EDITOR'S NOTE: This article was originally published in Success With Your Money 2011. To order a copy, click here.
The health insurance marketplace for individuals will change drastically in 2014, when policies will be sold on state-run exchanges and insurers will no longer be able to deny you coverage or charge higher rates because of your health. Until then, take advantage of new rules and resources to help you find coverage.
New resources. A new tool at the government’s HealthCare.gov provides detailed information about the policies available in your area and makes it easy to narrow your search based on the size of the deductible, out-of-pocket expenses, and type of plan (such as HMO or PPO). You’ll see details about benefits, copay rates, exclusions and base premiums.
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The tool does not provide personalized premiums based on your health. For more-specific quotes based on your medical condition, go to www.ehealthinsurance.com, which asks questions about your health and lists prices and policy details from many companies. You can also get help from a health insurance agent through www.nahu.org.
If your employer lets you continue coverage through COBRA -- the federal law that requires employers to continue to offer you coverage for up to 18 months after you leave your job -- shop around before you take it. It can be pricy because you must pay both the employee’s and the employer’s share of the premiums yourself. If you’re healthy, you may find a better deal on your own.
Improvements to high-deductible plans. High-deductible plans are a good way to save money on premiums. In many cases, the premium savings more than makes up for the higher deductible. And new laws now require most insurers to provide preventive-care screenings without charging deductibles or co-payments, even if you have a high-deductible policy. Depending on your age, you could be eligible for free blood-pressure, diabetes and cholesterol tests, mammograms and colonoscopies, flu shots, routine vaccines, well-baby and well-child visits and other preventive services.
If your health insurance policy has a deductible of at least $1,200 for individual coverage (or $2,400 for family coverage), you can make tax-deductible contributions up to $3,050 to a health savings account for 2011 (or $6,150 for family coverage), plus $1,000 if 55 or older. That gives you a stash of tax-free money to use for medical expenses in any year.
New options for people with health issues. If you’re leaving a job that offered health insurance, you’ll usually be able to keep that coverage no matter how bad your health is for up to 18 months under COBRA. Most states must provide a continuation policy after you’ve used up your coverage. (See www.coverageforall.org for your state’s rules.)
If you aren’t eligible for COBRA, you may be able to find coverage through the new Pre-Existing Condition Insurance Plan, which was introduced last year as a part of the health-reform law. These plans are run by the federal government in 23 states and the District of Columbia; 27 states run their own plans, which must also follow the federal rules. The federal-run plans recently reduced premiums by up to 40%. However, there’s a big catch: You can qualify for this coverage only if you’ve been uninsured for at least six months.
Even if you haven’t gone for that long without insurance, you may still qualify for a policy through your state’s own high-risk insurance pool, which may not require a six-month waiting period. For a list of options and rules, see www.healthcare.gov or www.coverageforall.org.
