Tip #1 – Sign up to save
Insurance provides financial and medical protection in the event of a serious injury or illness. Insurance can protect your health and help you avoid financial hardships, such as debt, bankruptcy, or even death.
Private health insurance is available if you do not have insurance through your employer, spouse, parents or other sources. Pre-existing medical conditions could have resulted in people being denied coverage or paying high premiums. Today, private health insurance can be purchased through the Health Insurance Marketplace.
It is the best way for you to plan for a healthy financial future.
Tip #2 – Don’t miss your deadline
Open enrollment is when the Health Insurance Marketplace accepts new applications for health insurance. Open enrollment occurs every year between November 1 and January 15.
Tip #3: Find a health plan that best suits you.
Consider these things when you are looking for a health plan.
- What are my family’s most pressing needs in terms of health care?
- Who is currently healthy? And who will need more care in coming years?
- Do you have any plans for a pregnancy or surgery?
- Are I satisfied with the current plan? Is there something missing?
- What was my total health insurance spending last year? Do you expect this amount to change in the next year?
- How much should I spend on my monthly health insurance?
With your family and those you care about, discuss the answers. A plan built around your values will help you plan for the future.
Tip #4 – Change or renew your current plan
Open enrollment allows you to renew your plan or change it without having to have a qualifying life event. Open enrollment is a great time to reflect on your current insurance benefits and make suggestions for improvements.
It doesn’t matter if your income has increased, someone has left their job, you have a new family member or not, it’s time to review all options and choose the best plan for you. Advocate Health Care gives you easy access to compassionate caretakers, the latest medical technology and world-class, personalized care.
You are happy with your plan, and want to renew? Make sure that your current insurance plan still exists. You have two options: you can shop outside the market or choose a new plan if your existing plan is no longer offered. You won’t get government subsidies if your health insurance is purchased outside the marketplace.
No matter what plan or where you purchase it, choose a plan that is designed with you in the mind. Advocate Health Care is included.
Tip #5 is to only shop for insurance that covers health.
The Health Insurance Marketplace can only be used for private insurance. Marketplaces are not available for life insurance, long-term insurance, or any other type insurance.
Medicare is another type insurance that is not available through the Health Insurance Marketplace. You can apply or renew Medicare benefits if you are eligible for Medicare.
Medicare alone might not be sufficient to cover your medical expenses. To ensure that you receive the best care, you can add Advocate Health Care to your Medicare benefits.
Tip #6. Go for the Platinum (or Bronze, Silver, or Silver plans).
You can choose from four types health insurance plans on the Health Insurance Marketplace. They are:
Bronze- This plan provides the lowest monthly premiums, but the highest out of pocket care costs. Bronze plans are good options if you are looking for coverage for catastrophic events, such as an accident or life-threatening illness. Remember that routine care will most likely need to be paid out-of pocket.
Gold – Gold plans have a moderately high monthly premium and a deductible that matches. Although you will pay slightly less per month than you would with a Bronze policy, your out-of-pocket expenses will be lower.
Silver – An option for those who can afford a higher monthly premium but want to have lower out of pocket medical costs, the Gold plan might be a good fit. The Gold plan is recommended for those who are likely to visit a lot of doctors in the next year.
Platinum – platinum plans have the highest monthly premiums but the lowest out of pocket expenses. Platinum plans will help you reduce out-of-pocket costs if you require frequent medical care.
Every plan offers the same essential health benefits: hospitalizations, emergency cares, rehabilitative services and lab tests. Prescription drugs, lab testing, laboratory tests, pediatric care and preventive care are all included. Treatment for mental disorders and substance abuse is also covered.
Insurance covers many preventive services 100%, regardless of which plan you choose. You can have wellness check-ups, screening colonoscopies, and regular screening mammograms without having to pay any extra. After your year-end out-of pocket maximum has been reached, the insurance company must cover any medical expenses that exceed it.
There are four main differences between these plans: How much your insurance company will pay you, how much monthly premiums you have to pay and how high your maximum deductible.
Advocate Health Care will be included in your plan, so you can access world-class healthcare at your fingertips.
