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The Hood Magazine

Identify the Best Health Insurance Plan

Nov 01, 2014 11:41AM ● By Hood Magazine
By Jackie Jockheck, Marketing Director, Avera Health Plans

Recent updates with the Affordable Care Act provide more opportunities than ever to individuals and families who need health insurance. Open enrollment for 2015 coverage begins November 15 and will end February 15, 2015.


Here are some helpful tips to identify the best health plan for you:

  1. Look beyond the premium payment. You will want to find a premium that works with your monthly budget. The benefits within the plan will make a difference when it comes to seeing your doctor. Review and compare the co-pays, coinsurance, deductible, and out-of-pocket maximums to really see how the plan will impact your family budget.
  2. Make sure you understand how much you will pay when you go to see a doctor. A co-pay is a fixed amount paid when you receive a service. Coinsurance is a percentage of the costs for services you will pay. You will pay the full amount for the visit with an HSA-compatible plan until the out-of-pocket maximum is reached. Remember, no matter what the plan, most preventive services will be free.
  3. Identify a deductible and out-of-pocket maximum you can manage if something should happen to you or one of your dependents. The deductible is the amount you owe for health care services your plan covers before your health insurance or plan begins to pay. Your out-of-pocket costs include expenses for services that are not reimbursed by insurance such as deductibles, co-pays and coinsurance.
  4. Network is important and is cost-effective. A great health care team will identify best pricing to reimburse you for a health care service or procedure. You may get a better monthly premium with one health insurance carrier, but if they don’t have the network of providers who understand the benefits of working together to provide you a better network, you will pay more. With a team of health care providers and health insurance working together, you will pay less.

What if you choose to not have health insurance?

The penalty for not having health insurance is based on your income. You will pay either a flat rate of $325 per person or 2 percent of your household income — whichever is greater. There are many resources to help you select the best plan. Find someone you can trust and who is educated on the latest updates regarding the Affordable Care Act. 

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