Rowan Rey Sutherland 
Whether you are comparing plans offered by your employer or buying an individual insurance plan yourself please take full advantage of this information as it could save you big bucks during the open enrollment and allow you to select a good health insurance plan for the entire year!
Health care in the United States has its merits and flaws, however, it is a no-brainer to me that everyone really needs to have a health insurance plan. If you don’t have a health insurance plan, that could be a financial risk for obvious reasons.
So, let’s go over 10 important things to look for when choosing a health insurance plan:
- First of all, mark your calendar with the dates when the Open Enrollment is active in your state. This is the only time when you can apply for health insurance unless you qualify for a special enrollment. In most states, the open enrollment starts in November and ends in mid-December. Although, many states have extensions and open enrollment lasts longer. In California, the open enrollment lasts 3 months from November 1 through January 31.
If you are offered employee benefits at work, check with the HR department when is the specific open enrollment at your company.
- Make sure you check if you qualify for an advance premium tax credit. You will be surprised how many people lose on this opportunity and don’t take full advantage of a subsidy offered via exchanges. For example, if you reside in California and your income for a family of 4 is around $160k per year you can
still qualify for a lower monthly premium.
I have separate videos on this topic where I discuss in detail the plans, so feel free to check it out! Besides, the American rescue plan allows many individuals who never qualified for any
subsidies or discounts, to qualify for the first time for a reduction in their health insurance premium.
- Video illustrating how much a family of 4, making $157,000/year pays for health insurance– https://youtu.be/a8Qxa4599aI
- PPO or HMO?
PPO’s are preferred provider organizations. Typically the PPO health insurance plans are more expensive, but those would allow you more flexibility. Specifically, with a PPO plan you are not required to select your primary care doctor, you can go to any specialist without an appointment and you basically can go to any doctor, though you will pay less if you see in-network providers. HMOs are a bit cheaper but with the HMO, you will have to stay in-network for care, select a primary care provider and get referrals to see specialists. In any case, it makes sense to look at various health plans before you decide to purchase a specific one.
- You can read more about PPO, HMO, EPO, and POS plans on our blog.
- Estimate your real costs!
Even though getting a basic bronze plan with a high deductible seems smart for someone that is low risk and rarely sees a doctor, it is wise to look at your specific situation when determining whether a bronze, silver, gold, or platinum plan will work best for you!
Definitely run a side-by-side comparison of various plans and ask yourself: How high are the monthly premiums? What are the copayments?
How high is the deductible?
What plan would make the most financial sense to get?
If you need help with this comparison, feel free to reach out to us. This is exactly what I have been doing for the last several years and have helped many individuals save money on their
healthcare while choosing the best medical insurance plan. I am licensed and certified and by law, I am not allowed to charge anything for my services and your premium will not be higher if you work with me. So, basically, I am offering qualified free help at no extra cost.
If you are interested to speak with me and get a side by side cost comparison of medical insurance plans available in California, feel free to reach out or requesting a Calendly appointment on my website:
https://insurancecenterhelpline.com
- Understand the restrictions!
When buying a health insurance plan you will have to understand that certain things are not covered by medical insurance plans. For adults’ dental and vision insurance is not included in a medical plan, so if you need it you can add it separately. Also, cosmetic or alternative medicine is not covered by a medical insurance plan. So, if you are buying health insurance in order to cover your massages, well – you will be disappointed- those are not covered by a medical insurance plan in the US.
- Make sure you look at a major medical insurance plan and not as some sort of disability or another type of plan that is not considered insurance by law.
- Do not leave your phone number online for salespeople to call you about health plans. This is not a good idea. If you are looking for health insurance quotes online and had to fill a quote form or an application – you know what I am talking about. Please do yourself a favor and don’t’ do this. Most of these cold calls come from people that don’t even have a license and will hard sell you something that might not work! Instead, look for an independent licensed insurance agent in your local community who can help or go directly to the official exchanges to run quotes
yourself, but never give away your phone number and email online and get hundreds of phone calls.
If you don’t have a licensed and independent insurance agent, feel free to reach out to us! We can help!
- Check with your employer and see if they provide employee benefits that include health insurance. Most employers offer a generous package to their employees that include medical insurance, dental, vision, pension plans, life insurance as well as other perks!
If you are offered a plan at work, make sure to take advantage of that offer as these are typically pretty good and the employer is required to cover at least 50% of the cost.
- If you are a business owner or run a small business perhaps you may look into the possibility to offer yourself and your employees a health insurance package. There are certain requirements and not all small businesses qualify for group insurance, but if you are a small business owner you may want to check the requirements in your state or reach out to a certified insurance agent who can help with group health insurance for your corporation.
If you are self-employed you can still take some tax advantages and save 100% on your health insurance premiums. You may check out with your accountant to see if you qualify.
- And since we are talking about tax advantages definitely look into the HSA plans. These are the health savings accounts that allow you to set aside money on a pre-tax basis to pay for qualified medical expenses.
In order to open an HSA account by IRS rules, you will have to show proof that you are enrolled in a high deductible health insurance plan. You can’t use the money from the HSA account to pay for monthly premiums, but you can use it to pay for copays,
coinsurance, deductible, and remember – these are pre-tax money!
There are rules and restrictions related to the qualifications of the HSA accounts so do some research and see if these would work best for you!
More details: www.InsuranceCenterHelpline.com
