step won’t be necessary. However, for the millions who aren’t, open enrollment officially begins on November 15, 2014. There’s a special enrollment period open before this time for individuals with qualifying life events (i.e. marriage or divorce, expecting a child, or problems trying to enroll in the Marketplace earlier).
Other great Marketplace features include: a 24/7 call center and tutorials, a separate search system for small business (50 employees or fewer) and tips for avoiding fraud.

3. Review your options.

More than a few companies set aside a two week period between October and December for employees to select health insurance plans. Use this time wisely. Gather information from each plan and review. Did your prescription drug coverage fall short last year? Planning a child in the next year or scheduling a major surgery? Asking these questions and comparing your current plan with the new, offered options may help you save money and headaches in the coming year.

Also, major insurers, like United Healthcare, are beginning to offer incentive programs to help their insured live healthier lives. Consequently, your plan may offer gym membership discounts and weight loss programs, as well as resources for kicking your smoking habit and dropping your cholesterol.

4. Make insurance a priority.

Most often, members of this in-between age bracket are uninsured. However, there are options available that not only make insurance accessible, but also affordable. Under the ACA, a parent can keep a child enrolled on their health plan through the age of 26, even if they aren’t at home or enrolled in school. While staying on a parents’ plan is an option, it isn’t always the best if the child attends an out-of-state school. Another option for students is a school-provided insurance plan. These are provided by major insurers, but with payment/coverage timetables that correspond to the average school year.

P.S. Working part-time? There’s coverage for that! Many employers are starting to offer health insurance, vision and dental plans for part-time employees. Check with your company’s HR department for additional information.

Melody Willett