How to Find Health Insurance That Is Affordable Under Obamacare

Beginning on January 1, 2014, most of the provisions of the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare will go into full effect.  One of these provisions is the requirement that every American have health insurance or pay a fine.  Therefore, it is very important to find health insurance that gives you the coverage you need at a price you can afford.  But how do you do this?  Despite the controversy about the overall cost of the Affordable Care Act, there are some new ways to find affordable health insurance on an individual level.  Here are 4 ways that you can find health insurance that fits your budget and medical needs.

Reformed Group Insurance through an Employer

Obamacare has reformed the group insurance model.  While originally set to be implemented in 2014, the employer mandate to provide health insurance has been postponed until 2015.  Still, once it is put in place, you will be able to find health insurance through your employer that puts limits on what you pay for the plan and what your out of pocket limits will be.

The Affordable Care Act requires that employers with more than 50 full-time employees offer medical insurance to all of their full-time employees.  Full-time is defined as anyone who works at least 30 hours per week.  There are different calculations that go into the full-time definition, but just know that if you average 30 hours per week, you must be offered coverage.

The coverage that you are offered must have at least a 60% actuarial value, meaning that on average, for every dollar that the insurance covers, the insurance plan must pay for at least 60 cents.  One of the ways this is achieved is by limiting the individual’s out of pocket maximum.  In 2014, the limit is $6,350 and includes deductible, coinsurance, and copays.

Also, the employer cannot make an employee pay more than 9.5% of their salary to participate in the plan.  If you make $2,000 per month, the most you can pay for your insurance is $190.  Having said this, there is no cap on the cost of insurance for a dependent.

Still, with these provisions in place, you can find health insurance that is probably cheaper and better than before.

Health Insurance Marketplaces

Obamacare created health insurance marketplaces – originally called exchanges – to help people find health insurance plans quickly and efficiently online.  The marketplaces will make the search for a good plan easier than looking for individual insurance on your own.  Everything will be in one place.

While it will be interesting to see if the actual premiums of the plan are any cheaper than pre-Obamacare, some people will get help paying their premiums by way of tax credits (see here for tax credit eligibility).

If someone can find health insurance and use a tax subsidy, a good plan at a low rate will be available.

Parent’s Plan

The Affordable Care Act requires insurance companies to allow children to enroll in their parent’s insurance plan until age 26.  This is very advantageous because many times the cost to add a dependent to a plan is lower than the cost of an individual plan.  In fact, many times a new dependent can be added at no cost since some plans have one premium rate for all children on a plan.  In that case, someone under age 26 can effectively find health insurance that is free.

Medicaid

When Obamacare was passed, it required Medicaid to be expanded in every state.  This expansion will make it easier for adults to find health insurance through this government program.  The Supreme Court took away the requirement, and as a result, many states will not be expanding this coverage.

However, if you live in a state that is expanding Medicaid, check to see if you are eligible for this low cost way to care for medical needs.

Find Health Insurance at an Affordable Rate

When you try to find health insurance at an affordable rate, make sure to be patient and look at all your options.  Good coverage at a reasonable price is available.

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What is a Health Insurance Broker and Should You Use One?

Buying health insurance can be a complicated process.  There are so many plans, so many insurance companies, so many forms, and so many premiums, that a lot of people will just throw up their hands and not go through with the purchase.  Or they will end up with a plan that is either not in their best interest or costs too much.  One of the ways this can be avoided is by hiring a health insurance broker.  A health insurance broker can simplify the insurance buying process and get you a great plan at a price you can afford.

Knowledge of the Health Insurance Industry

Whenever you try to purchase something intricate about which you have no idea, there is a good chance you will miss something or pay too much.  Like negotiating with an experienced car salesman, there are tricks to the trade in the health insurance industry that many people know nothing about.

However, a health insurance broker knows all of those tricks.  They know how to leverage their client’s situation as best they can to get a good medical plan.  They know what to ask the insurance companies about and what traps to avoid.

Brokers also spend their time networking with industry insiders, such as agents and executives of insurance companies.  Because of these relationships, they are able to talk on a more personal level than an average customer.

It is very hard to get the best deal without expert knowledge of the insurance world, and a broker can bring that to you.

Leverage of Having Multiple Clients

Since a health insurance broker has multiple clients, he or she can use that to help get good pricing for all of them.  Insurance companies want to keep brokers happy so that the brokers keep coming back to them for possible business opportunities.

When individuals go out and look for a good insurance plan on their own, they do not have this leverage.

A Health Insurance Broker Leaves You Free to Do Other Things

Because a broker searches for good insurance plans for a living, they can do the work much more efficiently than an non-expert.  They know exactly who to call and exactly how to read policies and contract.

This leaves their customers to go about their business without worrying about looking up insurance companies and calling agents.  The customer can hire the broker and wait for the broker to bring them the best plan.

How Do Brokers Get Paid?

A health insurance broker gets paid through commissions in the policy premium.  Typically this rate has been around 5%.  However, with limitations on the loss ratio of medical plans, some insurance companies have begun to lower the rate they pay out in commissions.  If you hire a broker, just make sure to find out in advance how much they take in commissions.

Will There Be a Difference if I Use a Health Insurance Broker?

If you try to find low cost insurance on your own you can probably find a good plan at an affordable price.  But it will take you time and energy and you might not find the best plan at the best rate.  A health insurance broker can give you peace of mind that you are getting the coverage you need.

