Confused about health insurance?

Today, November 1, is the beginning of open enrollment for those who buy health insurance on the individual market. Over the last several months there has been a lot of confusing news about health insurance, so we want to help clear up some of the confusion.

Enrollment Process

  • www.healthcare.gov is still the place where Iowans can find health insurance plans where eligible consumers can use premium tax credits to help them pay their health insurance premiums. To enroll over the phone, the phone number is still 800-318-2596.
  • This year, the open enrollment period has been shortened: it goes from November 1 – December 15, 2017. During that time anyone can purchase a health insurance policy for 2018.
  • The enrollment site will be closed for maintenance for 12 hours (midnight till noon) every Sunday during the enrollment period, with the exception of the last Sunday, December 10.
  • To find local help with enrolling, do a zip code search at Get Covered America.

Plans and Costs

  • There has been a lot of news about premiums rising, and it is true. However, if you are eligible for a premium tax credit to help pay your premium, the higher premiums are not a major concern.
    Why? With the premium tax credit, you only pay a certain percentage of your income; the tax credit pays the rest of the premium.  That means your premium costs for 2018 will be similar to 2017 if your income is similar.
  • Find out if you are eligible for a premium tax credit at https://www.healthcare.gov/lower-costs/save-on-monthly-premiums/. Income guidelines vary by family size: for a single individual, the maximum 2018 income is $48,240; for a family of 4, it is $98,400.
  • For most of Iowa, there is only one insurance company offering plans through healthcare.gov. Be sure to find out if your medical providers are participating in the plan before signing up. You will be able to find that information during the enrollment process before you enroll. The network appears to be quite broad, but it is still important to know if the company’s provider network will meet your needs; no one wants to be caught by surprise after they have enrolled.
  • If you are not eligible for a premium tax credit, you can still use healthcare.gov to purchase health insurance, but you will need to pay the full premium. Before making a decision, it would be wise to compare other options, perhaps through one or more local insurance agents. Health insurance purchased elsewhere may provide reduced coverage, and may be a challenge for people with pre-existing conditions, but it is always wise to check multiple options before making a decision.
  • If you are under 30, you may be eligible to purchase a lower-cost, very-high-deductible catastrophic plan.  An earlier blog post describes these plans.
Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

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If you got married this year…

wedding ringsIf you got married this year, or are going to get married this year, congratulations!

During the past months your mind may have been occupied with details of wedding, honeymoon, housing decisions, moving, or other events.  In the midst of those big events, it’s easy for some small-but-important details to be overlooked.  Remember to:

Notify Social Security and get a new Social Security card  if your name changed.  If you don’t, you’ll run into problems when it’s time to file your tax return!  (I speak from personal experience on this…)

Check your tax withholdings to be sure you are having the right income tax amount taken out of your paycheck.  Your filing status and total income will be different on this year’s tax return, and if you are having too much or too little taken out of your paychecks then problems can result.  The IRS Withholding Calculator is an easy tool to make sure you are on track.

Notify www.healthcare.gov   If you purchased health insurance in the new Marketplace, log in to your www.healthcare.gov account and let them know of the change in your marital status, household size, and income.  Changes in income and family size will affect the amount of “premium tax credit” which you receive toward your health insurance premiums.

Best wishes for “happily ever after.”  ~Barb

NOTE: the IRS has more info for newlyweds, including you tube videos and podcasts.

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

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Bronze, Silver, Gold… Olympic Health Insurance?

olympicsAs the Winter Olympics launch this week, gold, silver and bronze medals will be awarded to the athletes who performed best – the highest honors in the world of sports.

In the new health insurance marketplace, consumers can choose from health insurance plans that are designated as bronze, silver, gold, or platinum plans.  Health insurance metals are not the same as Olympic medals. For one thing, in health insurance we have a fourth option: platinum.

The more important difference, though, is that with health insurance metals, there is not an absolute BEST.  For some people Bronze may be best; others will decide that Silver, Gold, or Platinum is the best choice for them.  The best choice for you depends on your situation.

Here’s how it works:

All the health insurance plans in the marketplace cover the same essential health benefits – hospitalization, prescriptions,  mental health care, and more .  All plans in the marketplace also offer free preventive care, with no co-payments or deductibles.

What’s different from one plan to another is how the cost is split between the consumer and the health insurance company.  The insurance companies set up plans that have different cost-sharing elements – these are the deductibles, co-payments, and out-of-pocket maximum limits which consumers pay when they use health care.  And then they set appropriate premiums for each plan, based on all their statistics about costs and typical consumer use.

