Choosing The Right Insurance Plan—A Checklist

Open enrollment is underway. It’s the period when people who aren’t insured through their workplace can shop or make coverage changes.

The 2018 open enrollment period runs Nov. 1 to Dec. 15, 2017. It’s a shorter window than previous years, so being prepared will help you make the best decisions.

Here are a few things to check off your list:

Know if you qualify for a subsidy
As a part of the Affordable Care Act (ACA), subsidies are available to help pay for health coverage for those with household incomes at or below 400 percent of the federal poverty level (FPL) who don’t have affordable coverage at work. It includes people with incomes of:  

  • $47,520 a year for one person
  • $97,200 for a family of four

See if you qualify by using our Tax Credit Calculator.

Consider your preferred doctors
Double check whether your doctor accepts the insurance plan before you enroll. If you end up going to a doctor who is outside of your network, it can cost you more than if that doctor is in-network.

Check here for providers that participate in BCBSND plans.

Make sure the plan covers all the ACA requirements
The ACA law requires 10 essential benefits:

  • Outpatient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatments
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services as well as chronic disease management
  • Pediatric services, including dental and vision care

All BCBSND plans available during open enrollment include the 10 essential benefits.

Know all your coverage options

  • Traditional plans—you select the copay amount you want to pay for services and prescriptions. The insurance company pays benefits from the start. 
  • High deductible plans—you pay for all your care (except preventive) until you meet your deductible, then you and the insurance company share costs.
  • Catastrophic coverage—coverage for people under age 30 who want a safety net option.

Check out the BCBSND guide to selecting the right plan for you.

Consider the overall cost
Remember, your monthly payment is not the only cost of a health insurance plan. All plans require some level of cost-sharing when you receive medical care. Cost-sharing can take the form of copayments, deductibles or coinsurance.

Generally, the more you pay in monthly premiums, the lower your out-of-pocket cost-sharing. However, you should run through several cost-sharing scenarios before you choose a plan.

Don’t be afraid to ask for help
It’s a lot to take in, we know. Call us and we’ll put you in touch with an agent who knows all the ins and outs of health insurance. 800-280-BLUE (2583)


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