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How to Choose a Health Insurance Plan With open enrollment drawing to a close, anybody who wants health insurance must enroll by February 15, 2015. After.

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Presentation on theme: "How to Choose a Health Insurance Plan With open enrollment drawing to a close, anybody who wants health insurance must enroll by February 15, 2015. After."— Presentation transcript:

1 How to Choose a Health Insurance Plan With open enrollment drawing to a close, anybody who wants health insurance must enroll by February 15, After February 15th, you can enroll in or change plans for 2015 only if you qualify for a Special Enrollment Period (60 days following certain qualifying life events). I created this step-by-step, power point presentation, to explain the steps and consideration I used, when choosing a health care plan. Brought to you by Jennifer Albach RN, CCM,

2 Since I don’t meet the criteria to qualify for a subsidy, I’ve gone to the open market for an individual insurance plan. Humana is my choice, for my geographic area and my insurance needs. I encourage everybody to do your own research to find a carrier best suited for you and your needs. Before choosing a carrier, be sure to check their provider network, to ensure your doctors are within their network. If you are eligible for a subsidy through the Affordable Care Act, do not apply here. You must apply through the exchange to take advantage of any eligible subsidies.

3 Here are the 3 least expensive, individual plans I could find. First look at the monthly premium vs the deductible * The deductible is the amount you pay out of pocket before your insurance carrier pays their share

4 When comparing these 3 plans, you can see one plan requires co-payments, even after the deductible is met

5 The Maximum out-of-pocket is the total amount of annual health care costs you are responsible for, after paying your premiums. Notice the lowest-deductible, highest-premium plan, does not have the least out-of-pocket expenses.

6 Most health insurance plans require you to meet your deductible, before any benefits are payable. This plan provides some coverage for sick visits before having to meet your deductible

7 Look for those hidden extras. This plan pays up to $ for labs and x-rays, before you are subject to the deductible. * It’s these changes to the deductible for different services, that disqualify this plan from being HSA qualified.

8 Beware of hidden costs. Even after meeting your deductible, some plans require additional co-payments.

9 All qualified health plans cover preventative medicine at 100% and the deductible is waived. Preventative medicine includes screening exams, such as mammograms, physicals, pap smears, colonoscopies, etc

10 Another thing to consider is your prescription needs. This plan offers coverage for Tier 1 drugs, with a $ 20 co-payment and no deductible.

11 All three plans offer in-network and out-of-network coverage. You can choose any provider for treatment, without a referral.

12 This is the only plan, out of the 3, which qualifies for a Health Savings Account or HSA.

13 What is an HSA? Why is it important? An HSA is a health savings account that offers tax breaks. You do not have to pay income tax on your contributions. The money grows tax-deferred. The funds can be withdrawn tax-free for medical expenses. * Not all health plans qualify to pair with an HSA. According to Kiplingers; If your policy has a deductible of at least $1,300 for individual coverage and $2,600 for family coverage in 2015, you may be eligible to contribute to an HSA. But not all high-deductible policies are HSA-eligible. The policy must also make everything subject to the same deductible (other than preventive care, which must be covered by all health plans without any deductible or cost-sharing). Some plans, for example, aren’t eligible because they have a separate deductible for prescription drugs. Ask your insurer if the plan is HSA-eligible; plans aren’t always clearly marked, especially on the state exchanges. You can contribute up to $3,350 if you have individual coverage or $6,650 if you have family coverage in 2015, plus up to $1,000 if you’re 55 or older anytime during the year. Your contributions are pretax if made through your employer or tax-deductible if you’re on your own, and you can use the money tax-free for medical expenses in any year.

14 Why an HSA could make sense for you $6, is the maximum annual contribution you can make to an HSA, if you have a qualified, high-deductible, family plan. Let’s take a look at the potential tax savings. $ 6, X 25% (US tax bracket for married filing jointly with an income of $73,801 to $148,850) $ 1, Your annual, income tax savings

15 Ultimately, I chose the plan with the HSA. By utilizing a plan with an HSA, the tax savings more than offset the higher premium. If I utilize the full, income-tax savings with my HSA, I will save nearly $400.00/year, with a $300-$600/year lesser deductible.


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