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Carla Menendez
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ACA Open Enrollment 2020 – 5 tips to save money
Stop right now!
There is no such thing!
We will have to wait until next year to know what you might have done differently.
What we CAN do right NOW is to work together to find the best value health insurance coverage in 2020, for you and your dependents, whether young or senior.
The ACA open enrollment (for most states November 1st to December 15th) is your opportunity to EXPLORE YOUR OPTIONS.
Firstly, let’s start with some overall advice.
If your employment offers ACA compliant health insurance as part of your remuneration package, it is generally a good option to accept. BUT
Make sure the terms offered meet your specific needs. E.g. Metal Tier, according to your anticipated need for medical treatment and prescription drugs. If your spouse also has group coverage you should consider which plan is more advantageous. It often pays to split the coverage!
NOW let’s consider how you can SAVE MONEY AND provide the lowest cost health insurance that will meet your family circumstances.
Here are 5 things for you to consider.
- Shop on a Health Insurance Exchange, Federal, State or Private. Their advice and services are free to you AND by shopping through an exchange you can take advantage of TAX RELIEF on your monthly premiums and Cost Sharing Reductions (CSR)
• Over 80% 0f US citizens benefit from Benefit Tax relief or CSR. Don’t miss out!
A private exchange will generally be able to consider a wider range of services such as ‘Eyes’, ‘Ears’ ‘Teeth’ and even ‘End of Life’ to help you to negotiate a ‘complete’ package
2. Don’t make any decisions without considering what actually happened in the past and what might happen next year.
For example, someone in your family may need regular prescription drugs, you may be expecting an addition to the family or planning medical treatment.
3. Don’t fall for the ‘cheapest’! ACA compliant BRONZE plans provide the security 0f the TEN ESSENTIAL BENEFITS and offer the lowest premiums BUT they come with a warning: ‘You will have to pay for the UNEXPECTED’
A single visit to the Emergency Room or an extended course of prescription drugs could easily outweigh your hoped-for economies
SILVER and GOLD plans may result in higher (predictable) monthly outgoings but set a predicable cap on the ‘out-of-pocket’ (unexpected) expenses
4. Don’t always opt for branded medications. Always ask if there are generic alternatives. A report published by AARP (American Association of Retired Persons) suggests that the cost of name branded prescriptions (patented medications) can be 18 times higher than non-patented (generic) equivalents
Remember, you will pay a proportion of your medication costs. This is even more important for individuals with chronic (long term) medication needs
5. Finally, always look at the options
a. Don’t expect the first quotation to be the best
b. Don’t wait to the last minute
c. Do check where the dollars went last year
d. Do estimate where you expect the dollars to go in 2020
e. Do use ‘Open Enrollment’ to explore
f. Do consult the Exchange
FOCUS ON THE FUTURE
ACA Open Enrollment 2020: 5 things not to do
Don’t enroll or renew without reading this article!
(it could save you $thousands)
You may be enrolling for the first time or renewing either as an individual or as a member of a group (employer) scheme.
The same rules apply. Focus on the future!
Even if you decide to do nothing, make sure you have considered the alternatives…
Here is a list of DON’Ts
- DON’T opt out
- DON’T miss Open Enrollment
- DON’T take the easy course and simply let your current plan rollover, (auto-renew)
1)Don’t opt out
It is in fact, illegal not to have Health coverage which is ACA compliant. There are no legal penalties for not being insured but you will be entirely responsible for any medical and care costs associated with an illness or injury affecting you or one of your dependents.
80% of US citizens benefit from Premium tax relief or Cost sharing reductions (CSR). Don’t miss out.
2)Don’t miss open enrollment
ACA open enrollment runs from 1st November-December 15th.2019 (for the year 2020). It is your opportunity to review (confidentially)your anticipated insurance needs and circumstances with an advisor from an insurance exchange; Federal, State or Private. They all offer free, unbiased guidance on the choice of coverage and the net costs to you after premium tax relief and potential CSRs
3)Don’t rollover (auto renew)
Of course, it is easiest to ask for the ‘same again’! We all do it! But with insurance, and especially Health Insurance it is never the same again. Contract terms may change and some policies automatically rollover. Your circumstances will definitely have changed. You may have plans….
You need to consider
- Changes from last year to this year
- Medical condition (you or a dependent)
- Anticipated needs, predicable medical treatment, prescription drugs, healthcare.
- AND
- Could you have paid less for the healthcare services you received last year?
- Were you happy with the administrative support you received from your insurers?
- Was the ‘network’ of providers convenient and appropriate?
4)Don’t assume that low premiums will give you lowest costs
Health insurance premiums and deductibles are related.
- Lower premium-Higher deductible
- Higher premium-Lower deductible
These are broadly described by the metal tiers
- Bronze
- Silver
- Gold
- Platinum
Consider your circumstances and compare at least three plans. As rough guide, add the annual premium to the maximum ‘out of pocket’ for your preferred plans. Take advice from a Health Insurance Exchange. They can help you through the maze of options. They act on your behalf to find you ‘best value’
5) Don’t make your calculations without taking premium tax relief and cost sharing reductions (CSR) into account.
- You can claim tax relief on monthly premiums if your income is not more than 4X the Federal Poverty Level (FPL)
- You are entitled to CSR up to 2.5 times the FPL
- In some cases, tax relief entirely covers the cost of your premium.
- Access to preventative care benefits can be FREE
THINK PINK. WEAR PINK. October is Breast Cancer Awareness Month.
The average lifetime risk of developing breast cancer is ONE in EIGHT (12% of women). About 300,000 cases of breast cancer are diagnosed each year in the USA of which about 85% are successfully treated.
Sadly, breast cancer is the most common form of cancer (after skin cancers) but despite progress in treatment over 40,000 women (in the USA) die from the disease each year.
Of course, there have been significant advances in ‘late-stage’ treatments but the best opportunity to combat the condition is early detection.
ACA compliant health insurance covers the total cost of screening mammograms (including dependents up to the age of 26).
If a ‘screening’ mammogram reveals an abnormality your physician may suggest a ‘diagnostic ’mammogram.
The diagnostic investigation may entail further x-rays or a biopsy. In most cases the result is negative. BUT early indications are your opportunity to access early treatment.
Not all health insurance policies cover the cost of ‘diagnostic’ assessments. Talk to us before you choose.
Use ACA open enrollment (November 1st -December 15th, 2019) to make sure that you and your family are eligible for your 2020 screenings.
Think pink. We do!
Refer: https://www.healthline.com/health/breast-cancer/treatment-breakthroughs-2019
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Attention
This website is operated by TrueCoverage and is not the Health Insurance MarketplaceSM website. In offering this website, TrueCoverage is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220 (c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans (QHPs) being offered in your state through the Health Insurance MarketplaceSM website. To see all available data on QHP options in your state, go to the Health Insurance MarketplaceSM website at HealthCare.gov.
Also, you should visit the Health Insurance MarketplaceSM website at HealthCare.gov if:
-
- You want to select a catastrophic health plan.
- You want to enroll members of your household in separate QHPs.
- The plans offered here don’t offer pediatric dental coverage and you want to choose a QHP that covers pediatric dental services or a separate dental plan with pediatric coverage. Pediatric dental services are an essential health benefit.
TrueCoverage offers the opportunity to enroll in either QHPs and off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.
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