Banging on the walls chanting "OPEN ENROLLMENT FOR ACA THRU JAN 15" like some deranged town crier. Election results aside, you have options to access healthcare as a RIGHT through the ACA. NO one can dismantle the Affordable Care Act in less than 4 years, so SIGN UP! GET YOUR CARE! USE THE SYSTEM!
You have options RIGHT NOW that will be stable thru the next year, the one after that, and I'd be shocked to see them shrink even the year after that. That means RIGHT NOW you can get signed up for next year to gain 100% covered preventative care (your annual check ups, pap smears, dental cleaning, vision check). You have the option to get checked and screened as you need, do NOT be dissuaded from exploring ACA choices. They are SOLID, LEGISLATED, and WORK BEST WHEN PEOPLE USE THEM.
I can't change most things around me, BUT I CAN tell everyone I know that THEY CAN GET LIFE SAVING CARE. THEY CAN GET PRESCRIPTIONS. THEY CAN GET PREGNANCY CARE. THEY CAN GET CANCER CARE. AND THEY WILL GET THAT CARE!!!!!!
SIGN UP BY DECEMBER 15, 2024 FOR COVERAGE TO BEGIN ON JANUARY 1, 2025. ENROLLMENT AFTER 12/15/24 WILL HAVE COVERAGE BEGINNING FEBRUARY 1, 2025.
Welcome to the Health Insurance Marketplace®. Official government website.
My fellow Americans
Take advantage of what our civil servants have built for you and spread the word.
I have reblogged this before but insurance is kind of what I do, so if you are looking for insurance on the marketplace and have no idea what plan to pick, DM me and I’ll help you.
A quick overview for what to look at in terms of figuring out costs.
1. Premium= this is the amount you pay per month for the plan whether you use it or not. If you don’t pay this they cancel your plan.
2. Deductible= This is the amount you pay for healthcare services out of pocket before your plan kicks in and covers. Your insurance will typically still afford you discounts on services prior to meeting your deductible. Additionally preventative services are covered without meeting your deductible. On some plans office visits including mental health visits may be covered with a copay, before hitting your deductible. On some plans it is not until you hit your deductible.
3. Co-pay: this is the amount you pay at the time of a medical visit. It’s usually between $25 and $100. Sometimes ER visits have a copay that’s significantly higher.
4. Co-insurance: Once you meet your deductible your plan will pay a percentage of the healthcare costs. On marketplace plans this is usually between 50% and 80%, leaving you with the rest as co-insurance until you hit your Out of Pocket Maximum.
5. Out of Pocket Maximum: this is the amount you will pay out of pocket (deductible, copays, co-insurance) for a calendar year before your plan covers 100% of covered, in network services.
The Summary of Benefits and Coverage document should show you all this information for each plan.
A few more things to keep in mind:
In-network providers: some ACA plans have very narrow networks. Make sure to check that your PCP, therapist, specialists are in network before you select a plan. Many plans have no out of network coverage and even when they do, it’s very poor coverage and you’ll pay a lot out of pocket for out of network coverage.
Types of Plans:
PPO: these tend to have the widest networks and some out of network coverage. You also don’t need a referral for specialists
HMO: you need to designate a PCP and you will need referrals to specialists. No out of network coverage
EPO: Exclusive Provider Organization. Slightly larger network than an HMO. Usually don’t need referrals, no out of network coverage.
POS: similar to an HMO plan in that you need referrals, tends to have some limited out of network coverage.
Some insurance 101 for you and feel free to ask questions if you have them.
