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Understanding Health Care Plans And Why I Am So Thankful For Mine

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2014 brought a lot of health plan usage to our family and I was so thankful to have health insurance. One thing I realized was that I didn’t completely understand my health plan or the Affordable Care Act and I knows others don’t too. 

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Over the past 6 months I had to be hospitalized twice, once was after having a major surgery and the other was from complications due to the surgery. I don’t talk about it much because I’m thankfully much better now, and because I had health insurance. I think having health insurance really aided in my recovery because I was able to focus on getting better and not worrying about the financial aspect of being ill.

I know that health insurance isn’t the most exciting thing to talk about. It can even be confusing… but I’ve learned that it doesn’t have to be confusing and that being prepared makes staying healthy easier.

Since the Affordable Care Act started I’ve really been looking into my insurance options and I’ve learned that the more you know about the the Affordable Care Act the better prepared you’ll be to make smart decisions about your coverage. Thankfully there are a lot of resources to help us understand it all better, but here is a quick recap.

ACA is all about helping more people get access to affordable health insurance. The Act also guarantees coverage for pre-existing health conditions, and financial assistance for those who qualify. This may include savings on your health insurance premiums via a tax credit or a government program, such as Medicaid, the Children’s Health Insurance Program (CHIP), or Medicare.

Now let’s get a bit deeper.

The first thing you need to learn about is what has changed in health care.

The ACA has raised the Medicaid limits in some states so more people are eligible along with offering subsidies to eligible income levels above medicaid, but still in the realm of struggling. Although this doesn’t apply to my family I know that this is a huge help to others.

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Secondly, you need to understand what open enrollment is all about and why it matters to you.

Essentially, you need to use the time of open enrollment to get the proper health plan bought and set for your family. Open enrollment is between Nov 15 and Feb 15. During this time you have to pick a plan in order to have coverage from the 2015. There are certain qualifying events that allow you to use a special enrollment period. When we adopted The Little One I remember that we then qualified for a special enrollment period. There are other events that can qualify you too.

Lastly you need to know about exchanges and marketplaces… they are where you can learn about, compare and purchase plans. 

The exchanges or the marketplace are websites that allows you to compare plans from a variety of providers much like Travelocity does for travel. The websites will be either the government Healthcare.gov website or your state’s individual marketplace website.

I started on the government website and it directed me to my state exchange. 

The process is pretty straightforward with directions every step of the way. Even though I currently have insurance I still wanted to see what options were out there for me and my family… especially once I learned that 87% of health insurance exchange applicants saved $250 a month or more on their health insurance last year. That is a huge savings! Can you imagine what you could do with that extra money each month?

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After you understand more you will want to know how you can get the most from your health care plan.

Since costs within health care can be daunting. You will want to check your deductible and out-of-pockets on a regular basis to stay ahead. When deciding on a plan, look for value ads provided by the company such as nurse lines, apps, and health club discounts too! Also, make sure to ask your Doctor how much medical tests will cost and if there are less costly alternatives. You can also take a few minutes to watch these short videos to find out more.

Be sure to learn more about available Health care plans now since open enrollment ends soon on February 15th.

Have you looked at your health care plan options recently?

 

Heather Reese
the authorHeather Reese
Heather Delaney Reese is the storyteller and photographer behind the lifestyle and family travel blog, It's a Lovely Life®! For the past decade, she has vacationed over 150 days a year with her family. She is a vegan, and loves being by the water, spending time with her children, husband, 2 Shih Tzus and Cat.

35 Comments

  • Here in MA, it’s mandatory, but my hubby is a federal employee, so we get some great options.

  • My Hubs has been searching for a great health insurance for both of us. Not easy to find one that fits all of our needs.

  • I don’t know what people do without health insurance. It has to be hard. I’m happy about the affordable care act even though I’d say it needs a lot of work to work effectively for everyone. I’m thankful for pretty decent insurance through my husband’s job. You never know when you will need it.

  • We just changed our health care plan. My daughter is chronically ill, so it’s important that we find the best plan possible.

  • Health insurance can be so confusing. The only reason mine is taken care of is because my husband sold it for years so I leave it up to him!

  • Whenever health care and insurance is mentioned I am so thankful I’m in Canada. It’s so confusing in the US and I just couldn’t imagine!

  • This is really great information. I am lucky and have decent health insurance through my job.

  • I am thankful for having access to health care and doctors. I didn’t have it for a short period of time and it was horrible. I now have medical issues and rely on my insurance company to help pay a portion of my medical bills. I’m hoping that the push for medical care will help reduce the rising costs.

  • We get insurance through my husband’s employer. Sadly, ACA didn’t help us. Our plan was grandfathered and the other one that was offered that wasn’t grandfathered got worse after ACA went into affect. It’s good coverage, but we have to drive really far to see doctors, the ones by us aren’t covered.

  • We have health insurance through my husband’s employer but with so many medications it is still quite expensive to keep up. I wish for everyone to have good health insurance coverage, no one should be without help with medical needs and medication.

  • Our insurance is terrible. I hate that it is mandatory. I would much rather sock away the money that we send to the insurance company to save for when we do need it. I pay boatloads for them to cover nothing. I just don’t get it.

  • When my husband was unemployed we bought our own insurance directly. We briefly had employer insurance and then had to go back to buying our own insurance. Even with the tax credits, our insurance costs increased by over 30% after the affordable health care act took place.

  • My husband had insurance when he was an extern at the hospital he was going through his clincal’s at. As a hospital employee, the insurance is really cheap and you hardly have to pay for anything. We were spoiled. Now that he has graduated he’s working at 2 hospitals and even though he gets full time hours hes not considered a full time employee as they hired him on as per diem (as needed.) So no benefits. We have been wading through all the Affordable Healthcare stuff and really haven’t been able to come up with anything close to what we had without paying $800 a month. If we stay within the price we paid when he was getting the insurance, we have a super high deductible (like over $10k) and the co-pays and medication aren’t cheap. It makes me feel like we are better off just being cash payment people and paying the income tax fine until his employer hires him on full time and we can get back to having hospital insurance.

  • You’re right, health care is not an exciting topic, but it’s one everyone should understand. You need he right plan at the right price.

  • Heather, Great post I understand You concern. I hope others follow we cannot go without insurance. we do not know when we may get sick. thanks for sharing.

  • Shopping for Healthcare is so difficult and I hated doing it. Your post has given me more insight to how important it is to have coverage and how to shop for them.

  • Healthcare is so important and do is understanding your plan. I think a lot of people don’t really understand how their plans work and could benefit from so many services that they maybe don’t even realize are included.

  • You are right that having health insurance will aid in recovery. With health insurance, you are more likely to go get a problem (or surgery complication) checked out because you have that peace of mind. I am thankful to have health insurance now after many years of not having it.

  • We may spend close to $700 for our plan each month, but it is security. Our daughter has heart defects so her bills alone make the premium worth it.

  • I’m so glad to read that you are doing better. If it weren’t for subsidized health insurance, I’d be in bad shape too. I can never understand the mentality of those who want to do away with ACA.

Comments are closed.