Once you get registered on the federal or state ACA site, some tips:
The work really begins at that point. It's time to review the health insurance policies available to you. That's more or less complex, depending on where you live. But, it's a tedious step you need to take carefully. For most people, you'll have a choice from a bunch of different possibilities put into four categories, Bronze, Silver, Gold, and Platinum. Here's sort of how they break down:
Bronze - Lowest monthly premium, but largest deductibles and percentage of care you pay for as a co-pay. The low premiums may sound great, but look at what will happen if you need healthcare. With a bronze plan, you'll still get the free preventive care stuff that is common to all plans, but if you get sick, you'll have to spend a lot of your own money before your deductible is met and you'll have to pay a larger percentage of the bill once it has been met. If you're young, healthy, and don't do any risky things in your life, like commute long distances by car or engage in risky sports or other activities, a bronze plan may work well for you, keeping your premiums low. But, think carefully before opting for one of these plans. Look at the risks you might face if you do have a serious medical issue, and look at how that would affect you.
Silver - Slightly higher premiums, but somewhat lower deductibles and co-pays. Like the Bronze plans, look at these carefully and weigh the benefits of the lower premiums against your risk of needing medical care over the next year. Look at those things very honestly and consider all possible risks. If you're a woman, for example, think about a possible pregnancy. If you're a person who engages in risky activities, keep that in mind. For some younger people who have good jobs and substantial savings, a Silver plan might be an excellent bargain, but don't stop there. Look at the God and Silver plans, too.
Gold - These plans have reasonable deductibles, probably in line with your current health insurance, if you have it. Premiums are, again, higher than a bronze or silver plan, but the lower deductible and generally a 20% co-pay are in line with most people's current health insurance packages. Be sure to check the annual maximum out of pocket figure. If you can handle that from savings or other means, then a Gold plan is probably a good option for you. Once you've reached that, the insurance picks up your health care costs beyond that amount, for stuff it covers.
Platinum - Highest premiums, but lowest deductibles and maximum out of pocket amounts. For example, the plan my wife decided on has a $1000 deductible and a $1000 maximum out of pocket. After that $1000 is spent on healthcare, there are no co-pays for covered healthcare at all. For those above about 40 years old, pay careful attention to those numbers. Your odds of a serious medical issue increase after age 40. A heart attack, any cancer, or other serious medical issues can be very costly. As always, weight the cost of the premiums over a year's time against the potential for high medical bills within that year.
For all plans:
1. Measure your current health insurance premiums against the premiums for all levels under ACA. If you can afford what you have, comfortably, but no more, look at plans that are equivalent in cost or less. Odds are you'll get better coverage at a lower price. My wife's premiums, for example, for the Platinum plan she chose, are almost exactly 50% of what she was paying for much worse coverage before.
2. Check to see if the doctors, clinics, and hospitals you use or favor are covered by the plan you're considering. If not, check other plans at the same level. Odds are that one of them will include your current provider. Be careful before choosing a plan that doesn't include your current providers. It can be a real PITA to change providers, particularly if you have any sort of chronic issue. It takes time, but you can check this on the website. Don't skip that step.
3. Check the coverage. Look at the entire list of what's covered and what's not in any plan you're considering. How does the plan handle emergency and out-of-state care? If you travel, you should take special interest in that. Coverage of conditions is fairly uniform, but note anything that might apply specifically to you to make sure it is covered.
4. Run the numbers. Annualize your current medical expenses as best you can. Look at your income. Keep what you currently pay for health insurance in mind. Figure everything on an annual basis, and see how each plan you're considering matches your projections. Use that information as part of your decision making.
5. Cut the list of potential choices down to three or four, and then get into the details of what each covers and how it will support your current income, activities, health risks, and any other factors you can think of. Compare closely.
6. Remember that you can change your plan each year during the open enrollment period. You're only stuck with a plan that doesn't work the way you want it to for a year. If you make a mistake, you'll learn about it during the year, so you can change plans at the next enrollment period.
7. If you're truly struggling economically, you may well qualify for Medicaid coverage in your state. Don't neglect that possibility while you're on the ACA site. After you enter your income, you'll find out if that's a possibility.
8. Start now. If you haven't already gotten started, do that right away. The decision making process takes some time, and there's going to be a big crunch after December 1, with people trying to get in by the December 15th deadline to begin coverage on January 1. Don't wait until the last minute. Website problems or other issues may mess things up. Get it done as soon as you can!
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