While major changes in health insurance seem likely as a result of the election, "That doesn’t mean you should avoid signing up for 2017 insurance coverage," writes Trudy Lieberman of Rural Health News Service. Any changes are unlikely to affect coverage for the coming year, given the constitutional ban on impairing existing contracts.
While choice on the government health-insurance exchanges is more limited this year, especially in rural areas, Meaning "high premiums and limited options for doctors and hospitals," Lieberman writes. "Some careful shopping is in order to minimize any surprise bills."
Lieberman notes that White House Press Secretary Josh Earnest said “the vast majority” of consumers eligible for Obamacare subsidies would have monthly premiums of $75 or less, but she warns, "That doesn’t mean the vast majority should automatically buy a policy with a $75 premium. That strategy can mean expensive trouble later on. Reviewing the basics before wading into the Obamacare marketplace this year is essential."
Obamacare plans come in four types: Platinum policies, generally the most costly, cover 90 percent of medical costs; gold plans cover 80 percent; silver plans pay 70 percent; and bronze 60 percent.
"Silver plans have been the most popular, largely because those who buy them and have family incomes below $60,750 get extra government subsidies to help pay their deductibles, copays and coinsurance," Lieberman notes. "Bronze policies are popular, too, because they have low premiums, but people buying those policies won’t get the extra subsidies, a point that’s worth remembering. Those subsidies can be a big help if you need a lot of medical services. Both bronze and silver policies generally come with lower monthly premiums, but that doesn’t mean they are cheaper in the long run."
For example, Lieberman writes, "It’s possible a bronze policy and maybe a silver one could end up costing more than a gold one with a higher premium if you get sick. That’s because of the relationship between the premium, co-pays, co-insurance and deductibles. Insurers mix and match these features to fit their marketing strategy. In general, a lower premium means higher deductibles and higher other out-of-pocket expenses. A policy with a higher premium often means lower out-of-pocket costs."
In 2017 the maximum out-of-pocket cost for a family is $14,300. "That’s a lot of money, and enough to deter some people from signing up. Many people say paying that much before insurance pays isn’t really insurance," Lieberman writes. "It’s also high enough to keep people from seeking medical care even when they need it."
Lieberman reports that an Indiana couple she has followed shopped around for coverage after their insurer sent them a notice that their $836 monthly premium would jump to about $1,300 and they would have to pay 50 percent of hospitalization costs instead of 20 percent. Their shopping found them a plan for only $700 a month, she reports.
"Choosing an Obamacare policy or any other insurance coverage comes down to how much risk you want to assume," Lieberman advises. "If you are reasonably certain you won’t need many medical services, you may want to take a chance and buy less expensive insurance that comes with high deductibles, copays, and coinsurance. But if you’re like the Indiana couple, and afraid of high expenses for unexpected medical care, buy the best policy you can afford that reduces that risk."
Lieberman invites consumer to share their insurance-shopping experiences with her at trudy.lieberman@gmail.com.
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| Trudy Lieberman |
Lieberman notes that White House Press Secretary Josh Earnest said “the vast majority” of consumers eligible for Obamacare subsidies would have monthly premiums of $75 or less, but she warns, "That doesn’t mean the vast majority should automatically buy a policy with a $75 premium. That strategy can mean expensive trouble later on. Reviewing the basics before wading into the Obamacare marketplace this year is essential."
Obamacare plans come in four types: Platinum policies, generally the most costly, cover 90 percent of medical costs; gold plans cover 80 percent; silver plans pay 70 percent; and bronze 60 percent.
"Silver plans have been the most popular, largely because those who buy them and have family incomes below $60,750 get extra government subsidies to help pay their deductibles, copays and coinsurance," Lieberman notes. "Bronze policies are popular, too, because they have low premiums, but people buying those policies won’t get the extra subsidies, a point that’s worth remembering. Those subsidies can be a big help if you need a lot of medical services. Both bronze and silver policies generally come with lower monthly premiums, but that doesn’t mean they are cheaper in the long run."
For example, Lieberman writes, "It’s possible a bronze policy and maybe a silver one could end up costing more than a gold one with a higher premium if you get sick. That’s because of the relationship between the premium, co-pays, co-insurance and deductibles. Insurers mix and match these features to fit their marketing strategy. In general, a lower premium means higher deductibles and higher other out-of-pocket expenses. A policy with a higher premium often means lower out-of-pocket costs."
In 2017 the maximum out-of-pocket cost for a family is $14,300. "That’s a lot of money, and enough to deter some people from signing up. Many people say paying that much before insurance pays isn’t really insurance," Lieberman writes. "It’s also high enough to keep people from seeking medical care even when they need it."
Lieberman reports that an Indiana couple she has followed shopped around for coverage after their insurer sent them a notice that their $836 monthly premium would jump to about $1,300 and they would have to pay 50 percent of hospitalization costs instead of 20 percent. Their shopping found them a plan for only $700 a month, she reports.
"Choosing an Obamacare policy or any other insurance coverage comes down to how much risk you want to assume," Lieberman advises. "If you are reasonably certain you won’t need many medical services, you may want to take a chance and buy less expensive insurance that comes with high deductibles, copays, and coinsurance. But if you’re like the Indiana couple, and afraid of high expenses for unexpected medical care, buy the best policy you can afford that reduces that risk."
Lieberman invites consumer to share their insurance-shopping experiences with her at trudy.lieberman@gmail.com.
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