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Published on December 11, 2015

Shopping for the Season? Don't Forget Health Insurance

Shopping for health insurance isn’t as fun as holiday shopping, but it’s still a critical purchase you might have on your list, alongside the stocking stuffers and Christmas turkey.

If you are enrolled in a plan, in most cases you will automatically renew. With the recent news of rate increases, it is important to take a look and shop around as you may be surprised how much you can save.

There’s only one time of the year you can shop – and that’s now. Open enrollment for health insurance is now through Jan. 31.

The Affordable Care Act, also known as Obamacare, mandates that participating insurance providers offer a number of things:

  • Plans must offer 10 essential health benefits ranging from emergency care to prescription coverage and prenatal and postnatal care.
  • Many preventive services are provided at no cost to the member, including one yearly well care visit and immunizations.
  • Coverage is guaranteed, so if you have a chronic condition, you won’t be turned away or pay higher rates.

Even though shopping for health insurance online is a little easier than in years past, there are still things to consider:

Penalties Add Up

The Affordable Care Act also made it law that everyone must have health insurance, or pay a fine, and these fines increase yearly. The fine in 2016 will be whichever is higher — 2.5 percent of yearly household income or $695 per person ($347.50 for children under 18).

“The penalties are getting a little stiff for not having health insurance,” said Janice Lewis, sales associate with Avera Health Plans. “There are obvious benefits to having health insurance like physicals and screenings. I always ask, do you really want to pay for nothing or do you want to pay for something?”

Consider Cost

If you are currently insured, get an idea of where you stand now. Look at your Summary of Benefits and Coverage to see what you’re currently paying. Also consider current income to create a clearer picture of what you can afford.

“It’s like buying a car,” said Debra Muller, Chief Administrative Officer for Avera Health Plans. “When you’re buying a car, you put together a plan. Do you want a Toyota or a Ford; an SUV or a sedan? Then you go online and do research and look at your options.”

Are Subsidies an Option?

Yes. Your ability to receive subsidies and tax credits relies on your income, but can reduce the costs of premiums and even co-pays, deductibles and coinsurance, which can add up, Lewis said.

Are You a Frequent Visitor?

You also should consider ongoing health conditions and additional costs you’ll have throughout the year in prescriptions and other out-of-pocket costs.

“Every situation is different,” said Lewis. “Do you have a lot of doctor’s visits every year? Then you need a plan with a low co-pay and out-of-pocket maximum. If you’re healthy, you can get a lot of the preventive stuff for no additional cost. Lower premiums and a higher deductible might work because you’re not going to use your insurance as often.”

Don’t Miss Out

And remember, after open enrollment, your chance to enroll has passed unless you have a qualifying life event like marriage, the birth of a child or a job change. And you never know what will happen during that time.

Compare plans at Avera Health Plans or contact an agent today at 1-855-692-8372 to find out more.

Live Better. Live Balanced. Avera.

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