Unless you have health care coverage and benefits under your employer, the task now falls to you to select the right healthcare plan for you and your family. Since the passing of the Affordable Care Act (ACA), also known simply as “Obamacare,” it is now mandatory for each person to select a healthcare plan or risk paying a penalty annually at tax time.
So learning the ins and outs of the still-complicated healthcare system is now an urgent necessity. In this post, learn more about how the Affordable Care Act provides you with options so you can choose the right plan for your family.
An Overview of Obamacare Health Insurance Plans
The federal government’s healthcare website, Health Insurance Marketplace, offers you an overview of how Obamacare insurance plans are structured to work.
For example, there are 5 categories of health insurance plans you can choose from, listed here in order from least amount of coverage (and lowest premium) to highest:
There are also different types of plan structures, including these:
- HMOs (health maintenance organizations). You must use providers that participate in the plan and may need to live in certain geographic areas.
- PPOs (preferred provider organizations). You can use any provider but will pay less if you use providers that participate in the plan. You don’t need a referral to see a specialist.
- POS (point of service plans). After getting a required referral from your primary care doctor, you will pay less by using the providers in the plan.
- EPOs (exclusive provider organizations). You will be covered if you use the providers in the plan’s network.
- HSAs (health savings plans). You can save up a certain amount annually on a tax-free basis to use for approved health care expenses. Usually, HSAs are a benefit included as part of a health plan.
How to Save Money on a Family Health Care Plan
The Affordable Care Act maintains that financial assistance in the form of a subsidy is available for individuals and families whose income falls below a certain threshold. But in order to get the subsidy applied to your monthly health care premium, you must purchase your healthcare plan through the Health Insurance Marketplace.
The website will walk you through how to calculate how much of a subsidy you may qualify for by inputting certain personal and financial information. You can then choose whether to apply all of your subsidy, part of it or none of it. You can also reserve part of it to purchase optional dental or vision coverage.
Another way to save money on a family health care plan through the Marketplace is to choose a lower level of coverage. Platinum, as the highest level of coverage, will come with the highest premiums. Bronze, as the lowest level of coverage, will come with the lowest premiums (save for Catastrophic, which is a category only certain individuals are eligible to choose).
If you choose to work with an insurer, you can get free insurance quotes to decide on the most affordable premium for the level of coverage you need.
How to Decide How Much Coverage Your Family Needs
The best way to determine how much coverage you may need is to take the health history of each family member. You can then start with any ongoing issues that require medical treatment and review each plan to ensure the level of coverage is adequate to address those issues.
It is also important to remember that, under Obamacare, preventative health care services for women have expanded and pre-existing conditions can no longer be disqualified by insurers. Also, in some plans, dental and vision care is automatically provided for minors. In this way, these new plans strive to give you the most coverage economically.
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