Navigating the End-of-Year Healthcare Hustle
Oh. Obamacare. The good. The bad. The so very, very controversial…
And yet, I cannot stay away from this topic all together because securing health insurance is critical for financial health. (As well as our physical health, too!) So let me navigate this delicate topic by starting here.
When it comes to health insurance, it’s time to get scrappy. The game has changed drastically in the past couple of years and it’s our job to be informed consumers and maximize the opportunities that have been afforded to us and our families while still being savvy shoppers.
Luckily, I know just the person to talk to.Meet Alexandra Eidenberg. She is the co-founder and President of The Insurance People. She and I have worked together for the last several years and I respect her opinions tremendously.
Alexandra has been generous enough to share some of her favorite tips for choosing a health insurance policy.
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1
Pick The Least Expensive Health Insurance.
Pick the least expensive health insurance that meets your immediate needs.The best health insurance plan for you is achieved when the needed doctors (network) meet the monthly cost (premium). This means picking the least expensive insurance for your need. Gone are the days of buying Cadillac plans for life’s WhatIfs. Now, it’s about buying exactly what you need for your anticipated health care needs and not a bit more.
Think about your current conditions and planned medical needs for the coming year. Do the math around these items and calculate your fixed cost (monthly premium) and the projected variable cost (deductible and out of pocket).
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2
You've Got One Year...
Know that any plan you select will only last 1 year. Insurance renews every year and every year you can change plans. Many times you are forced to change plans especially in the individual market. While changing your plan can be a hassle, it is good to know that if your policy changes – or if your medical coverage needs change – you will be able to seek out a better option for yourself in a few short months.
The 2017 enrollment schedule is here:
November 1, 2016: Open Enrollment begins. Apply for or change your coverage.
December 15, 2016: Deadline in order to have coverage that begins on January 1, 2017 (if you apply on December 16 you’re coverage will most likely not start until February 1).
December 31, 2016: Coverage ends for 2015 plans. You will be auto-renewed if you don’t change your plan.
January 31, 2017: This is the last day you can apply for 2017 coverage before the end of Open Enrollment.
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3
Confirm Network Status.
Always confirm doctor network status using both the carrier website and your doctor’s website.
a) Networks are not stable. If you have the option of joining a group, employer plan, that may offer a better network.
b) What is in today might be out tomorrow. Always double check network status before scheduling expensive procedures and surgeries.
c) Do not hesitate to ask a hospital or doctor to prescreen your benefits. This allows you to know your exposure prior to using your insurance.
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4
Consider Different Plan Types.
a) HMOs have a gatekeeper doctor but lower out of pocket costs.
b) HSAs have higher out of pocket costs and in return give tax deductions while allowing the freedom of a PPO.
c) POSs have multiple deductibles built in but can often lower monthly costs while allowing the freedom to move around a vast network.
d) PPOs tend to be a fan favorite because of the freedom they offer with a combination of network selection and built-in copays – but they are the most costly.
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5
Business Owners: Consider Several Plans.
If you own a business consider offering several plans and paying a flat dollar amount contribution.
This allows your staff to use the contribution you are comfortable giving towards a plan of their choice. Employees like it because they gain more power and employers love it because it gives them the power to control costs.
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6
65 or Older?
If you are soon to be 65 or over 65 make sure to be organized for open enrollment. Supplements and Part D are only offered for the January 1 start date unless you have a loss of coverage or are new to Medicare.
a) If you are new to Medicare make sure to get Part B going. Without it you can not access a supplement or part D.
b) If you are currently on a supplement or Part D and have had health and medication changes over the past year then shop around for a new plan to start the following January.
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7
Insurance Is About Stability.
The individual market forces you to change plans annually. Do not be alarmed by this.
If you own a business focus on picking an insurance option that gives your staff security. Bouncing around to price chase is not as popular with employees as passing along more of the cost to them. They want the best. Let them help pay for it and together create stability.
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8
Don’t Panic. Ask For Help.
Find quality resources to help you pick the best options for you, your family and business.
Alexandra Eidenberg and The Insurance People are not affiliated with LPL Financial and Stonebridge Wealth Advisors, LLC.