Featured Editorial

An Essential Resource Guide to Understanding Basic Health Insurance Facts

An apple a day keeps the doctor away. If only health care were just that simple, I'd have one of the finest apple orchards imaginable. Have you managed to figure out the ins and outs of open enrollment period for health insurance? Mastering the overwhelmingly complex pros and cons of coverage options very often leads to feelings of confusion and frustration. I am by no means an expert in the realm of health insurance, open enrollment or the Affordable Care Act, however thanks to the sponsorship of UnitedHealthcare, I have found a wealth of informative tools and videos from the UnitedHealthcare website. 

It's time to grab a pen and some paper to take notes on the valuable information I have researched in terms of what you need to know about basic health insurance facts about the Affordable Care Act (ACA).  The primary goal of the ACA is to offer individuals and families access to affordable health insurance. With reliable resources providing information about health insurance, we can be best prepared to make informed decisions about finding the most suitable coverage. See- Health Insurance Definitions And Terms

Let's start by learning about some of the changes that have most recently come into effect in health care reform. The ACA has increased the Medicaid income eligibility limits in certain states therefore more people are eligible for benefits. There is also the availability of subsidies to eligible enrollees with income levels slightly above Medicaid guidelines, yet facing extenuating financial difficulties. Pre-existing conditions in children under 19 years of age and the elimination of annual or lifetime limits opens the door to the health insurance marketplace for so many previously uninsured people. See- Health Care Reform Demystified: Why Health Care Reform Matters

While comparatively researching plans, take a look at the specifics of open enrollment and learn how and why the differences in benefits matter significantly to you and your family members. See- Open Enrollment Guide:Tips On Comparing Health Plans

As a self-proclaimed planner, it is my recommendation that you use the time prior to the open enrollment period to research the best fitting health plan to be selected for your family. Prime time for finding a health insurance plan would be between November 15th and February 15th to obtain coverage from the marketplace this year. Review the guidelines for certain qualifying events that will allow you to utilize a special enrollment period. Refer to the Health Benefit Exchange or Marketplace website for the comparison of plans from a variety of providers. The resources from the website will be found either on the government's Healthcare.gov site or your state’s individual marketplace website. See- Shopping for Health Care Services

It stands to reason that the individual costs of health insurance will be substantially lower for healthier lifestyles. Preventative health care and maintenance benefits are now being more readily included in insurance plans. It is also important to remember that health insurance plans are an annual commitment with very limited options for changing plans. See- Qualifying Life Events: Changing Your Health Insurance Coverage

  • Consider factors such as dependents, deductibles, copayments, premiums and maximum out-of-pocket expenses as well as member benefits covered when comparing health plans. 
  • Evaluate the specific needs of yourself and your family, such as doctor visits, prescriptions and even operative procedures. Your health insurance costs will be affected by the amount of coverage, deductibles, and co-payments selected through your particular plan. 
  • Check your deductibles and out-of-pocket expenses promptly and regularly. When deciding on a plan, look for add-ons provided by the company such as nurse call-in lines, health care apps and health club membership discounts.
  •  Review your Explanation of Benefits (EOB) and consult with your physician on the necessity and charges for medical tests and less costly options within your budget.
All of this is to say, an apple a day is a great start to health care, but there is so much more to learn and understand for the wellness of yourself and your family.  Use the basic information provided as a starting point for making one of the most important health decisions you will ever have to make. Check out the UnitedHealthcare website for more informative videos, health insurance resources and wellness tips.