Tip #7. Consider a High Deductible Plan
HDHPs are high-deductible health plans (HDHPs), which aim to keep monthly premiums down. The monthly premiums for Bronze and Silver plans on the Health Insurance Marketplace are typically lower than those for other plans. You will need to pay more for out-of pocket costs if you do get care.
HDHPs are cheaper than traditional insurance plans and have a higher maximum deductible. It means you will have to pay a minimum out-of pocket amount before insurance kicks in.
How It Works
Once you have met your deductible, your insurance will kick in and the company will begin paying coinsurance. The insurance company will pay 100% of your healthcare costs after you have met your deductible. The majority of HDHPs have an 80/20 policy. After you meet your deductible, they will pay 80%. You are responsible to pay the 20% remaining.
You will continue paying 20% until the out-of-pocket maximum is met. This is the maximum amount you could pay for health insurance in a calendar. The insurance company starts paying 100% of your medical costs once you have reached that maximum.
Real-World Example
Let us say that you have chosen an HDHP with the following features:
- Minimum $2,000
- 80/20 coinsurance
- Maximum out-of-pocket expenditure: $4,000
The monthly premium would be low for that plan. The out-of pocket fees for doctor visits, urgent care visits, laboratory tests, and other types of non-preventive care would be higher.
Each health care visit you pay would add up until your $2,000 deductible. Your insurance company would then start paying 80% of all your health care costs. The remaining 20% would be yours until you reach $4,000.
A $3,000 doctor’s bill would cost you $2,200. $2,000 for your deductible, $2,000 to pay $200, and then 20% of any $1,000 balance.
A $12,000 doctor’s bill would cost you $4,000, $2,000 to meet yourdeductible, 20% of the remaining $10,000, or $2,000.
A $200,000 doctor’s bill would still be $4,000, as that’s your annual out-of pocket maximum.
As you can see the monthly premium and the deductible are not the only costs associated an HDHP. Also, you need to think about the initial out of pocket costs and coinsurance. This is how much the insurance company pays once you have met your deductible. The out-of–pocket maximum is the maximum amount you could pay in a given calendar year.
A high-deductible insurance plan may be right for you if your health is good, you don’t have any major future health concerns, and you are not planning on any major surgery.
These plans may be worth considering. You might also want to set aside money for an emergency fund or a savings account (HSA), which can help you cover out-of pocket costs.
Ready to buy an HDHP Select one that includes Advocate Health Care.
Tip #8: See if you qualify
Tax credits or subsidies may be available to offset the cost of private insurance if you cannot afford to purchase healthcare insurance from the Healthcare Marketplace.
The income of your family, as well as the size of your family, will affect your eligibility for tax credits. These credits may be used to lower your monthly premiums or refund your taxes.
Additional to tax credits, you might be eligible for a reduced cost health insurance plan or for the Medicaid program in your state based on your income.
If you have difficulty finding affordable health insurance or are worried about your ability to pay for medical care, we can help. Find out more about our financial aid options.
Tip #9 Choose the right network
In-network can be used to refer to a group of providers with whom your insurance company has agreements. Your insurance will usually cover more of your expenses when you are in-network, and your overall health care costs will be lower.
If you decide to visit a hospital or doctor outside your network, you are more likely to be charged higher out-of–pocket fees than if you were in-network. It’s important to remain in-network, and to choose the right network.
Advocate Health Care will be available to you if you select a health plan that includes Advocate Health Care.
- The top U.S. hospitals
- Physicians and healthcare providers who are known for their medical innovation and excellence.
- Best-rated specialty programs and clinics
- Nearly 400 care sites and 12 hospitals are located throughout Chicago.
- Flexible appointment times available for evening, weekend and online appointments to suit your lifestyle
Tip #10, Take the best care of yourself
If you choose the right insurance plan for you and your network, you will have access to a high quality healthcare system. This includes the best doctors, hospitals, and the most advanced care options.
If you are looking for the best health care system, then this is where to look:
- See customer ratings. How do others rate the quality of the care they received?
- Advocate was recognized for his clinical excellence and medical innovation.
- Search for convenience. Nearly 400 sites of healthcare and 12 hospitals are located close to your home.