Tuesday, October 1, 2013

Health Insurance Marketplace Opens Today.

Starting today the Health Insurance Marketplace opens. Open enrollment runs October 1st to March 31st and is expected to take effect January 1, 2014.

If you have insurance through your employer, you will fair better financially since they pay a portion of your premium than if you purchase a plan independently.  But if you have no insurance, here’s some of the important things to consider when reviewing the insurance plans offered at the marketplace:

1.      Are your physicians and hospitals in-network for the specific plan you are interested in?
2 .     Will you be eligible for any subsidy?
3.     Are the prescription medications you are on covered?

There are 4 main levels of plans and offer essential benefits but each will have a different level of coverage and out of pocket expenses.  There is also a catastrophic plan available to those under 30 years of age or who have financial hardship.  Here’s the breakdown on the 4 main plans:
  • Platinum will cover about 90% of costs.
  • Gold will cover about  80%.
  • Silver will cover about 70%.
  • Bronze will cover about 60%.
Annual out-of-pocket costs like co-pays and deductibles will average around $6,350 for individuals and $12,700 for families.

Things you need to have available when applying are:
1.        employer information
2 .       income information
3.        social security number
4 .       any current health insurance plan information
5.    completed employer coverage tool form which can be downloaded at https://www.healthcare.gov/downloads/MarketplaceApp_Checklist_Generic.pdf

We recommend that you shop for insurance through a government website.  To shop online, visit http://www.healthcare.gov (English and Spanish are available) or call 1-800-318-2596. Hearing impaired patients using TTY/TDD technology should call 855-889-4325.
To find in-person counseling, please visit: http://www2.illinois.gov/gov/healthcarereform/Pages/Assisters.aspx

Another site if you live in Dupage County is http://www.enrolldupage.org/

If you prefer to use an insurance broker, we suggest:
James C. Pusateri
1501 East Woodfield Road
Suite 101-East
Schaumburg, Illinois 60173

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