The Obamacare Transition: Tips for Buying Health Insurance

By Richard Cox
Richard Cox
Richard Cox
July 18, 2014 Updated: April 23, 2016

Now that the Obamacare transition has come into effect, it is important to understand some of the differences that are now at work. Understanding some of the changes can make it easier to get the greatest benefit from new policy changes that might affect you most. This can also help you to avoid potential negatives. For example, missing the important March 31 deadline can result in a fine of $95 or 1% of your total income (whichever number is greater).
“For those that do not qualify for Medicaid, you will be required to pay your monthly premium fee to your selected insurance company in order to receive coverage,” said Jim Holm of . “In some cases, customers will need to pay for their deductibles along with a set copay fee for doctor visits or a portion of the cost for the medical service.” This latter scenario is referred to as co-insurance, and customers will generally need to complete these payments before the insurance company can actually cover your medical costs. For most information on this, you can visit the federal government’s website at , a federal government website, and learn more about your options for each insurance plan. To find this information, located the section entitled “See plans before I apply.”

Plan Choices

Many industry experts recommend that you narrow down your potential choices to five comparable plans, and then go to the insurer’s official website in order to educate yourself about the various benefits available in each program. It is important to look for the types of things that might not be covered — for example, acupuncture or hearing aids. This can help you to avoid plans that are probably not best-suited for your expected needs. It is also a good idea to pay attention to the company’s cited coverage examples. These will help explain exactly what the patient will be expected to pay and which costs will be covered by your plan. Note the ways that co-pays, co-insurance and deductibles are explained, as these elements help form the basis for what your plan has to offer.
Choosing your Doctors

Making the proper doctor selection is another important factor to consider. In some cases, your doctor or hospital has not contract ties to the network of your health plan. This can mean you will be responsible for paying out much more. Because of this, it is a good idea to go to your favorite doctors and then to see which health plans they are able to accept. Your health insurance plan will also have a list of drugs and medicines that they will cover. In cases where your prescription is not on this list, you can expect your bills to be higher. So, it is also important to make certain that your insurer offers access to the medications you need.
Potential Tax Credits

The new healthcare system offers ways of reducing your total medical costs. But this can be done in ways that extend beyond simple cost reductions. Additional gains can be made from the Federal tax credits that can make premiums more affordable. These tax breaks apply to households with annual incomes that fall between 100% and 400% of the federal poverty line. In Dollar terms, this equates to roughly $11,500 to $46,000 for individuals, and $24,000 to $95,000 for a family of four. The government’s website also includes some informative statistics in this area. If your annualized household income falls below 250% of the federal poverty level (which comes out to just below $60,000 for a family of four), you could qualify for reduced out-of-pocket expenses when buying a silver plan.