Between Obamacare and Affordable Care Act

When you ask people on the street a question about Obamacare versus the Affordable Care Act the answer reveals that many people are adamantly against Obamacare but are for the Affordable Care Act – yet, they’re one and the same thing. For years now, we’ve been bombarded with conflicting information, promises, opinions, legal challenges, and more, and the verdict is still out. Whether you’re for Obamacare, against it, or still confused about what it really is, turmoil in the marketplace will continue for years to come.

Here’s what we know for sure:

You have to enroll in a qualified health insurance plan or pay a penalty
Unless you qualify for subsidies, and even if you do, you’ll likely have higher than expected out-of-pocket expenses.

Health insurance was supposed to get better, and cheaper, right? Perhaps for some, but it looks as if employees are feeling the burden. According to Aflac’s 2015 Workforces Report, companies are continuing to shift the cost of healthcare to employees:

31 percent increased employee’s’ share of their premiums
30 percent increased copay amounts
21 percent switched to high deductible plans with HSAs
Some even dropped coverage for partners and spouses.

These figures translate into more out-of-pocket costs for employees. If you’re feeling the burden, it may be time to look at alternative solutions. Changing plan types may not provide enough financial protection. Regardless of what type of coverage you are interested in, individual or company sponsored there are somethings you can do right now to protect yourself financially.

Many people can’t afford the Gold and Silver plans for their families, opting instead for high deductible Bronze plans in order to keep their premiums affordable. What happens when they get sick or injured? Their insurance won’t kick in until their deductible has been met.

With an average 2015 deductible for a family enrolled in a Bronze plan being $10,545, the Affordable Care Plan is far from affordable. This leaves many in a very uncomfortable financial situation. One solution may be a pre-tax health care saving plan. The plan can divert monies pre-tax into a savings account that can be used to pay health care cost. Talk to your company’s human resources department to see if they can set it up for you. If not go to a qualified CPA to set one up.

The key here is preparation be prepared to cover the out of pocket cost when injury or accidents happen.

 

The Time When You Can’t Afford Health Care

There’s a huge difference between health care and sick care.

Your insurance pays for sick care. That’s what happens when you get sick and the doctors do tests, give medicine, or do surgery.

Health care is everything else. It’s choosing good foods because good foods support your body. It’s choosing massage and bodywork because it keeps you limber and pain free. It’s exercise because that moves your body.

Health care is everything that supports life. It’s a standard of living that means you can do what you want when you want.

Sick care is profitable, health care is not. Sick care costs you lots of money, health care costs little.

The average person pays about $400 per month on health insurance (about $900 if your company pays it, now you see why you didn’t get that raise?). It’s estimated by 2020, that cost will be $1,200 to $2,000.

Unfortunately, this means health insurance will be beyond nearly all households. And Medicaid is cutting more treatments, drugs, and procedures every day. Medicare is nearly gone.

So, instead of being sick, be healthy. Choose the $35 per session massage and chiropractic. This could save you pain, lost time at work, and medication costs. Herbal sessions are often cheaper. I’ve worked with people and their herbs cost them less than $20 per month. Yet, just the co-pays from the prescriptions would have been over $100 per month.

This goes far beyond just feeling good now. If you don’t take care now, and wait to get sick, you’ll be a high risk patient and client. If we start to move towards a system where we pay for what we need, waiting and expecting the government to take care of us will only result in no care at all.

If you choose to be healthy now, and to use alternatives now, you will delay problems, eliminate lifestyle diseases, and be able to make more choices later on. You will be able to choose your life.

And I use these alternatives myself. I visit the doctor once per year when I need my physical (then again, my doc also told me I’m so healthy they needed to put me off to see the sick people). I use exercise, food, massage, chiropractic, and herbs to keep my health.

At some point, we’ll be faced with a choice: Health care or sick care. Choose health now, and avoid sick later.

 

How Health Plans Work

Over and over I hear about how these new metal level plans does not work or pay for anything. This simply is not the case. The reality is most people just don’t have a thorough understanding of how these plans work. Under the new affordable care act law; in general all the plans are based on these three criteria; age, geographical location and ability to pay; in some states tobacco use is taken into consideration, when it comes to your premium dollars.

