how to choose a health insurance plan with open enrollment drawing to a close, anybody who wants...
TRANSCRIPT
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How to Choose a Health Insurance Plan
With open enrollment drawing to a close, anybody who wants health insurance must enroll by February 15, 2015.After February 15th, you can enroll in or change plans for 2015 only if you qualify for a Special Enrollment Period (60 days following certain qualifying life events). I created this step-by-step, power point presentation, to explain the steps and consideration I used, when choosing a health care plan.
Brought to you by Jennifer Albach RN, CCM, LNCC @ www.MedicalRecordsReviewSpecialists.com
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Since I don’t meet the criteria to qualify for a subsidy, I’ve gone to the open market for an individual insurance plan. Humana is my choice, for my geographic area and my insurance needs. I encourage everybody to do your own research to find a carrier best suited for you and your needs. Before choosing a carrier, be sure to check their provider network, to ensure your doctors are within their network.
If you are eligible for a subsidy through the Affordable Care Act, do not apply here. You must apply through the exchange to take advantage of any eligible subsidies.
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Here are the 3 least expensive, individual plans I could find. First look at the monthly premium vs the deductible
* The deductible is the amount you pay out of pocket before your insurance carrier pays their share
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When comparing these 3 plans, you can see one plan requires co-payments, even after the deductible is met
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The Maximum out-of-pocket is the total amount of annual health care costs you are responsible for, after paying your premiums.
Notice the lowest-deductible, highest-premium plan, does not have the least out-of-pocket expenses.
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Most health insurance plans require you to meet your deductible, before any benefits are payable.
This plan provides some coverage for sick visits before having to meet your deductible
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Look for those hidden extras. This plan pays up to $300.00 for labs and x-rays, before you are subject to the deductible.
* It’s these changes to the deductible for different services, that disqualify this plan from being HSA qualified.
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Beware of hidden costs. Even after meeting your deductible, some plans require additional co-payments.
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All qualified health plans cover preventative medicine at 100% and the deductible is waived.
Preventative medicine includes screening exams, such as mammograms, physicals, pap smears, colonoscopies, etc
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Another thing to consider is your prescription needs. This plan offers coverage for Tier 1 drugs, with a $ 20 co-payment and no
deductible.
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All three plans offer in-network and out-of-network coverage. You can choose any provider for treatment, without a referral.
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This is the only plan, out of the 3, which qualifies for a Health Savings Account or HSA.
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What is an HSA?Why is it important?
An HSA is a health savings account that offers tax breaks. • You do not have to pay income tax on your contributions. • The money grows tax-deferred. • The funds can be withdrawn tax-free for medical expenses. * Not all health plans qualify to pair with an HSA.
According to Kiplingers; If your policy has a deductible of at least $1,300 for individual coverage and $2,600 for family coverage in 2015, you may be eligible to contribute to an HSA. But not all high-deductible policies are HSA-eligible. The policy must also make everything subject to the same deductible (other than preventive care, which must be covered by all health plans without any deductible or cost-sharing). Some plans, for example, aren’t eligible because they have a separate deductible for prescription drugs. Ask your insurer if the plan is HSA-eligible; plans aren’t always clearly marked, especially on the state exchanges.
You can contribute up to $3,350 if you have individual coverage or $6,650 if you have family coverage in 2015, plus up to $1,000 if you’re 55 or older anytime during the year. Your contributions are pretax if made through your employer or tax-deductible if you’re on your own, and you can use the money tax-free for medical expenses in any year.
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Why an HSA could make sense for you$6,650.00 is the maximum annual contribution you can make to an HSA, if you have a qualified, high-deductible, family plan.
Let’s take a look at the potential tax savings.$ 6,650.00 X 25% (US tax bracket for married filing jointly with an income of $73,801 to $148,850)
$ 1,662.50 Your annual, income tax savings
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Ultimately, I chose the plan with the HSA. By utilizing a plan with an HSA, the tax savings more than offset the higher
premium. If I utilize the full, income-tax savings with my HSA, I will save nearly $400.00/year, with a $300-$600/year lesser
deductible.