Understanding Health Insurance
If you’ve got a baby on the way, or if you’re raising a young child, chances are you’ll be spending more time than you’d like in that doctor’s office waiting room. The good news is, there are more ways than ever to help you pay for it. But, first you have to get through the jargon.
Health Insurance Options for Your Child and Family:
www.FloridaKidCare.org or call 1.888.540.5437
www.HealthCare.gov or call 1.800.318.2596
Need more information about the process? Read Sam's story below:
Weighing pros, cons of various plans
After years of working 40-hour weeks for someone else’s bottom line, Sam was proud he’d finally taken the leap to become his own boss.
And as his own boss, Sam enjoyed some great benefits; setting his own schedule was one of them. But there was a downside – Sam had to find and pay for a health insurance plan that fit his family’s needs, and he wasn’t sure where to start.
Fortunately for Sam and other Palm Beach County residents, agencies like the Health Council of Southeast Florida can provide assistance through navigators, which are people who have been trained to offer unbiased information about the new Health Insurance Marketplace.
“It is vitally important for people to understand their options, then to enroll in the appropriate plans, and finally to effectively utilize the health benefits they will have,” says Andrea Stephenson, Executive Director of the Health Council of Southeast Florida.
As part of the Affordable Care Act, which went into effect January 1, states are required to provide these navigators to assist the public in accessing the Marketplace. The service is free, and can help individuals access various plans and explain their benefits before purchase. (See the Resources box for help finding a navigator in your area.)
Changes due to ACA
The Affordable Care Act precludes insurance companies from refusing coverage due to pre-existing conditions.
But a poll conducted in April 2013 by the Henry J. Kaiser Family Foundation suggests that 42% of Americans weren’t aware of the changes that would take place under the ACA. The process for applying for private health insurance will not change, but now there are new options, including finding a plan in the Health Insurance Marketplace. Also, if you’re between a certain income level ($23,550 to $94,200 for a family of four in 2013) you may qualify for a subsidy. But you’ll have to select your plan from the Marketplace.
Something else to consider, says South Florida independent insurance agent Jeff Messett, is that if you are offered coverage through your employer, that plan may not cover your spouse and dependents. Also, if your family of four makes less than $94,200, and one spouse accepts employer-sponsored health insurance, the rest of the family may not qualify for the subsidy any longer.
“At that point,” says Messett, “it could be beneficial to price out private plans for the family instead of accepting the employer’s plan.”
For more information about health care changes in Florida, read Children’s Services Council’s Health Care Update.