Picking the Best Health Insurance for 2015

Insurance companies use these different types of charges — the premium vs. the deductible, for example — sort of like dials to keep their own costs manageable. A basic plan they sell might dial down the monthly premium on a particular plan, so it looks inexpensive. But that same plan might have a high, “dialed up” deductible of, say, $6,000 — meaning you’ll have to spend $6,000 out of your own pocket on health services each year before your insurance begins to pay its portion of the cost. If you picked that plan, you’d be betting you won’t have to use a lot of health services, and so would only have to worry about your — hopefully affordable — premiums, and the costs of a few appointments. But even if your premium is being taken out of your paycheck each month, don’t forget to factor in the cost. Online marketplaces usually provide a link to the summary of benefits, which explains all the plan’s costs and coverages.

Most of the employers still cover family members, but 29% of the employers surveyed plan to apply a premium surcharge for spouses who are offered health coverage through their own employers. If your employer offers health insurance, you won’t need to use the government insurance exchanges or marketplaces, unless you want to look for an alternative plan. But plans in the health insurance marketplace usually cost more than plans offered by employers. This is because most employers pay a portion of workers’ insurance premiums.

• If you’re eligible, choose a plan through your job, Medicaid or Medicare.
• A basic plan they sell might dial down the monthly premium on a particular plan, so it looks inexpensive.
• The median deductible for 2015 will be $1,000 for employee-only coverage and $2,325 for family coverage, and employees will pay a median of 20% of the premiums for themselves and 23% for their families.
• Average monthly cost for a 40-year-old buying a Silver health insurance plan.
• The policy with the lowest premiums may cost you more when you start to use the coverage.
• Employers are improving their tools to help you understand the cost of your health care choices.

Affordable coverage is adequate and won’t stretch your budget; a cheap policy will save you a lot of money but might not protect you when you need it to. If you’re shopping in the Affordable Care Act marketplaces, however, the number of choices can feel overwhelming at first. In Austin, Texas, “we had 76 plans to review with clients,” says Aaron DeLaO, director of health initiatives with Foundation Communities. Open enrollment for individual health insurance ends on February 15, 2015, but you may be eligible to buy a new policy after that if you’ve experienced certain life changes. Find out what to look for when choosing the best policy for your family — whether you have coverage through your employer or are buying a policy on your own. Most state exchanges are adding one or two new insurers in 2015, and some are adding even more.

• And you may have to pay a penalty or higher premiums if you don’t participate.
• Affordable coverage is adequate and won’t stretch your budget; a cheap policy will save you a lot of money but might not protect you when you need it to.
• Find out how to deal with these changes when you use your policy.
• In order to compare the true overall cost of health plans and figure out which one might work best within your budget, you need to get familiar with several important insurance terms — words like premium, cost-sharing, deductible and copay.
• The bad news is that the “open enrollment period”—the period of time when people can enroll in a health plan through the above-mentioned marketplaces–for 2015 just closed for most people.
• One way to keep your plan within your budget is by paying attention to the type of company you’re buying from.

(EPOs typically don’t require a referral, but some do, so read the fine print.) An EPO may help keep costs low as long as you find providers in-network; this is more likely to be the case in a larger metro area. A PPO might be better if you live in a remote or rural area with limited access to doctors and care, as you may be forced to go out-of-network. More provider options and no required referrals, but higher out-of-pocket costs. Here’s a start-to-finish guide to picking the best health insurance for 2015 help you find affordable health insurance, whether it’s through a state or federal marketplace or through an employer.

Do you like your current doctor?

Some charge spouses extra if they could have gotten coverage from their own employer, and 9% of employers don’t cover those spouses at all. Employers may even give their own employees a bonus for choosing to get their coverage elsewhere. You can get health insurance through work, on the marketplace or outside of the marketplace. The kind of health insurance you buy depends on whether you have access to an employer-sponsored plan, your age, your location, your family structure and your health care needs, among other things. If you have a choice of plans, estimate your out-of-pocket costs for your drugs and dosages.

Look for a summary of benefits

If you earn more in 2015, you may have to pay back some of the extra subsidy when you file your 2015 tax return; if you earn less, you may qualify for a larger subsidy. The size of your subsidy is likely to change anyway because it’s based on the premiums for the second-lowest-cost silver plan in your area, which is generally a bit different than it was in 2014. You can use the calculator at the Kaiser Family Foundation to estimate your after-subsidy costs based on your age, zip code, family size and income. But you’ll need to go to your state’s site to change the income you report to the marketplace. Compare the levels of coverage for the health insurance plans that your job offers. Most people should get a midtier plan that balances the cost of the plan with its medical coverage.

How to compare health insurance plans

“The bad news is that you may have to pay 30% to 50% coinsurance. You want to make sure you know where the drug is covered and how it’s covered.” Some insurers require you to try a lower-cost drug first, or have your doctor fill out detailed preauthorization forms. When comparing your options, consider not only premiums but also deductibles and coinsurance for medications and other health care. Check whether your doctors and other providers are included in the network, and add in the value of any incentives, such as contributions to an HSA. You may have more options this time; 77 insurers will be selling policies on the health insurance exchanges for the first time in 2015, a 25% increase from last year. Some big insurers that only dipped their toe in the exchanges in 2014 will bump up their presence significantly.

Step 4: Compare costs

Different families have different policy needs, so make sure you get all the relevant details before purchasing. Choose a plan that gives you convenient access to medical care, including any specialists you regularly see. Also, choose a plan that covers the specific prescriptions you take. This can help you stay with the exact medication that works for you, rather than having to switch to something similar. Most people get health insurance through their job, which usually provides the best coverage at the cheapest price.

The biggest surprise many people had as they started to use their policies in 2014 was that their doctors weren’t included in the plan’s network – even if they were covered by the insurer in the past. Many insurers had several versions of their policies on the exchanges, some with lower premiums in exchange for smaller provider networks, a trend that is likely to continue for 2015. After you’ve narrowed your options, contact both the insurer and your doctors to make sure they’re in the plan’s network.

Holdout States Haven’t Expanded Medicaid, Leaving 2 Million People In Limbo

How you shop for health insurance will depend on what’s available to you. Whether you get coverage through your employer or buy it on your own, use our strategies to make smarter choices during open enrollment. QuoteWizard.com LLC has made every effort to ensure that the information on this site is correct, but we cannot guarantee that it is free of inaccuracies, errors, or omissions.

If you’re at all confused about this sometimes-convoluted process, don’t fret, as the following 11 questions should help you come to some useful conclusions regarding which plan or plans may be the best for you given your current situation. Actually, it’s a good idea to take another look at your health plan even if you are pretty happy with it. It’s possible some aspects of your current plan will change between now and when the next open enrollment period begins late this fall.

But you won’t be eligible for premium tax credits or subsidies to help with the cost. Consider the coinsurance payments, which are your share of the costs related to a specific healthcare service after you’ve paid your plan’s deductible. Another is copay, which are the fixed amount you pay for a particular service, such as a doctor’s office or emergency room visit, you’ll be responsible for should you pick one plan over another. An important piece of advice to share here is to not focus on just the premium or deductible you’ll have to pay for a health insurance plan.