If you can shop on Amazon you can shop for your health insurance! Healthcare.gov is the official website for marketplace health plans, but let’s face it, it is not the most user friendly experience. Many insurance professionals use an alternate site that allows us to sift through the numerous plans quickly and efficiently. But before we get into that, let’s go over some of the key features to look for in your major medical insurance and how “Obamacare” came to be.

What is the Affordable Care Act?

In March of 2010 the Affordable Care Act (ACA) was signed into law with three main goals: Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level, to cover all adults with income below 138% of the FPL, and to support innovative medical care delivery methods designed to lower the costs of health care generally.

When we’re talking about Obamacare coverage, we’re referring to health insurance plans that are compliant with the ACA and offered by private health insurance companies on the Marketplace / exchange. (You can also buy ACA-compliant coverage outside of the Marketplace/exchange.) ACA-compliant means that the plans conform to ACA rules for things like minimum benefit levels, maximum out-of-pocket limits, guaranteed-issue coverage and various other consumer protections.

In making health insurance more affordable, the Marketplace offers to methods of financial assistance. The first, the Premium Tax Credit, reduces the enrollees monthly premium on any of the four ‘metal’ tiers of coverage. The second type of financial assistance, the Cost Share Reduction, reduces the enrollees maximum out of pocket and other out of pocket costs. Unlike the Premium Tax Credit, the Cost Share Reduction is only offered on Silver level plans.

Financial assistance is determined on a sliding scale based on income.

If Marketplace plans are not what you are looking for, check out the many options available with Private Health Insurance.

What should I look for in my plan?

When choosing your plan it is important to consider out of pocket costs: monthly premium, health and drug deductibles, copays and coinsurance, and the maximum out of pocket limit. It is also important to consider your current providers and verify that they will be in network with the plan you select. Then you would consider all current prescriptions and how they would be covered on the new plan. Some plans have separate drug deductible, while other plans include health and prescription benefits subject to the same deductible. Sometimes the plan that is most beneficial for health benefits does not have the most beneficial prescription coverage; we provide for each of our clients dealing with these circumstances additional resources for savings and prescription programs and a guide to savings with their specific script.

Monthly Premium: the amount you pay for your health insurance every month

Deductible: the amount paid out of pocket before the insurance company pays the claim. (Which is why we help our clients find low deductible and/or plans with copays for routine services which are exempt to the deductible) Most people don’t hit their deductible and that is ok!

Copay: the fixed dollar amount for a covered service.

Coinsurance: percentage of the billed cost the insured must ay.

Maximum Out Of Pocket: the most the insured pays for covered services in a year. Once met the plan pays 100% of the cost for covered services.

Provider Network: list of doctors, hospitals, and other healthcare providers contracted with a plan to provide medical care.

Summary of Benefits: overview in plain language of the plans costs, covered benefits, some limitations and other features important to consumers.

Step by Step Guide to Choosing Your Marketplace Plan

STEP 1. Open the link to HealthSherpa and input your zipcode.

STEP 2. Choose if you would like to see if you qualify for a subsidy.

STEP 3. Add age and gender for each person in the family that needs health insurance coverage.

STEP 4. Add the number of people in your tax household, even if they do not need coverage. Then add the estimated annual income for the household.

STEP 5. The marketplace will calculate if you qualify for the Premium Tax Credit and if you qualify for the Cost Share Reduction. Remember if you see the gold badge with CSR, to look especially at Silver level plans, as the Cost Share Reduction only applies to these plans.

These images are just examples and do not guarantee that you will receive a tax credit.

STEP 6. Add your doctors and prescriptions at this step, or skip ahead to view the plans. You will be able to add them in later.

STEP 7. Now that you are viewing all available plans in your zipcode, use the drop down bar on the top right to filter between the lowest premium, lowest deductible, or lowest max out of pocket.

STEP 8. Add your doctors if you haven’t already. Then select the box next to their name to find the plans they accept.

STEP 9. Select the plans that interest you to compare up to 5 plans. Once you decide add to cart and begin the application process.

STEP 10. If you feel overwhelmed by the many options and numbers, fill out a quote request below and let our experts guide you through the process. As independent brokers we are able to compare all plan options for you and are not biased to a particular plan or insurance company.