According to the health care advocacy group, Families USA, during the pandemic, more than 5 million Americans have lost their employer-sponsored health plans. Living through a pandemic has shown us the importance of having health care coverage during unforeseen circumstances. The Open Enrollment Period begins on November 1st and is for anyone looking to make a change to their health insurance coverage, whether through their workplace or the federal market. This includes looking for a cheaper plan with similar coverage, gaining coverage if you previously had none, or changing your coverage altogether to better meet your needs. Before rushing a decision to meet the December 15th deadline, take some time now to review your coverage.
Tip #1: Assess Your Current Costs
When thinking about changing your health insurance plan, it’s important to reassess your healthcare-related expenses. Take a look at how much you’re currently paying per month for your plan as well as the out-of-pocket expenses you paid over the past 12 months. Unless you foresee major health changes in the coming year (such as pregnancy), this could be a helpful indicator when it comes to determining if you should have a plan with a higher or lower deductible.
Tip #2: Choose Your Marketplace
If you have the option to gain coverage through your employer, this will likely provide you with the lowest premiums. If your employer does not provide healthcare coverage, you can obtain coverage through the federal or state marketplace. To apply, visit Healthcare.gov, which will redirect you to your state’s marketplace (if applicable). While premiums are likely to be higher, you may be eligible for premium tax credits to help offset the monthly cost.
Tip #3: Decipher Your Available Plan Options
Health Maintenance Organization (HMO): HMOs tend to have lower monthly premiums and out-of-pocket costs. You are limited to seeing providers in your network, and it must be coordinated by your primary care provider (unless it’s an emergency). This gives you less overall flexibility.
Preferred Provider Organization (PPO): PPOs offer more freedom when it comes to choosing healthcare providers and specialists. You can see doctors outside of your coverage network, although this will typically result in higher out-of-pocket costs. Additionally, you will not need a referral from your primary care provider to make appointments with specialists. Out-of-pocket costs and premiums tend to be higher for PPO plans, especially when compared to an HMO.
Health Savings Accounts (HSA): If you enroll in a high deductible health care plan, you could have access to contribute to a Health Savings Account ($3,550 for individuals; $7,100 for families in 2020). Your HSA contributions are tax-deductible; the earnings in your account grow tax-free; and you can withdraw funds from your HSA, tax-free, as long as they are used to pay for qualified health care expenses.
Tip #4: Account For Your Current Health Providers
When comparing plans, check whether or not your current doctors are in-network. If they are, you should have no problem continuing to see them as you did before. If they are out-of-network, you will either have to find a new provider or prepare to pay more for every visit.
Selecting the right health insurance plan can feel daunting, confusing and rushed. Reduce the stress and headaches of choosing the right coverage by understanding the type of plan that is suitable for you. When enrollment begins, you will be prepared to make a decision that’s right for your healthcare needs.
The legal and/or tax information contained herein is general in nature, is provided for informational purposes only. Please consult your tax professional on how you could be impacted specifically. Zenith Solutions LLC is not engaged in the practice of law, tax, or accounting. This content is developed from sources believed to be providing accurate information, and provided by Twenty Over Ten. It may not be used for the purpose of avoiding any federal tax penalties. Please consult legal or tax professionals for specific information regarding your individual situation. The opinions expressed and material provided are for general information, and should not be considered a solicitation for the purchase or sale of any security.