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Options to Access Health Insurance for Young Adults

With the requirement of the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare, that every American purchase health insurance or face a tax, there are many young adults that will be looking to access health insurance for the first time in their lives.  There are so many options out there, it can be difficult to choose which is the best way to cover them and their families.  With that in mind, here are some of the best ways to access health insurance that is comprehensive and affordable.

An Employer’s Plan

The Affordable Care Act expanded the eligibility requirement of group plans.  Under Obamacare employers must offer medical coverage to all of their full-time employees, defined as employees working at least 30 hours per week.  If the employer refuses, they will pay a fine.

There are some formulas to determine the hours an employee works, but as long as a worker meets the 30 hours per week mark they will be offered the same coverage options as everyone else.

In addition to being offered coverage, the law requires that the insurance be affordable.  An employer cannot charge more than 9.5% of an employee’s monthly salary to access health insurance at the workplace.  If more than 9.5% is kept out of a paycheck, the employer will face a fine.

A Parent’s Plan

Another big advantage of Obamacare is the requirement that children be allowed to enroll in a parent’s plan until age 26.  Before the legislation was passed it was up to the insurance plan to decide how long children could be covered.  Now, a dependent can be enrolled long enough to give him or her time to establish their own means for paying for a medical insurance plan.

A parent’s plan can be an inexpensive way to access health insurance since many employers subsidize the cost of children on a plan.  If another child is already enrolled, then there usually is no extra cost to add another.

Health Insurance Marketplaces

Obamacare established health insurance marketplaces, online sites designed to help individuals and small businesses access health insurance with ease.  The marketplaces, also called exchanges, will offer 4 levels of plan design from various health insurance companies.  The exchanges are the responsibility of each state, and some states have built their own exchange.  Some others are sending their residents to a federal exchange.

If someone does not have coverage offered at work, earns less than 400% of the federal poverty level, and purchases insurance on the exchange, they will be eligible for tax credits to help offset the cost of the premium.

Individual Insurance

If group insurance and the health insurance marketplaces are not a viable option, there is still the possibility of finding individual insurance on your own.   There will be some legwork involved, as it is not necessarily easy to sort through plan designs from different companies.  However, you will have more options as to which level of insurance plan you would like than you will on the exchange. The coverage bar required to satisfy the individual mandate is not very high, and you can find plans that meet the requirements at a low price, albeit without much coverage.

If you do not want to find individual insurance on your own, you can hire a broker to access health insurance for you.

Medicaid

Before 2014, it was hard for adults in many states to qualify for Medicaid.  However, Obamacare expanded Medicaid to make it much easier to be eligible for assistance through this program.  Like the exchanges, Medicaid is administered through the states, so check with your state’s Medicaid office for more information.

No Pre-Existing Condition Exclusions

Being able to access health insurance is much easier post-2013 than it was before due to the fact that insurance companies cannot deny coverage to people due to pre-existing conditions.  This has made it less complicated to find a quality plan at a reasonable price.

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What are the Best Health Insurance Companies for You?

Purchasing medical insurance is not always an easy task.  Trying to decipher between the best health insurance companies takes time and an understanding of what makes a good benefit plan.  Between the different plan designs and carriers available, finding the right fit for you and your family is not an easy decision.

With the requirement that all Americans have health insurance or else face a fine/tax, there will be many people looking for the best place to buy coverage for their medical services.  Here is what to look for when searching for the best health insurance companies.

A Network That Includes Your Doctor

Most health plans now include networks of doctors and facilities.  These networks offer competitive pricing for medical services through discounts and less out of pocket expenses for the policyholder.  If a provider is not in the network of your insurance plan, you will be required to pay more out of pocket through the health insurance plan.  Plus, the doctor or facility can balance bill you, meaning they can bill you for charges not paid through your insurance plan.  Whether you use Blue Cross Blue Shield, Aetna, Cigna, United Healthcare, or any other of the multitude of health insurance companies, if you use a network provider, what you pay through your benefit plan will be all you owe.

The networks of the best health insurance companies can be investigated on their websites.  Before signing up for a plan, make sure your doctor, hospital, lab, etc. are included in the potential network.

Great Customer Service

Since medical and prescription drug insurance plans are not the easiest contract to understand, you will undoubtedly have a question about your plan or how a claim was processed.  The best health insurance companies will have a friendly and helpful customer service.  This customer service should include an understanding of how your plan, and insurance in general works.

Sometimes, a claim will not be paid the way you think it should.  The insurance company should give you an option to appeal, and if the appeal goes against you, they should be able to provide you with a clear explanation of why.

Mobile Apps

One of the services that the best health insurance companies are now incorporating into their services are mobile apps.  These apps allow individuals and families to keep track of their claims, how much they owe for medical services, and how much they have paid out of pocket.  The apps are free and easy to use.

Great Coverage

Before you fall in love with an insurance plan that has a great premium, make sure that it has all of the necessary coverage for your medical needs.  The Patient Protection and Affordable Care Act, also known as Obamacare, requires minimum coverage in order to avoid the individual mandate penalty, but the minimum coverage isn’t a high bar to reach.  Because of this, some companies are offering inexpensive plans that do not cover much.  The best health insurance companies will give you a great price with great coverage.

Low Premiums and Renewals

The saying “you get what you pay for” definitely applies in health insurance.  However, that does not mean that you should ignore the premium.  If you find a few plans that meet your medical needs and offer great customer service and networks, then by all means, factor in the premium.  That’s what competition and the health insurance exchanges are all about.

Also, the best health insurance companies will not offer a low initial premium only to follow it up with a high renewal.

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