It’s open enrollment season — are you ready?
Probably not. The market just opened today, and you have three months to look over the health insurance plans and sign up — but that time will fly by if you procrastinate. Doing your homework on your insurance options requires time, effort, research, and stress. You’ll almost certainly experience shock at the price increases this year — and you may need to do some number-crunching to know how you can afford to keep yourself and your family insured.
Companies with low premiums may offset their costs through exorbitant copays, prescription drug prices, and out-of-network costs.
In some cases, it may just be cheaper to pay the penalty for skipping out on insurance altogether.
Others opt for nontraditional, temporary insurance plans without all of the Obamacare market protections. Health-sharing ministries may start to look more appealing to the desperate customer. But no matter what you decide, it’s going to be expensive.
Here are some tips to make the most of the open enrollment period.
1.) Look further than the premium cost.
A low monthly premium might seem like the automatic choice for insurance — but keep in mind, premiums aren’t the only way insurance companies make money. Companies with low premiums may offset their costs through exorbitant copays, prescription drug prices, and out-of-network costs.
“For these plans that keep the premiums low, most doctors are not covered in the network,” said one policy analyst.
“One of the big challenges is that for these plans that keep the premiums low, most doctors are not covered in the network,” said David Barnes, policy director at Generation Opportunity in Arlington, Virginia. “So you want to make sure that if you have a doctor you really like, he or she is covered in the network.”
On the other hand, Barnes said, if you don’t have a special relationship with your doctor and don’t mind switching, a lower premium plan with fewer in-network doctors might work better for you — especially if you keep your health expenses to a minimum. Just bear in mind you might have to commute a lot further to find an in-network physician. And if you decide to go out-of-network, you’ll get socked with big bills.
2.) Use the website tools.
David Barnes has used healthcare.gov every few months for the last four years as part of his work. “It is much, much better than it was in 2013, when I tried logging in on Day 1 and it was broken. It works fine. You can go through and check all the different options. It’s a pretty intuitive process,” he told LifeZette.
The website has a subsidy calculator; you can plug in your taxable income and see the subsidies you qualify for. Another feature allows you to compare plans, including premiums, deductibles, copays, and other costs. Overall, Barnes said, you can trust the website’s tools to work.
3.) Get free help from insurance navigators.
The Affordable Care Act provides communities with paid navigators who can help walk you through the enrollment process. The healthcare.gov site has a feature to help you “find a navigator,” and plugging in your zip code will take you to your state site. That will then lead you to a navigator in your area. These people are trained on how to help you find the best insurance fit for your family and your needs.
4.) Don't assume your current plan is the best plan.
Shop around for what other plans have to offer; make sure you know all your options. If this is your first time on the exchange, take your time and know what is available. If you've been on the exchange before, Barnes suggests you look for a new plan: Your old one has probably been canceled amid all the other changes this year.
5.) Keep your eye on other options.
If you don't have any medical issues on the horizon, look at other options. "Mini clinics" are cropping up at various locations and can take care of minor medical problems. For example, if your child develops an ear infection, clinicians at Walgreens or CVS can diagnose the problem and prescribe medication. These clinicians can help with minor illnesses, minor injuries, screenings, skin conditions, vaccinations, and some women's services. The total cost for a visit to one of these clinics is usually around $50 and could be handy in a pinch.
If you choose to forgo insurance this next year, remember that you'll probably have to pay the penalty fee.