Life & Health Insurance/Health insurance
QUESTION: Thank you so much for your time! I am currently looking for health insurance. I have been in remission for 6 years for breast cancer. I am not sure what type of plan would be best for me. In my state (Arkansas), I qualify for help with my monthly insurance bills. I don't go to the doctor as much as I use to but I do have about 2 pet scans every year and see my oncologist about 3 times a year. What would be the best insurance for me? I am looking at Arkansas Blue Cross. Thank you again! Happy New year!
ANSWER: Hello, Tanya:
Firstly, I want to make clear that I am not licensed in Arkansas. That said, due to the ACA, most health plans are very similar no matter the state.
I have visited the Arkansas BCBS website and perused the plans available. Assuming you have visited www.healthcare.gov when you determined that you qualify for premium assistance, do you know if you also qualify for a lower deductible/co-pays as well? If so, you must choose a Silver level plan to receive this additional benefit.
Personally, I recommend an HSA (Health Savings Account) plan. Whether you rarely see a doctor or have an appointment every week, HSA's are the way to go. But to determine which plan is best for you it must first be determined whether you qualify for a lower deductible.
Please let me know if you qualify for a lower deductible and we'll go from there.
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QUESTION: Thank you for getting back to me. I found out that I actually do qualify for a lower deductable.
As mentioned, because you qualify for a lower premium and deductible, the Affordable Care Act (ACA,) mandates that you must choose a Silver level plan to enjoy the lower deductible/co-pay benefits.
Most importantly is the insurer you choose, and thankfully you have chosen your local BCBS. As you will see when enrolling through www.healthcare.gov, there are other insurers to choose from, but in my opinion there is only one that stands out, BCBS. Especially now, the importance of being insured with a nationally recognized and financially sound insurer is paramount.
So, you've done the hard part. You have chosen an insurer, and you now know you must choose a Silver level plan. The BCBS Silver 3350 HSA is your best bet in my opinion. Because you qualify for a lower deductible than the standard $3350, it makes it that much more of a value. You will notice that the other non-HSA Silver plans from BCBS have co-pay benefits, such as $20 to see a doctor, and prescription co-pay benefits too. But what you will also notice is that the maximum cost-sharing amounts are much higher than the Silver HSA 3350. The maximum cost sharing (aka maximum out of pocket) is the most important number when shopping for health insurance. It is your worst case scenario number, the most you will have to spend in any given year for healthcare, excluding premium. Please look for the BCBS Silver plan on www.healthcare.gov with the lowest maximum cost sharing amount and choose that plan. My guess is that it will be the Silver 3350 HSA, and it will be the least expensive Silver plan as well. Many people are more comfortable choosing a plan that includes co-pay benefits for office visits and prescriptions, and you may be as well. Nothing wrong with choosing one of these plans instead of the HSA. My point though is that from a purely financial perspective the HSA will win every time. You will get the most coverage for the least cost with an HSA, and you will likely have lower rate increases each year with an HSA. HSA's also have fantastic tax advantages, but we won't delve into that aspect here.
Lastly, please verify that your current physicians are in-network. If they are not in-network I strongly suggest finding doctors that are. The reality is that if they aren't contracted with BCBS, chances are they are not contracted with any other reliable insurer. This is an important step, as it will cost you much more when using out of network doctors, or possibly not covered at all. There will be a link next to plan where you can look-up physicians in-network.
Hope this helps, and Happy New Year!