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Decrypting Health Insurance

The landscape for health insurance is very hard to navigate these days.  With Obamacare or the “Affordable Care Act” (ACA), going into full effect last year, there are still many questions about the industry, and the process to secure coverage. If you have individual health care insurance, there is now an open enrollment period where you can change your plan.  Barring special circumstances, the only time you can change your plan is from November 1- January 15.

You can get coverage outside of that period if you are eligible for a special enrollment period.  7 qualifying events . Events like, loss of job, moving to a different state, or a divorce are some of the common exemptions. The Health plan you choose has to be compliant with the ACA or you will get a fine.  It can get pretty steep-

The way health plans are priced these days are very different than before.  All plans have what I call a “base rate”.  These rates are fixed based on only two things.  Your age, and if you smoke or not.  Your current state of health has no bearing on pricing anymore. Rate sheets for all plans are available through each individual companies websites. What will have the most impact on your premium, is your income.  If your household makes less than 400% of the national poverty level, you will get a subsidy, or a discount on what you pay for your premiums. The less money you make, the cheaper your health insurance will cost.  For example,  a family of 4 making less than $94,000 is eligible for subsidy.


You will have you prove your income when tax time rolls around.  The accountants are going to be in for an exciting spring, I can tell you that. I would encourage you to read all the mail you get from your health insurance carrier for the next few years.  If you want to keep some semblance of control over your plan, you have to play a role in that.  The landscape is very hard to understand, but there are professionals (like me) out there putting in the time and effort to learn for you and help you make the best decision available.

I would encourage you to shop your rates every year.  Every company’s rates change regularly and it makes sense to see where the pricing is with each company.  The coverage within the policies are very similar these days.  The government has regulated what type of coverage has to be within each type of plan so there isn’t a big difference between the plans.

If you have an individual plan- PLEASE READ ALL OF YOUR MAIL BETWEEN NOW AND THE END OF THE YEAR.  You are receiving important information about the renewal of your current plan.

Many states have their own exchange to purchase these plans and it is actually pretty easy.  Here in Idaho, you just have to go to  to get started.  If you would like I can email you a link to get started.

Give me a call or send me an email.  I’d be happy to walk you through the process.  (208) 939-7123.

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