Getting health insurance is essential as you start a new job, move to a new state, or take on other life changes. You might think about getting healthcare through your employer or through the marketplace. In either case, your options are plentiful and you need to understand them well before making a decision. However, this isn’t always an easy task. Since there are so many different health insurance plans available in Montana, it can be tricky to choose which one is best for you. There are numerous considerations when deciding which plan is right for you and your family. To help you make an informed decision, we have created this guide with some of the most important things to consider when choosing Montana health insurance.
Deciding between an employer-based plan and the Health Insurance Marketplace
One of the first factors to consider is whether you want to choose a plan on the marketplace or through your employer. There are pros and cons to both options. For example, employer-based plans typically offer more coverage than marketplace plans. They often offer lower monthly costs, a wider network of specialists, and more prescription coverage. However, there are some drawbacks to employer-based plans as well. For example, some plans have high deductibles that you have to pay out of pocket before coverage kicks in. Deductibles can be as high as $5,000 per year. Employer-based plans can also be more complicated to navigate than marketplace plans. Since these plans are fully funded by your employer, you have less control over the types of coverage you receive. If you choose an employer-based plan, there are some additional considerations you should keep in mind. First, is your employer offering plans through the marketplace or the Public Health Service (PHS)? If so, you have the option of enrolling in the marketplace. If not, you may want to consider switching to a different plan with a different provider. Another option is to look for an employer that offers plans through the marketplace. If you are considering switching to a different plan, you should discuss it with your employer first. You may be required to provide proof of comparable coverage from another provider. If you switch to a different plan, you will likely need to re-enroll in the marketplace.
Basics of Obamacare and What’s Changed
Before we dive into the details of choosing a plan, you first need to understand the basics of the Affordable Care Act, or Obamacare. The ACA is what got us to this point of having insurance plans available at all. In short, the law mandates that everyone have access to health insurance. It also protects consumers by prohibiting insurers from charging people more based on their health history. In the past, people with pre-existing conditions often struggled to find affordable coverage. The ACA changed this by providing insurance subsidies and making it easier to purchase coverage through the marketplace. One of the most important changes since the ACA has been implemented is the level of coverage available. When the ACA was first passed, the plans available were gold, silver, and bronze level plans.
Important Factors to Consider When Choosing Montana Health Insurance
The type of coverage you choose is just one factor to consider when choosing a plan. Other important factors include the cost of the plan, the network of providers available to you, and the amount of coverage you receive. Let’s take a closer look at each of these factors:
- Cost – The price of each plan is different, and the price you pay is based on a combination of factors. These can include your age, where you live, the amount of coverage you receive, and the type of plan you select.
- Network of Providers – The network of providers is the list of medical providers you can visit when covered by a particular plan. You should carefully review the network of providers for each plan to make sure the providers are near you and accept the insurance.
- Amount of Coverage – The amount of coverage you receive from each plan is based on the plan’s deductible and out-of-pocket maximum (OOM). The deductible is the amount you must pay before the insurance company starts paying for your care. The OOM is the maximum amount you must pay for covered services, even if your insurance company pays for all or part of the deductible amount.
Your Guide to Understanding Your Options in the Marketplace
As we have talked about, there are many factors to consider when choosing a plan. To help you navigate this process, we have created a chart to walk you through the different options available in the marketplace. The chart outlines the following facts about each plan: type of plan, monthly cost, amount of coverage, out-of-pocket maximum, and networks of providers.
Bottom line
Choosing a plan can feel like a daunting task, but it doesn’t have to be. By carefully considering the type of plan you want, the coverage you receive, and the cost of each option, you can make a smart decision. If you are choosing a plan through your employer, make sure to talk to your employer about your options. Health insurance can be complicated, but it is a critical part of life. Make sure you choose a plan that works for you and your family.
GET IN TOUCH