By: Joel Harrison
The clock is running… America is scrambling to get ready for one of the biggest social economic changes since the implementation of welfare, Medicare and Medicaid. Big changes mean big questions. With less than 6 months to go in 2013, people are anxious to see what healthcare is going to look like. Many people don’t want to make a move until everything is in place and working. For people who are currently denied coverage due to a pre-existing condition, the days are creeping by until they can purchase the care they need. Insurance carriers know that they will be paying more in claims in the future; this means that right now carriers are trying to collect as many healthy people as possible to help balance the scales. There big advantages to shopping this year that could greatly improve your healthcare situation in the future.
1.) The healthy pool When you buy insurance you are often put into a “pool” – a group of people who are grouped by certain criteria. Often this is done by your geographical location. Your “pool” also contains a group of people of varying health status. The design is intended to strike a balance between premiums coming in and claims going out. If you are healthy, and purchase your healthcare before Jan 1st 2013, you meet the criteria to join a healthy pool. This means that the overall cost of your “pool” will be less, because healthier people cost less in claims.. The best news is the pool doesn't evict you later . Once you’re in… as long as you keep your policy, you can stay in the healthy pool. This will not avoid rate hikes in the future, however it will make your rate hikes more manageable than the healthy guy who buys in January and jumps into the “everybody pool.” The “everybody pool” will include any and all illnesses and have a very high claims cost.
2.) Essential health benefits On January 1st 2013 every major medical plan must include certain coverage for EVERYONE. Are you a single 24 year old male, or a couple in their 50’s? Neither are planning on having children, however they will both be paying for maternity and fertility coverage… Haven’t taken a pill in years? Sounds like you need prescription coverage. Don’t want it? Too bad, every single major medical plan sold in 2014 will have these, and other benefits mandated. These rich plans are great you’ll be covered for everything, however they will also be VERY expensive. If you don’t need all of these benefits then now is the time to shop. Each carrier handles the upgrading of current plans to new benefits differently. Blue Cross Blue Shield of Illinois will upgrade all plans on January 1st 2013. The new plans are defined by richness of benefits, and assigned a “metal” level – bronze, silver, gold or platinum. When these plans get “upgraded” (aka ” metalicized”, meaning they will now fall into one of the newly defined metallic levels of benefits,) the price will skyrocket; estimates are anywhere from 50% to 200% increased cost. Some carriers will let you put off this upgrade until the one year anniversary of your plan, others even let you keep your current plan design until Dec 31st 2014… Postponing a huge rate hike a whole year sounds like a GREAT reason to shop now to me.
3.) Cost as previously mentioned, healthcare premiums are about the skyrocket. Estimates are range from $350-$500 MORE PER PERSON. These plans will offer GREAT coverage and anyone can get them regardless of health status, location, medications, weight, or any other reason someone would be denied coverage today. But again, they will be hugely expensive. Cost is the big ugly monkey on the back of healthcare reform. Paying more claims means premium costs must go up across the board. Another new rule is that no one person can pay more than 300% more than any other. Currently a difference of 500% is allowed.,. Younger, healthier people will face much higher rates in order to subsidize rates for others.
4.) State Marketplace (the artist formerly known as the public exchange)GREAT COVERAGE FOR EVERYONE… if you can afford it. Yes the government will be subsidizing premiums for those under 400% of the poverty level (which starts out around $42,000 for an individual and increases based on family size.) The cost of healthcare purchased from the State Marketplace is the “unknown” factor that has most people waiting to shop. STOP WAITING. We have been doing extensive research on this topic all year. We now have the ability to estimate what subsidy you may be eligible for and what your premium will be on the public marketplace. These numbers will not be exact; however they will tell you whether or not waiting is a good idea.
Healthcare is and will remain to be one of the top expenses for families for a long time to come. How far do you drive to save a few pennies on gas? How long do you spend each week cutting coupons to save a few dollars on groceries? Could you stop wasting that time if you made one big cost-saving move? Shop around for healthcare, find an agent who you feel you trust to find the best plan and price for your family, and prepare for the future. Healthcare reform is coming whether you want it to or not. Stop ignoring it and make the best move for your family and your wallet.
