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.
- 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
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