Health Insurance Open Enrollment 3.0 – Tips to solving your options

November 1st was the first day of Health Insurance Open Enrollment for 2016.  The tax for not having a Qualifyed Health Plan (QHP) in 2016 has increased to 2.5% of your household income and a family of 4 can expect to pay up to 7.5% of their income for NOT buying a QHP.  Open enrollment ends December 15th for a January 1, 2016 start, but will continue to the end of January for a March 1st start.

Here are some healpful tips to navigate your options:

• 1. If you are taking any kind of prescription medication, check to see if it is covered under the health plan’s formulary.

If it’s not, you should consider switching to a different medication, paying the entire cost or switching health plans. The formulary will also show which payment “tier” your drug is placed on by the insurer, determining how much you will pays at the pharmacy.  Insurance companies include a link to their formularies for all their health plans on their websites.  Here is an example from Blue Cross of Arizona –

• 2. Find out what, if anything is covered without having to first meet your annual deductible.

All plans will pay for Wellness visits, flu shots and well child visits.  Some plans will cover additional doctor visits – generally primary care – or prescriptions without the consumer first paying the full annual deductible, which can be thousands of dollars.  Check the specific benefits of the plans under consideration to see if what, if anything is waived, the deductible for any doctor visits or drugs.

• 3. Consider your income. Those earning up to 400% of the federal poverty level, or $47, 080 for an individual, can get a tax credit to help cover monthly premiums.  Those below 250 % of the poverty level, or $29,424, can also qualify for plans with lower annual deductibles and smaller payments for doctor visits and drugs.

Finally,  weigh your gut reaction: what level of financial risk are you willing to accept?  Some people prefer to lower monthly costs with the possibility of a high annual expense if a serious illness occurs.  Others would rather pay more up front in premiums – and less each time they go to the doctor or fill a prescription.

• 4. Ask for help.  We are licensed agents with years of expieience and knowledge ready to help you find the right policy for you and your family.  Do some shopping, then give us a call and we can help you make your final decision.  We will also be there during the year if you have questions or problems.