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Home / / 7 Tips For Choosing The Right Health Plan For You

7 Tips For Choosing The Right Health Plan For You

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If you bought a health insurance plan through the Marketplace in 2013/4 open enrollment period, you’ll need to decide whether to renew your current plan or change plans for 2014/5. If you are purchasing a plan for the first time, the options can seem overwhelming and you may not know where to start.

It’s important to compare health plans because new and more affordable plans may be available this year and you want to choose what works best for you and/or your family.

Here are some things to consider as you compare plans:

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  1. Are there more affordable plans available this year?Plans are grouped into four categories - Bronze, Silver, Gold and Platinum - and the category you choose affects how much your premium costs each month, what portion of the bill you pay for things like prescriptions and hospital visits, and total out-of-pocket costs.
  1. Do you or your family qualify for federal financial assistance, called a subsidy, to help pay for a plan?This subsidy may come in the form of a premium tax credit, which reduces your premium payment. Subsidies are only available through the Individual Marketplace. While you don’t have to use the Marketplace to buy insurance, you should fill out an application to see if you qualify for a subsidy. If you do qualify, you must buy a plan from the Marketplace to receive it.
  1. What are the plans benefits?All plans must offer coverage for the same Essential Health Benefits, including doctor visits, preventive care and prescription drugs. However, some plans may include additional coverage benefits such as vision, dental and medical management programs for specific diseases. For example, UnitedHealthcare benefit plans include a wide range of programs, services and resources to help you stay healthy. Whether you want to eat right, exercise more, stop smoking or just learn to relax, UnitedHealthcare can connect you with tools to help you meet your health goals.
  1. Are your current doctors in the plan’s network?Some plans require you to use doctors and facilities in their network of providers. Others let you go outside of the network for care, but may not cover the costs at the same level.
  1. Will your prescriptions be covered?Read the fine print carefully when reviewing plan options to make sure you're aware of what might not be covered. Separate insurance is typically required for things like prescriptions, vision care and dental coverage.
  1. What will your deductibles, copayments, and maximum out-of-pocket costs be?In general, the lower the premium, the higher the out-of-pocket costs when you need care. Premiums are usually higher for plans that pay more medical costs. For example, if you have a Gold plan you'll likely pay a higher premium than a Bronze or Silver plan, but may have lower costs when you go to the doctor or use another medical service.
  1. Did you know you can’t be denied coverage due to a pre-existing condition like diabetes or heart disease?You can’t be charged a higher premium because of your conditions. And you won’t lose your coverage if you get sick.

Remember, the 2015 deadline for insurance is February 15.  If you have questions, call the Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. You can also visit Localhelp.HealthCare.gov to find help in your area.

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If you are looking for a UnitedHealthcare health plan, there are many ways to enroll:

  • Online at uhc.com/join
  • By calling 1-844-JOIN-UHC
  • In person with help from Navigators, insurance brokers or agents.
By Derrick Lane | Published January 21, 2015

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