4 Important Things to Consider When Choosing a Healthcare Plan Through the Marketplace

Since the enactment of the Affordable Care Act, otherwise known as “Obamacare”, American healthcare has been changing dramatically. By way of Healthcare.gov, people are now directed to shop the “Marketplace” where there is a virtual insurance exchange with a selection of plans and carriers. This word ‘exchange’ has been a buzzword since the enactment, but it’s actually an old term. Many insurance companies, like Senior Health Direct and Senior Benefits Group, have been offering an insurance exchange, where clients have access to ALL the carriers and ALL their rates, right off the bat. Our advisors give unbiased advice about companies and products, because they don’t make commission based on what they sell.

We have come up with five things to consider when selecting a healthcare plan on any virtual insurance exchange you shop. If you don’t address these things before you select a plan, you may end up with unexpected limitations of coverage or overpaying tremendously. So keep these things in mind while selecting a healthcare plan to know you made the right choice for you and your family.

  1. Plan Type and benefits. On the Marketplace, the plan types are broken up into 5 groups: Bronze, Silver, Gold, Platinum and Catastrophic. Pay attention to the details of each plan. When I selected mine, with the help of my advisor, we found that the Silver option actually had better coverage for my son than the Gold, and it was less expensive. The devil is in the details of these plans, so research all of your options. Make sure the provided benefits are ones that you’ll use and check their co-pays and limitations carefully.
  2. Out-of-Pocket Expense. This is an extremely important aspect to selecting the right healthcare plan. Out-of-pocket costs can get VERY expensive while you are paying a premium and all healthcare expenses until you reach your limit. Double check the details of this expense always. There have been several times we have seen someone getting into a plan for them and their spouse that they thought was a $5,000 deductible, ends up being $10,000 because they each have to reach separate Out of Pocket maximums before actual coverage exists.
  3. Monthly Premiums. This is obviously important but notice the placement I put it in this list. The two things I mentioned above are more important than your monthly premium, even if it means you’re shelling out more for them up front. Personally, I would rather pay a higher premium for coverage knowing that I would have only a consistent expense, not any surprise expenses. So consider this carefully, monthly expenses aren’t fun- but at least you can plan for them.
  4. Provider network and insurance carrier. Carriers and networks are important to pay attention to when selecting a plan because some companies are better than others at a lot of things. Some carriers are known for specializing in different products like investments and life insurance, so they tend to lack in options for health insurance. And of course there are companies that specialize in healthcare, pay their claims faster because they are more financial stable and have minimal rate increases over a span of time. Pay attention to the insurance carrier rating because that will tell you the financial stability and capability of the companies.