Take time to shop for the best health coverage


Health Insurance Marketplace advice from Karen Love of Community Health Choice.

Wondering why the new Health Insurance Marketplace opens October 1, when actual coverage doesn’t go into effect until January? One crucial reason is to allow people to familiarize themselves with the online process and their coverage choices.

People living in the Texas Gulf Coast will have numerous insurance options through the Marketplace, and one of the most fundamental choices consumers will make is whether they want the budget stability of a plan with a low or no deductible, or if they want to take their financial chances with a high deductible plan.

While high deductible plans are traditionally linked to lower monthly premiums, the health coverage plans on the new Marketplace were designed with consumer affordability in mind.

Many people interested in obtaining coverage through the Marketplace will be eligible for subsidies from the federal government, making the plans even more affordable. Plan choices in the Marketplace include:

  • Affordable monthly premiums with no deductible,
  • More affordable monthly premiums with a low-medium deductible and
  • Even lower monthly premiums but with high deductibles.

Each person, and each family, should take the time to explore which plans are best for them. No matter when an individual chooses a plan during the open enrollment period— whether on October 2 or December 2— everyone’s coverage begins on Jan. 1, 2014.

While all coverage helps with access to healthcare, consumers choosing high deductible plans will need to budget $6,000 or more for out-of-pocket costs before benefits, such as copayments, kick in.

Consumers and families choosing plans with no deductibles will be able to schedule doctor’s visits in January and simply pay the copayment. For people who tend to contract seasonal viruses and infections such as winter sinus infections or bronchial infections, the no-deductible plans allow immediate use of co-pays to schedule a “sick” doctor or clinic visit.

The high deductible plans may be of most beneficial for people who feel certain they will not get sick or break a bone, or do not mind paying the entire cost of the doctor visit and related laboratory services and/or prescriptions out of pocket.

As a reminder, the Affordable Care Act provides core of essential benefits, including: Emergency services • Hospitalization • Maternity and newborn care • Preventive/wellness services • Mental health/substance abuse services • Prescription drugs • Rehabilitative services and devices • Laboratory services • Ambulatory patient services.

All plans on the Marketplace are required to provide these core benefits. To visit the Marketplace and look at coverage options, go to https://www.healthcare.gov/ after Oct. 1, 2013. For more information about Community Health Choice, please visit us online at www.chchealth.org/AffordableHealth/ 



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