The clock is running… America is scrambling to get ready for one of the biggest social economic changes since the implementation of welfare, Medicare and Medicaid. Big changes mean big questions. With less than 6 months to go in 2013, people are anxious to see what healthcare is going to look like. Many people don’t want to make a move until everything is in place and working. For people who are currently denied coverage due to a pre-existing condition, the days are creeping by until they can purchase the care they need. Insurance carriers know that they will be paying more in claims in the future; this means that right now carriers are trying to collect as many healthy people as possible to help balance the scales. There big advantages to shopping this year that could greatly improve your healthcare situation in the future.
1.) The healthy pool When you buy insurance you are often put into a “pool” – a group of people who are grouped by certain criteria. Often this is done by your geographical location. Your “pool” also contains a group of people of varying health status. The design is intended to strike a balance between premiums coming in and claims going out. If you are healthy, and purchase your healthcare before Jan 1st 2013, you meet the criteria to join a healthy pool. This means that the overall cost of your “pool” will be less, because healthier people cost less in claims.. The best news is the pool doesn't evict you later . Once you’re in… as long as you keep your policy, you can stay in the healthy pool. This will not avoid rate hikes in the future, however it will make your rate hikes more manageable than the healthy guy who buys in January and jumps into the “everybody pool.” The “everybody pool” will include any and all illnesses and have a very high claims cost.
2.) Essential health benefits On January 1st 2013 every major medical plan must include certain coverage for EVERYONE. Are you a single 24 year old male, or a couple in their 50’s? Neither are planning on having children, however they will both be paying for maternity and fertility coverage… Haven’t taken a pill in years? Sounds like you need prescription coverage. Don’t want it? Too bad, every single major medical plan sold in 2014 will have these, and other benefits mandated. These rich plans are great you’ll be covered for everything, however they will also be VERY expensive. If you don’t need all of these benefits then now is the time to shop. Each carrier handles the upgrading of current plans to new benefits differently. Blue Cross Blue Shield of Illinois will upgrade all plans on January 1st 2013. The new plans are defined by richness of benefits, and assigned a “metal” level – bronze, silver, gold or platinum. When these plans get “upgraded” (aka ” metalicized”, meaning they will now fall into one of the newly defined metallic levels of benefits,) the price will skyrocket; estimates are anywhere from 50% to 200% increased cost. Some carriers will let you put off this upgrade until the one year anniversary of your plan, others even let you keep your current plan design until Dec 31st 2014… Postponing a huge rate hike a whole year sounds like a GREAT reason to shop now to me.
3.) Cost as previously mentioned, healthcare premiums are about the skyrocket. Estimates are range from $350-$500 MORE PER PERSON. These plans will offer GREAT coverage and anyone can get them regardless of health status, location, medications, weight, or any other reason someone would be denied coverage today. But again, they will be hugely expensive. Cost is the big ugly monkey on the back of healthcare reform. Paying more claims means premium costs must go up across the board. Another new rule is that no one person can pay more than 300% more than any other. Currently a difference of 500% is allowed.,. Younger, healthier people will face much higher rates in order to subsidize rates for others.
4.) State Marketplace (the artist formerly known as the public exchange)GREAT COVERAGE FOR EVERYONE… if you can afford it. Yes the government will be subsidizing premiums for those under 400% of the poverty level (which starts out around $42,000 for an individual and increases based on family size.) The cost of healthcare purchased from the State Marketplace is the “unknown” factor that has most people waiting to shop. STOP WAITING. We have been doing extensive research on this topic all year. We now have the ability to estimate what subsidy you may be eligible for and what your premium will be on the public marketplace. These numbers will not be exact; however they will tell you whether or not waiting is a good idea.
Healthcare is and will remain to be one of the top expenses for families for a long time to come. How far do you drive to save a few pennies on gas? How long do you spend each week cutting coupons to save a few dollars on groceries? Could you stop wasting that time if you made one big cost-saving move? Shop around for healthcare, find an agent who you feel you trust to find the best plan and price for your family, and prepare for the future. Healthcare reform is coming whether you want it to or not. Stop ignoring it and make the best move for your family and your wallet.
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