Thursday, October 31, 2013

Healthcare Reform School - Lesson 22 - Review of Purchasing Options

Hello all of you wonderful people.  Today's lesson will be about the options that are available for purchasing health insurance.  The two major options are on the Federal Marketplace or on the Private Marketplace. I will explore these two options. 

As most people know, the Federal Marketplace website has experienced substantial problems with getting people signed up. Another concern about the Federal Marketplace website with many people is the protection and privacy of their personal information.  The privacy issue stems from the fact that shoppers need to enter a lot of personal information before being presented with any types of options for purchasing insurance.

But I am here to tell you that the FEDERAL MARKETPLACE IS NOT YOUR ONLY OPTION.  This very important fact has not been advertised at all by the federal government.  Zero, Zilch, Nada.
Actually buying insurance from the Private Marketplace (not the Federal Marketplace) is the best option for many Americans.  Taking this route before December 31st will be the best move for many young and healthy Americans. But this route will always be available during open enrollment. Following is a list of reasons that buying from the private market is the best option for that group.
  1. UNDERWRITING - Insurance charge less for young healthy people.  It is the job of underwriters to classify people and assign premiums.  This function of insurance companies is eliminated starting January 1st.  
  2. OPTIONS - Currently there are many options available that can help reduce the cost of health insurance premiums.  Most of these options go away in 2014.  For example, every single person will have maternity coverage starting next year, young and old alike.  Most people may not need maternity, but the mandated maternity coverage is reflected in premiums.
  3. PRICE - Because of underwriting a options.  The price is generally lower for policies that are written off of the exchange before January of 2014.
  4. DOCTORS NETWORKS - This is an extremely important element of health insurance.  I have reviewed many options on the Federal and State Marketplaces.  Some of the companies have very small, meager doctors networks. This means that fewer doctors and hospitals will take the insurance, which limits your options for care. Even Blue Cross/Blue Shield has cut down their networks for the plans they are offering on the exchange, especially at the lower cost levels.
  5. PPO's -vs-HMO - This is another extremely important element of health insurance.  The lower level plans on the Federal Marketplace are almost 100% HMO (Health Maintenance Organization) style networks.  Currently the popular choice for Doctors Networks when buying health insurance is a PPO (Preferred Provider Option).  HMO's were popular for a short while in the 1990's, but the model of health insurance proved unpopular because the HMO requires referrals from your primary care physician to see specialist and the HMO has the final decision on approving medical procedures, not the doctor providing the service.
  6. Quality of Care - Because of the Doctor's networks and the style of plan, you are likely to get a better quality of care by purchasing a plan of the marketplace.  This is tru even after Janaury of 2014.  Plans will still be available from insurance companies that are not on the marketplace and that have not reduced their networks and still provide the same care.
  7. Exact Same Benefits - The 10 Essentail Health Benefits mandated by the ACA will be built into every single major medical health insurance plan purchased after 2014 starts.  It does not matter if the plan is purchased on or off of the exchange.
  8. Deductibles - Believe it or not, there are many better options for lower deductibles when buying health insurance from the private exchange.  To get a low deductible from the Federal Marketplace, the monthly premium is very high.  The private marketplace now and in 2014, will have options to reduce the deductible while keeping monthly premiums low.
I try to keep these blogs short and sweet and just hit the major points, if you have questions, just post a response. 
If you would like to learn more, than choose the topic from the lessons below to learn what normal people will want to know.

Lesson #1 - Introduction
Lesson #2 - Basic Reason for creating the Patient Protection and Affordable Care Act
Lesson #3 - Public exchanges for Purchasing Insurance
Lesson #4 - Essential Health Benefits that will be added to all Health Insurance policies in 2014
Lesson #5 - Tax Credits to Help Pay for Health Insurance
Lesson #6 - Enforcement and Penalties in the Affordable Care Act
Lesson #7 - Preparing for the Affordable Care Act
Lesson #8 -  Options for Small Businesses
Lesson # 9 - Will my Insurance Premiums change in 2014?
Lesson #10 - What Will Happen to Small Groups in 2014?
Lesson # 11 - Why Should I Buy Insurance Before the Deadline?
Lesson #12 - What does the Delay in the Employer Mandate Really Mean? 
Lesson #13 - Can I keep my Current Health Insurance Plan?
Lesson # 14 - Who is Providing Insurance During Open Enrollment?
Lesson #15 - Out of Pocket Spending Limits - Law Change
Lesson 16 - SHOP - Marketplaces for Small Businesses 
at

No comments:

Post a Comment