  • With a bronze plan, the consumer’s share of the cost of care is higher (i.e. deductibles, co-pays and out-of-pocket maximum amounts are higher).  But the premiums the consumer pays are lower.
    In order to be called a bronze plan, the insurance company must pay, on average, 60% of health care costs for the average consumer.  This is the minimum value allowed for a qualified plan under the new law.
  • Silver plans must pay an average of 70% of consumers’ health care costs; therefore, the consumer’s share of cost (deductibles, etc) will be lower than bronze plans.  And the premiums will be higher.
  • Gold insurance plans pay an average of 80% of health care costs, so the consumer’s share averages 20%; consumers pay higher premiums for gold plans, compared to silver and bronze.
  • And – you guessed it – platinum plans pay an average of 90% of health care cost, leaving the consumer paying only 10% of costs through deductibles and co-payments.  Platinum plans will generally have the highest premiums.

You might be tempted to say that platinum plans are the best, because they cover more, and cost more.  We’re accustomed to thinking that the BEST always costs the most.

But I suggest that the best choice for you is the plan that makes the most of your dollars.  Why pay a high price for something you are unlikely to need?  If you use a lot of health care, a gold or platinum plan may be the logical choice; sure, your premiums will be higher, but then your out-of-pocket costs throughout the year will be lower.  On the other hand, if you don’t expect to need much health care, why spend the extra money on a higher-premium gold or platinum plan, if you’ll barely use any of the benefits?

The best plan for you depends on your expectation for health care needs in the coming year.

Here’s another piece of good news: you can change plans next year.  The plan you choose now does not lock you into that plan for future years – each year you can choose based on your current health care needs and finances.

If you don’t have health insurance now, be sure to check out the health insurance marketplace (www.healthcare.gov) soon – open enrollment continues until March 31!

~Barb

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

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Health Care Marketplace: Follow the dots

directionI had a call a few days ago from a woman who was stuggling to find the “Iowa Health Insurance Exchange” on line.  She had put that phrase into her search engine and come up with lots of options – some that were “dot-com” sites, others that were “dot-org” sites.  Among the options were a few “dot-gov” sites.

Listening to the news, it’s easy for our minds to become cluttered with phrases.  And we’ve become accustomed to being able to “google” anything to find it. 

If you, or someone you know, is looking for the official health insurance marketplace in your state, the place to begin your search is at www.healthcare.gov   Key point: use “dot-gov.”

Why does it matter? Starting somewhere else could lead to misdirection and possible problems.  Other sites may have a sales motive or a political agenda. A worst-case scenario might be identity theft; another risk is that a person might enroll in a health plan through another site and miss out on the cost reductions that are only available in the official health insurance marketplace.

Help your friends avoid misdirection! Remind them that, even though it’s not yet working as well as we would like, the correct website to find health coverage with the new Premium Tax Credits and Cost-Sharing Reductions is www.healthcare.gov

~Barb

 

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

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Obligation or Opportunity?

health costsThe idea of not having health insurance scares me.  I remember a time when I ended one job on a Friday (October 20), and my new job started on Monday (October 23). I was worried – asked questions: “what if something happened over that weekend?”  I don’t remember which insurance plan covered those two days, but I do remember that I received assurance that I was covered.

Beginning in 2014, everyone is required to be insured (with a just few exemptions from the penalty).  While that is an obligation, it is also an opportunity!

As I see it, health insurance is a safety net – one that has always been really important to me.  Even healthy young people can find themselves needing serious (and expensive) medical care.  Accidents happen, and so do illnesses that can cause hospitalization and tremendous costs.  Even a healthy pregnancy involves significant medical costs.  Currently the average cost for a 3-day  hospital stay is $30,000; the cost of a broken leg: $75,000.    Most people, regardless of age, are not prepared to take on the cost of a serious medical problem  – whether it’s $20,000 or $200,000 or $2 million.

The main reason young adults have been without health insurance has been cost.  Beginning in 2014, cost will be less of a problem, since assistance with paying health insurance premiums will be available to people with incomes up to about $45,000 (single adult) or more (based on family size).  A single adult with income under $20,000 will pay little or nothing for health insurance – as income rises, people pay more on a sliding scale.

To me, getting health insurance is a no-brainer.  No matter what my situation, I will always want health insurance if I can possibly get it.  I hope that young adults are not turned off by the fact that it’s now an obligation – I hope they instead focus on the opportunity to protect themselves from disastrous health costs. 

For more information on health insurance changes, here are some reputable resources:  www.healthcare.gov;  http://www.extension.org/pages/68659/health-insurance-faqs;  http://kff.org/health-reform/

Barb

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

More Posts

    

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