Our health insurance is not about polls, not about spin, and definitely NOT about what makes sense for government (for whom, we know, we know, Obamacare’s ‘working?’). There are at least 10 things we can do during this benefits season that will make sense.
1-Face facts, health insurance is expensive and puts us all in the unnatural position of having to gamble on what we believe we’ll need during the coming year. While the stakes are high, middle class Americans neither Medicaid eligible nor government employees will often face financial devastation if they get sick. It sucks but it’s true, pre and post Obamacare.
LET YOURSELF OFF THE HOOK, FINANCIAL RISK IS NOT YOUR FAULT: The upside is that today such financial devastation is something that’s been DONE to us and that we CANNOT avoid if we NEED medical care and services because health insurance products continue to slash benefits and-or increase costs, the out-of-pocket maximum has been raised again has gone up to $6,850 for individuals and $13,700 for family coverage, in addition to increased deductibles, copayments and coinsurance many of us are paying for needed medical services.
2-Quitting smoking, not getting old and having insurance will save you money, all other things being equal. This isn’t my moral judgment but reflects the President’s morality, which no sensible person listening to him equate illegal aliens with legal immigrants, equate those Americans anti his Iran cave-in with being like Iran hardliners, or listening to him lecture on spending for the environment while slashing food assistance can believe (can they?). Let alone the fact that alcoholism and drug addiction are not seen as punishable under the Act.
Nevertheless, Obamacare punishes smokers, specifically tobacco users and punishes the old with higher premiums and punishes those who opt out of health insurance with a fine (the individual mandate) and therefore you can save money by having health insurance.
Some might argue that paying the penalty is cheaper than paying for health insurance but that’s not the end of your punishment, and before you make that choice I recommend you research trends in what you’re charged for needed medical services without health insurance which so far seems to be unlimited price gouging.
3-Remember your health insurance is a one-year decision. You don’t get points for choosing the best darn health insurance policy you can, if you can’t afford it the next year you won’t be given a break, you won’t receive a refund if you don’t use it. It’s insurance not morality. Like all insurance you hope you won’t need it and that it’s a waste of money in purchasing the product because it’s going to cost you if you do.
4-The push to silver. There’s a push to get people enrolled in what Obamacare calls silver plans, 70 percent coverage of COVERED services. You’ll have to read through exactly what’s covered.
If you’re wondering why the push to silver it’s because of Obamacare entitlement payouts in the form of premium assistance and sometimes even cost sharing for copayments and coinsurance. Why? It’s not because the government wants you to have coverage it’s because people who believe they will need more medical services usually opt for silver plans or higher to keep their out-of-pocket costs lower which means that sicker and older usually choose silver.
In order to get the insurance company “mix” of healthy people who they won’t statistically have to pay out on with older people who they will, the government wants to incentivize silver. Even with these incentives enrollment in bronze exceeded what the government expected so check out the prices, likely bronze costs to you will be up a lot more from last year than silver plans.
5-Catastrophic plan choices will satisfy the requirements that you purchase health insurance (avoid individual mandate tax) if you qualify for an exemption which you must get paperwork for OR if you’re under 30. The benefits are obviously more limited but the cost in premium to you is much less.
If you’re UNDER 55, this year and you’re eligible for Medicaid, this will be a better option for you. But there is a caveat, remember your estate can be gone after for ‘reimbursement’ and if you’re over 55 and on Medicaid it’s REQUIRED that your state go after reimbursement.
6-Your eyes and teeth will cost you more. You must purchase dental and vision insurance separately.
7-If you know you take a certain medication or are treated for a certain condition, you can do something that many people can’t, you can predict what you’ll likely need. Make sure you read through your health insurance product choices to see what doctors and facilities you can use for your condition, what medications will be best reimbursed for your condition and any other needs you have.
8-Automatically choosing the ‘same’ plan is probably not a good idea because there is rarely a ‘same’ in the insurance product industry, usually it’s at least a little more expensive for a little less coverage. Double check, the scales might have tilted to support a decision to purchase a different plan.
9-There’s vast disagreement but I really hate HSAs that try to lure people into ‘saving’ money by putting it in an account that they’ll have to spend down as part of a high-deductible health insurance account if they actually NEED medical services.
These plans originally called the healthy-wealthy remain plans for the healthy-wealthy under Obamacare. If you’re married or living with someone and one of you has such a plan you might actually “save” money, but otherwise it’s usually a loser proposition because UNLESS you have OTHER money to use for your medical expenses allowing you to “rack up” all the savings they promise and invest those savings to make them grow even more, you’re paying more out-of-pocket before your insurance product works for you.
If you have enough money to ‘save’ pre-tax in an HSA, why wouldn’t you put it into retirement savings that don’t restrict what you can spend your money on which an HSA does (for medical expenses)? That’s why they’re usually ‘wealthy’ plans, another way to sock away money if you max out on retirement account contributions.
But, if you like the HSA, you’re not alone and likely it will save you money on premiums because it’s HIGH-DEDUCTIBLE. It’s also worth noting that government and health insurance companies love the product because it’s cheaper for them so that as insurers continue their pre/post Obamacare method of maximizing money in and minimizing money paid out eventually HSAs may become competitive as premiums, deductibles and other out-of-pocket expenses rise.
10-Don’t drive yourself nuts: The insurance product is supposed to help if the unexpected happens and unfortunately pre-post Obamacare that is often not the case, so there’s no choosing “wrong” just perhaps not “best” based on what you experience during the year, which unless you have a crystal ball cannot be determined. It’s a failure of being forced to purchase an inadequate product supposed to protect us from the WHAT IF that instead is a YOU MUST.
