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If you follow the news, you may have read that health insurance premiums are going up in 2017 for all health insurers serving Southeast Wisconsin. Much of this has to do with financial losses experienced by health insurers in 2016 and the fact that two of the Affordable Care Act’s premium stabilization programs are going away this year.

Don’t despair! At the same time prices are going up on health insurance plans, tax credits available to lower costs are also going up.  If you are willing to switch plans, you may find that a different plan could help lower your costs significantly.

You just have to know where to look, and we can help. The Affordable Care Act, while making plans more affordable, has also added to the complexity of an already confusing system. Here are some tips you should keep in mind when choosing a new plan for 2017:

  • Understand what it means to not have health insurance if this is something you are considering. Most people will have to pay a tax penalty and they won’t be financially protected. This great new calculator (sponsored by Social Interest Solutions, which is not affiliated with CGHC) can show you the difference between being insured and not having insurance if appendicitis strikes. If you wait too long to decide though, you won’t be able to purchase insurance after open enrollment ends on January 31, 2017.
  • The tax credits that the government provides for the purchase of insurance goes directly to lower your monthly costs for insurance. You don’t typically see this money, it just gets taken off your bill every month as your “tax credit.” But if you don’t buy insurance, you get nothing.
  • Because tax credits are based on the price of silver plans which are increasing in 2017, your tax credit will likely go up too. A recent study shows that tax credits for people living in Milwaukee are going up a whopping 46%, meaning that the cost of a silver plan only increased by $1 from 2016 to 2017.
  • When choosing a plan, know that only silver plans provide extra savings and are an amazing value to thousands of people that are eligible for cost reductions. If you are one of those people, you will pay much less for healthcare if you get sick or injured. That’s because a bronze plan typically has deductibles upwards of $6,600. In a silver plan, that deductible can drop as low as $0. If you get sick or injured and need to use your health insurance, that’s a huge difference in the amount you will have to pay out of pocket.
  • Be sure to enter your income when you are shopping on healthcare.gov or on our website. This way, you can see exactly the kind of savings and the kinds of plans you are eligible to buy. If you are eligible for extra savings on silver plans, you will see an “extra savings” flag on the upper left hand corner while you are looking at different plan options on healthcare.gov. You can hit the “refine results” button to only look at silver plans if you’d like.
  • Besides the type of plan you buy, you should also look at a plan’s network. CGHC’s provider network mainly consists of Aurora Healthcare and Bellin Health System providers. If you want to see a doctor in another health system, you probably don’t want to buy one of our plans.
  • If you take medication, you should also check a plan’s drug list, or formulary, to see if it is covered. Most plans have different “tiers” of medications. If your drug falls in a lower tier, such as generic or preferred brand, you will pay less for the medication. If it falls into a higher tier, you’ll pay more. If it doesn’t appear on the drug list, it’s not covered by the plan and you should look elsewhere or talk to your doctor about alternatives to your prescription.

We hope this information is helpful to you in finding a plan that fits your needs and your budget. While we’d love to have you as part of our non-profit CO-OP, it’s more important that you find the right plan for you. A CGHC staff person can help you look at your options, but don’t wait to call us at 855-494-2667. The deadline for buying January 1 coverage ends December 15, and the closer we get to this date the busier we get helping people find plans. Call us now while we can take the time you need to find the right plan for you.

 

 

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