Affordable Care Act, healthcare, Obamacare — October 19, 2015 at 12:14 pm

Health insurance open enrollment begins Nov. 1: Get ready to buy the right plan


Whether you already have insurance or are a first-time buyer, be a savvy shopper.

Buying health insurance is a lot like buying anything else: It pays to shop around. And with open enrollment beginning again on November 1, the time to start thinking about your insurance coverage is now.

The beauty of the Affordable Care Act (ACA), also known as Obamacare, is the fact that you do have a choice — something too many people still don’t fully appreciate. If I had a dollar for every time someone complained that their insurance company switched them to an expensive new plan “because of Obamacare,” I’d be a wealthy woman. Yes, some people’s insurance companies did push them into new plans when their old ones were discontinued because they didn’t meet the standards of the ACA. But no one was forced to accept those new plans — and of course insurance companies offered to switch folks to high-end plans. Insurance companies are in business to make a profit.

Those unhappy consumers didn’t pay attention to the fact that they didn’t have to accept whatever plan their insurer offered them. Everyone has the freedom during open enrollment to shop for a plan that gives them the coverage they need at a price that works best for them.

But it’s just like anything else: You have to do your homework to find the best fit. Most people wouldn’t buy a car or even a pair of running shoes without doing a little research. Why should buying health insurance be any different?

So here are some tips to help you make an educated buying decision during this year’s open enrollment period, which runs from November 1 through January 31, 2016. After that, you’ll be out of luck unless you have a qualifying life event — such as getting married, having a baby, moving or changing jobs — that lets you buy insurance outside of open enrollment.

A few basics.

If you’re new to buying insurance — or even if you’re not — check out this five-minute video created by Kaiser Family Foundation (KFF). It covers the most important insurance terms you need to know when buying and using insurance.

The video does a great job of explaining many of the variables to consider when shopping for insurance. But you may still have questions, so KFF created a list of Frequently Asked Questions (FAQ) about health reform. Peruse it before you start shopping and keep it handy if questions come up during the process.

Still want to know more? Our friends at Enroll America have put together a host of health insurance literacy resources from trusted sources like Consumer Reports.

Tips for comparison shopping.

When you’re shopping for insurance, remember that the monthly premium is only one aspect of choosing an insurance plan. You should weigh that against a plan’s out-of-pocket costs, deductibles, prescription costs and the out-of-pocket maximum you’ll have to pay each year.

In general, Bronze plans have a lower monthly premium but higher deductibles and out-of-pocket costs. This may be a better choice if you’re young or don’t have any health issues. Silver, Gold and Platinum plans have incrementally higher premiums and lower out-of-pocket costs, which may make them more attractive if you have a chronic condition like asthma, diabetes or arthritis. You’ll pay more every month, but will have lower additional costs.

For example, my Gold plan has a higher monthly premium but my out-of-pocket costs are extremely low. Because I see a lot of doctors to manage my diabetes, it’s more cost-effective for me in the long run to pay a higher premium so I can pay less to see a doctor. I’m also glad I chose a plan that includes chiropractic care — neck problems are an occupational hazard for someone who spends a lot of time at the computer. I’ll still compare plans to see what’s available for 2016, but I won’t switch to a plan without chiropractic just because the premium might be a little lower.

Once you’ve narrowed it down to a few plans, make sure your favorite doctors and nearby healthcare facilities like hospitals are covered. Checking on this before you enroll will save you a lot of hassles — and possibly money — later.

When you visit, in addition to comparing insurance plans you can check to see if you’re eligible for financial assistance to help pay for your coverage. It’s based on your income and you only have to answer a couple of questions to find out. It could make your insurance a lot more affordable. Keep in mind, though, that some types of financial assistance require you to buy a Silver plan.

If you bought insurance through the insurance Marketplace last year, your insurance company should let you know if you need to take any steps to renew your coverage. Either way, it’s a good idea to check out these tips for keeping or changing your existing plans. If you want to change plans — or if you’re buying for the first time — you need to sign up by December 15 to have your coverage start or renew on January 1, 2016.

Representatives are standing by.

This may sound like a lot to figure out on your own, but don’t sweat it. In addition to enrolling online through, you can call 1-800-318-2596 and a trained representative will walk you through the process of enrolling by phone.

What’s more, there are trained in-person enrollment assisters across the country who will sit down with you, answer your questions, and help you choose and enroll in the plan that’s right for you.

The easiest way to find an assisters near you is through the Get Covered America Connector. Because Get Covered America is an independent non-profit organization dedicated solely to helping people sign up for insurance, you can trust that they’re looking out for your best interests as a consumer.

Open enrollment is almost here, so make sure you’re ready. At Eclectablog, we’ll continue bringing you helpful information about buying and using health insurance.

If you got covered in the last two years — or you buy insurance during this year’s open enrollment period — I’d love to hear your story. Contact me HERE if you’re interested in being profiled in an upcoming post.

[Image credit: HebiFot via Pixabay.]