Choosing the right health insurance can be difficult. It is not just about choosing the plan with the most bells and whistles, it is about finding one that meets your needs and budget.
Figure out whether you are eligible for health insurance subsidies
If you have a lower income, the best health insurance costs may be subsidized. This means that the government will pay part of your monthly premiums to make them more affordable.
There are two ways to receive these subsidies: tax credits and cost-sharing reductions. Tax credits are typically applied as a discount on your monthly premiums (meaning they’re subtracted from the total amount due) while cost-sharing reductions are paid directly to insurers and reduce out-of-pocket maximums for eligible individuals with silver plans purchased through healthcare.gov or its state marketplace exchanges.
To qualify for tax credits, individuals must meet certain requirements based on their family size and annual income level:
- Under $48,000 for one person (or ~$100,000 for a family of four)
- Under $66,000 for two people (or ~$150k for four)
- Under $92,000 for three people (or ~$200k/400k)* Under $138,250 for four people
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Look beyond the plan’s premium cost
You’re not just considering the cost of your plan when you decide on a health insurance provider, even though that’s obviously an important factor. You also want to look at what you’re getting for that price.
Here are some key areas to consider:
- Deductibles and co-pays
- Provider networks
- Prescription drug coverage
- Mental health and substance abuse treatment
- Maternity services (theoretically)
The first thing to consider is whether your plan will cover the treatments you need. Although many plans have broad provider networks, some are limited, which can make finding specialists difficult. If you have a chronic illness that requires frequent visits with specialists, this could be a real problem.
Your prescription drug coverage is another important consideration. Many insurers offer only a basic plan that doesn’t include brand-name drugs, leaving patients with no choice but to pay full price for their medication or go without it entirely.
Consider a Health Savings Account (HSA)
If you’re interested in saving money on your health care costs, then Health Savings Accounts (HSAs) are the way to go. These are government-sponsored tax-advantaged savings accounts that allow you to put money away for future medical expenses.
You can use this money for copayments and deductibles, as well as prescriptions and other out-of-pocket costs associated with doctor visits and tests.
The best part about HSAs is that they come with some fantastic tax benefits: If your employer offers an HSA as one of their employee benefits packages, they’ll contribute up to $3,500 per year into your account—or even more if you elect a higher deductible plan (that is, the one where you have to pay more out of pocket before coverage kicks in).
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As long as you have medical expenses during the year that exceed those contributions plus any earnings on top of it—and assuming all these contributions were made within 2017—you won’t owe any taxes on those earnings when April rolls around next year!
In addition to these great investment opportunities though? There’s another big benefit: unlike 401(k)s or traditional IRAs where all withdrawals must be used for retirement purposes only (at least after age 59 1/2), funds withdrawn from HSAs may be used at any time for qualified medical expenses including prescription drugs!
Know that you can only enroll during the open enrollment unless you experience a qualifying life event
You can only enroll in a health insurance plan during open enrollment. If you don’t sign up for health insurance during this time, then you won’t be able to get coverage until the next open enrollment period begins (unless you have experienced a qualifying life event).
A qualifying life event is any change in your life that affects your eligibility for health insurance. Qualifying events include:
- Marriage
- Birth of a child
- Adoption of a child or foster care placement of an eligible dependent
- Divorce or legal separation from your spouse if that divorce or legal separation occurred after the end of the previous year’s open enrollment period; widowing if your deceased spouse had his/her own coverage at the time of death; ending an ineligible marriage due to death or annulment within 60 days; ending an ineligible marriage due to divorce within 60 days
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Consider your actual needs and budget
Before you begin shopping for a new health insurance plan, make sure that your current coverage is adequate to meet your needs. If you are already on Medicare or Medicaid, then this step may not apply to you.
Next, consider how much money is available for each month’s premium payment. Remember that different insurers offer varying amounts of coverage at different rates; some offer generous benefits at higher premiums while others offer lower premiums with fewer covered services and out-of-pocket expenses.
After comparing plans based on the criteria above and choosing the one that fits best within your budget, look into whether there are any ways in which it can be further reduced by raising deductibles or changing other aspects of your plan (such as switching providers).
Follow these guidelines to choose the best health insurance for you.
When shopping for health insurance, you’ll need to consider the following factors:
- Deductible, copay, and coinsurance. The deductible is the amount of money that you have to pay out-of-pocket before your insurance plan begins paying claims. Copays are the flat fees or percentages of medical costs you pay each time you visit a doctor or use other services covered by your health plan, and coinsurance is similar to copays in that it’s a flat fee or percentage of medical costs but applies only after your deductible has been met. If an annual out-of-pocket maximum exists with this type of coverage, it means there’s no limit on how much more money can be spent throughout the year on co-pays and coinsurance—but once this limit has been reached (i.e., once those expenses exceed $10K), they won’t count toward any subsequent annual limits on prescription drugs (see below). Finally: Some health plans require prior authorization before they’ll cover certain procedures—this means calling up their customer service line beforehand just so they can say “yes” or “no.”
- Provider network. This refers to who’s allowed under contract with an insurer as being able to provide care at reduced rates for clients within their networks; larger networks will offer more options than smaller ones so check them carefully before signing up just because someone sounds nice over email!
Insurance for seniors can be confusing, but it doesn’t have to be. The best way to start is by talking with someone who specializes in this area.
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Conclusion
The best health insurance is the one that meets your needs and budget. This can be a challenge, but it’s important to find an option that works for you no matter what. With these guidelines in mind, it will be much easier to make an informed decision when choosing your plan.
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