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5 Ways to Choose the Right Health Care Coverage

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Finding the right health care coverage every year is no small feat if you don’t have access to an employer-sponsored health insurance plan. Not only does the plan need to provide enough coverage, but it also needs to be affordable. No one likes to bust their budget with the cost of monthly premiums.

Woman talks to her doctor about how to choose the right healthcare coverage.

If you’re on the hunt for healthcare coverage in 2018, now is the time to enroll in a new plan or make changes to your current one. Open enrollment for Obamacare plans start on Nov. 1, 2018, and remains open until Dec. 15, 2018. Get covered by following these five tips to help you make the right choice.

1. Find the best value.

When looking for a health insurance plan, it’s important to do your research. But as you peruse the options, don’t be tempted to just choose the plan with the lowest monthly cost.

That may seem like a great option at first, but when you need to use your insurance, the out-of-pocket cost will likely be much higher than expected.

To see the real cost of your health care coverage plan take a look at the Annual Cost Summary provided by the insurance company. Included in the summary are three ways to think about how much your plan will cost over the year.

  • The listed minimum cost is the amount you will pay for the plan if you don’t use any health services during the year.  It’s your monthly premium x 12 months.
  • The estimated likely cost is your minimum cost (12 months of your premium) plus the amount you will likely pay for doctor’s visits, hospital stays, medications, etc.
  • The maximum possible cost is the estimated amount you will pay for the plan and health care services if you get very sick or have a serious injury.

While it’s tempting to pick a plan based solely on the premium, consider the total cost before making your final decision. That way you know what your true financial responsibility is and can avoid any surprises later.

2. Give yourself plenty of time.

Start shopping well before the deadline to allow yourself enough time to find the plan that’s right for you.  If you are enrolled in a plan from last year, hold off on automatically renewing it. There’s a chance new plans are available in your area that could save you money.  Ask yourself these questions as you determine what plan is the best for your situation.

  • Is your preferred doctor in the network?
  • Are your prescriptions covered, or what will your out-of-pocket cost be?
  • Can you afford your estimated likely cost?
  • Are you eligible for a subsidy?
  • Have your healthcare needs changed in the past year?

3. Use a lifeline.

Decoding unfamiliar insurance terminology and analyzing numbers can be confusing for anyone.

Fortunately, there are a variety of resources to help you navigate the Marketplace. You shouldn’t have to guess when making choices regarding your health care coverage.

Find the people or organizations in your community that are trained to answer your questions and help you enroll. Seeking help will ensure you make an educated decision and choose the right health care coverage.

4. Check to see if you are eligible for a subsidy.

A tax subsidy helps offset the cost of something. And, when it comes to individual health insurance plans, there are two subsidies available through the federal government.

  • The Advanced Premium Tax Credit lowers your monthly premium.
  • Cost-sharing reduction lessens the out-of-pocket costs you pay for health care services received during a policy period. That includes your deductible, coinsurance, and copays.

The subsidy amount you are eligible to receive is based on three different factors. The first is your anticipated household income for 2018, and the other two are the size of your family and the cost of health insurance where you live.

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5. Know the deadlines.

Open enrollment through the Marketplace is shorter this year than in previous years. If you want coverage to start Jan. 1, 2019, you must enroll by Dec. 15, 2018, unless you qualify for a Special Enrollment Period.

You’re eligible for the Special Enrollment period if you experience certain life events, like getting married, having a baby, or losing other health coverage.

If you plan to apply for Medicaid or the Children’s Health Insurance Program (CHIP), you can do so at any time during the year.

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