Affordable Care Act<\/a>, who makes $150,000 a year, their cost could be as much as $5,000 a month. The change is the subsidies have decreased. There were always subsidies available to people with the Affordable Care Act and there still are, but they have gone back down to pre-COVID subsidies. When COVID came through, they added more and more subsidies, which made it free for a lot of people and affordable for a lot of people. Once they stripped that away, we\u2019re now looking at this particular family of four [and] $2,200 is their minimum cost for a very high deductible, high maximum amount out of pocket and not a very good plan. That\u2019s the biggest thing that has changed so much. If you\u2019re making $150,000 a year for a family of four, you cannot afford $2,289 plus a $10,000 deductible.<\/p>\nWhat are your first steps when working with a new client?<\/p>\n
I would ask them if they currently have any expensive medications or preexisting conditions that they need treatment for and what their income is. This lets me know what might be the right direction for them. I would also ask how they ended up calling me. \u201cHow did you end up with no health insurance?\u201d \u201cDid you not have it before?\u201d \u201cWhat changed?\u201d That information will tell me if they qualify for the Affordable Care Act because they will be in a special enrollment period.<\/p>\n
Many people who don\u2019t have health insurance who want health insurance are self-employed. I may guide that person, depending on the scenarios, to start a corporation or a company and have another W-2. Now this person may qualify for small group health insurance and have access to small group PPO health insurance … so there are some ways to navigate through that system.<\/p>\n
What should people look for when comparing health insurance plans?<\/p>\n
First of all, people should look at what network that plan is using. \u201cAre my doctors and hospitals in that network,\u201d would be the first question I would ask. I would also ask, \u201cIs going to a specialist without getting a referral important to you?\u201d I think a lot of people are starting to just self-pay so they can go to the doctors they want to.<\/p>\n
People should also understand the benefits of that plan and any limitations or exclusions that it has. Does it cover preexisting conditions? Look at what the actual cost is. Even if you pick the cheapest plan, you still have to calculate, \u201cwhat is my deductible?\u201d \u201cWhat is my max amount out of pocket on top of that?\u201d<\/p>\n
What are some common mistakes you see people make when selecting a health insurance plan?<\/p>\n
I\u2019d say the biggest problem people have is that they bought coverage that their doctors don\u2019t accept. For those with the Affordable Care Act, they need to upload their income to the system so they can receive the subsidies. If they lapse on providing that information, they could end up with no health insurance because the subsidies will be canceled.<\/p>\n
One thing you wish clients understood before buying insurance<\/p>\n
I think it\u2019s important for them to understand that it isn\u2019t necessarily what the insurance does for you now or in a day-to-day. But if you\u2019re trying to be affordable, even the worst [coverage] that has a $10,000 maximum out of pocket\u2014if you need a $100,000 surgery, you only need to pay $10,000. These plans are still protecting that individual and the credit of that individual. Having some health insurance, even if it\u2019s not exactly what they wanted, is better than none at all.<\/p>\n
What advice would you give to someone currently seeking health insurance?<\/p>\n
Understand all the options and call a broker. A good broker will have more options than what you will find just looking online. We can tailor something specific for the individual as opposed to just getting what is out there. What I want people to know is there are now options out there that did not exist a few months ago. They have fixed indemnity plans that are much more affordable. There are also healthcare sharing plans from primarily organizations. It can be a lot, but that’s what I help guide people through when they call me.\n\t\t\t\t\t\t\t<\/p>\n","protected":false},"excerpt":{"rendered":"As the health insurance market continues to grow, navigating the options and choosing the right plan can be…\n","protected":false},"author":2,"featured_media":326161,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[11323,132,134,133,1604,2889,116633,251,116632],"class_list":["post-326160","post","type-post","status-publish","format-standard","has-post-thumbnail","category-austin","tag-affordable-care-act","tag-austin","tag-austin-headlines","tag-austin-news","tag-community-impact","tag-health-insurance","tag-jeff-lambert","tag-local-news","tag-the-lambert-agency"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/326160","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/comments?post=326160"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/326160\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media\/326161"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media?parent=326160"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/categories?post=326160"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/tags?post=326160"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}