Knowing What to Look For Is Critical When Looking For Health Coverage
Selecting an Arizona ACA health insurance plan in Arizona is no small undertaking. Comparing the costs, benefits, coverages, and other aspects of various Affordable Coverage Act-compliant plans can be confusing and time-consuming. But the plan you choose will have a significant impact on the health, well-being, and finances of you and your family. So, making the right decision is critical.
As with any other significant decision, however, you need to know what to look for when looking for an ACA (also called Obamacare) health insurance plan to ensure you are comparing apples to apples, not apples to oranges.
Selecting an Arizona ACA Health Insurance Plan – Essential Questions that Need Answering
Whether you are working with an experienced broker who can guide you through the process or evaluating coverage options on your own, here are seven key factors to consider when selecting an Arizona ACA health insurance plan.
Premiums and Costs
One of the most significant considerations when choosing a plan is cost, and one of the most significant aspects of a plan’s cost is the amount of the premium you will pay each month for coverage.
But as important as the premium may be in deciding whether a plan fits your needs and monthly budget, this is only one aspect of the total amount you will pay for coverage and care. You will also need to look at a plan’s deductibles, copayments, coinsurance, and other out-of-pocket costs you are responsible for.
For example, an ACA plan with a lower monthly premium may have higher out-of-pocket costs and vice versa. To truly evaluate a plan’s affordability, striking a balance between premiums and potential out-of-pocket expenses is crucial.
Related: Understanding Arizona Health Insurance Premiums
Coverage and Benefits
In addition to how much you’ll pay for coverage, before selecting an Arizona ACA health insurance plan, you need to consider and understand precisely what you will be paying for. Different health plans can offer many different levels of coverage and benefits.
Review the details of each plan to understand what services are covered, such as hospital stays, prescription medications, preventive care, mental health care, maternity services, and specialty treatments.
Deductibles and Out-of-Pocket Limits
Deductibles are your out-of-pocket costs for covered services, before your insurance begins to pay. Out-of-pocket limits cap the total amount you must pay from your own pocketbook for covered services in a year.
Plans with higher deductibles may have lower premiums, but you will pay more for care and services before the insurer begins to cover costs.
Related: Understanding Health Insurance Deductibles in Arizona
Prescription Drug Coverage
If you regularly take prescription medications, an essential aspect of selecting an Arizona ACA health insurance plan is knowing the prescription drug coverage offered by each plan. Review the list of covered medications (called the formulary), to ensure your prescriptions are on there.
Even if your prescriptions are in the formulary, you should consider copayments or coinsurance for prescription drugs, as these costs can add up over time. If a specific plan has lower monthly premiums but does not provide sufficient prescription drug coverage for your needs, your overall monthly costs may be higher than you anticipate.
Additionally, some plans may have preferred pharmacies with lower prices, so be aware of the network restrictions if you have a specific pharmacy preference.
Provider Networks
Review the network of healthcare providers and facilities in the plan for your preferred doctors and hospitals, ensuring these are in-network. Almost every ACA health insurance plan will require you to pay significantly more if you get care from an out-of-network provider or facility. Also, consider the size and geographic reach of the network, especially if you live in different locations throughout the year or travel frequently.
Health Savings Accounts and Flexible Spending Accounts
Some ACA health insurance plans may offer the option of pairing coverage with a Health Savings Account (HSA) or a Flexible Spending Account (FSA). Under these plans, you may open a bank account to set aside pre-tax dollars for eligible medical expenses. If you want to save for future healthcare costs or prefer the tax advantages these accounts offer, consider selecting an Arizona ACA health insurance plan that is HSA or FSA-compatible.
Additional Reading: The Benefits of Having a Health Savings Account in Arizona
Subsidies and Financial Assistance
Depending on your household size, income and assets, you may qualify for subsidies or tax credits to pay for a portion of your premiums and help make your health insurance more affordable. Discuss the possibility of financial assistance with your broker, or, if using the health insurance marketplace at healthcare.gov, use the site’s tools to estimate your eligibility for financial assistance.
Don’t Let Selecting an Arizona ACA Health Insurance Plan Overwhelm You – Speak With One of Our Experts Today
Yes, choosing the right Obamacare plan for you and your family is a big decision. But this is not a decision you have to make alone. Working with an experienced Arizona health insurance broker right in your neighborhood is the best way to get your questions answered and find a policy that fits your family’s needs and budget.
At Arizona Health Insurance Experts, we connect Arizonans with an invaluable resource to help them make the right decisions: the state’s most extensive collection of independent insurance agents and brokers. These local experts live in your neighborhood and are available to meet over the phone or in-person to ensure you receive the exceptional customer experience you deserve along with the family health insurance coverage you need.
Speak with an independent health insurance broker near you today.
