Now
that the Obamacare
transition has come into effect, it is important to understand some of the
differences that are now at work. Understanding some of the changes can make it
easier to get the greatest benefit from new policy changes that might affect you
most. This can also help you to avoid potential negatives. For example, missing
the important March 31 deadline can result in a fine of $95 or 1% of your total
income (whichever number is greater).
“For
those that do not qualify for Medicaid, you will be required to pay your
monthly premium fee to your selected insurance company in order to receive
coverage,” said Jim Holm of EnhanceInsurance.com . “In some cases, customers
will need to pay for their deductibles along with a set copay fee for doctor visits
or a portion of the cost for the medical service.”
This latter scenario is referred to as co-insurance, and customers will
generally need to complete these payments before the insurance company can
actually cover your medical costs. For most information on this, you can visit
the federal government’s website at HealthCare.gov , a federal government
website, and learn more about your options for each
insurance plan. To find this information, located the section entitled “See
plans before I apply.”
Plan
Choices
Many
industry experts recommend that you narrow down your potential choices to five
comparable plans, and then go to the insurer’s official website in order to
educate yourself about the various benefits available in each program. It is
important to look for the types of things that might not be covered — for
example, acupuncture or hearing aids. This can help you to avoid plans that are
probably not best-suited for your expected needs. It is also a good idea to pay
attention to the company’s cited coverage examples. These will help explain
exactly what the patient will be expected to pay and which costs will be
covered by your plan. Note the ways that co-pays, co-insurance and deductibles
are explained, as these elements help form the basis for what your plan has to
offer.
Choosing
your Doctors
Making
the proper doctor selection is another important factor to consider. In some
cases, your doctor or hospital has not contract ties to the network of your
health plan. This can mean you will be responsible for paying out much more.
Because of this, it is a good idea to go to your favorite doctors and then to
see which health plans they are able to accept. Your health insurance plan will
also have a list of drugs and medicines that they will cover. In cases where
your prescription is not on this list, you can expect your bills to be higher.
So, it is also important to make certain that your insurer offers access to the
medications you need.
Potential
Tax Credits
The
new healthcare system offers ways of reducing your total medical costs. But
this can be done in ways that extend beyond simple cost reductions. Additional
gains can be made from the Federal tax credits that can make premiums more
affordable. These tax breaks apply to households with annual incomes that fall
between 100% and 400% of the federal poverty line. In Dollar terms, this
equates to roughly $11,500 to $46,000 for individuals, and $24,000 to $95,000
for a family of four. The government’s HealthCare.gov website also includes
some informative statistics in this area. If your annualized household income
falls below 250% of the federal poverty level (which comes out to just below
$60,000 for a family of four), you could qualify for reduced out-of-pocket
expenses when buying a silver plan.
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