All level plans Bronze, Silver, Gold, Platinum, and Catastrophic all have the same 10 essential health benefits that must be included with every plan; they just have different deductibles, co-insurances, and co-payment amounts. The way level plans can be explained are: Bronze plans are for people who are healthy and goes to their medical providers once or twice a year, and these individuals should have money to afford higher deductibles.

Silver plans are for people who seek medical attention a little more frequently; three to four times a year; Gold or Platinum level plans are for people who are unhealthy and afflicted with chronic health conditions who need medical attention throughout the year at least once a month or even sooner, and they have the funds available to be able to afford the higher monthly premiums. This is just an overview of what you should consider when choosing a plan.

Catastrophic plans are for individuals under the age of 30 or who has financial hardships at any given moment throughout the year and can clearly show why he or she is unable to afford health insurance. These type of plans has high a deductible; why have such a high deductible in the first place if affordability is a concern? Choose a plan that will meet your individual needs for yourself and your family’s overall health and budget.

Some people think because he or she has a Gold or Platinum level plan they will have better benefits; this is not the case, remember as stated in the second paragraph, each plan just has different deductibles, co-insurances, and co-payments, if you choose to have a higher deductible you take on more risk in the beginning, paying for the majority of your care until you hit that deductible; your premiums will be lower. If you choose to have a lower deductible, your premium will be higher because you are wanting the insurer to start paying out claims much sooner.

My previous articles touched on financial responsibility if you fall through the cracks with too much income to receive assistance; there are ways to mastermind getting through the cracks so this whole new healthcare law can benefit you financially. We suffer as a people because of a lack of knowledge, and not allowing someone else with certain expertise to intervene on our behalf to make things better in situations regarding our health and financial well-being.

Be encouraged and reach out to others who specialize in other areas when you need them; part of your team should include but not limited to: a good business attorney, medical providers when needed, an insurance agent, and an accountant to help you see your way through this new era of healthcare reform.

Always keep in mind; insurance is in place when you need it and not if you need it. Gain a better understanding of this, and perish not

Before Apply a Health Insurance Policy

Choosing the right health cover is an important decision as it provides you a sense of security by offering immediate medical assistance in case of an emergency. However, there are many people who buy the policy as per their agents’ advice and don’t bother about their personal requirements. To them, it is advised to keep in mind the following 8 tips while choosing a health cover:

Tip 1: You must always purchase a health insurance policy no matter whether or not your company offers you a corporate health cover. There are times when you quit the job or your company decides to withdraw the benefits or provides a cover that is not fit for you, in these cases your personal health cover may benefit you. This becomes more important if anyone in your family is suffering from a chronic disease.

Tip 2: Always choose the right amount of sum insured. If you are living in a small city, your health cover should be around 3-5 lakhs whereas if you live in a metropolitan city, your health insurance cover should be no less than 5-10 lakhs. Don’t purchase a new plan; instead port it to get maximum benefits out of it. When you port the plan, the benefits which have been already accumulated in your old plan get transferred in the new policy. Also, keep upgrading your health cover from time to time to take care of your medical inflation.

Tip 3: Buy a health insurance cover as early as possible, especially before you reach in your 40’s. This is because, you are less likely to make claims in early stages of life and can later reap the benefits of no claim bonus and add up to the original coverage every claim-free year.

Tip 4: Always purchase a cover that offers lifetime renewability. This way you will have a health cover at the older age – the time when you have a major health problem and that protection is possible only if your policy offers lifetime renewability.

Tip 5: Buy a policy which gives you restore limit just in case you fully use your sum assured. This will act as a backup cover in an unforeseen critical illness which may be very expensive to manage. For example, Rs 3 lakh plan with Rs 3 lakh restore limit almost gives you Rs 6 lakh cover for critical illness at no extra cost.

Tip 6: Always purchase a health cover through a reputed agent who can help you with claims too in future. For this, you can seek help of online websites to select a plan or examine features but only buy the health cover through an agent or company which has the ability to help you with the claim or offer easy claim settlement procedures.

Tip 7: Always provide the right and true information in your application form. If you suffer from any disease or illness, don’t forget to mention it in your application. You can seek the help of an agent who can assist you in getting the right plan which will cover the disease even after a waiting period. Presently in most policies all preexisting diseases get covered after 3 to 5 years.

Tip 8: Buy the policy with no or minimal sub-limits. Keep an eye out for plans with offers a cap on hospital room rates. This way save your money and give you a sense of relief too.