When it comes to your health insurance, Open Enrollment is the most important time of the year. This is the time that you’ll be able to change your plan, or enroll in a new one that better suits your needs and saves you money. It’s imperative that you know when the Open Enrollment Period (OEP) starts and how long it lasts so that you don’t miss out! If you do miss the OEP, you may have to wait an entire year in order to make changes, that is unless you qualify for a Special Enrollment Period (SEP). With all that being said, it’s super important to act before the deadline and avoid waiting until the last minute. To help you on this endeavor, we’ve outlined the key OEP dates for every state, to ensure you have ample time to get enrolled!
The 2025 OEP begins November 1st, 2024 in most states, and since changes to the OEP last year, it generally runs through January 15th in most states. Some states, though, have extended their OEP a little longer. Take a look at the following so you know when your state’s OEP begins and when it ends.
States With January 15th Deadlines
Alabama
There are currently 33 states that have a January 15 deadline for the health insurance OEP.
Alaska
Arizona
Arkansas
Delaware
Florida
Georgia
Hawaii
Illinois
Indiana
Iowa
Kansas
Louisiana
Michigan
Mississippi
Missouri
Montana
Nebraska
New Hampshire
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
West Virginia
Wisconsin
Wyoming
States with Different OEP Dates
Some states with their own ACA exchanges have different date ranges for the 2025 Open Enrollment Period. The chart below shows the State Enrollment Period (SEP) and OEP dates for these states; other states have not yet announced their dates (these are also listed below).
State
State Open Enrollment Period for 2025 Plans
California
November 1, 2024 – January 31, 2025
Colorado
November 1, 2024 – January 15, 2025
Connecticut
November 1, 2024 – January 15, 2025
Idaho
October 15, 2024 – December 15, 2025
Kentucky
November 1, 2024 – January 15, 2025
Maine
November 1, 2024 – January 15, 2025
Maryland
November 1, 2024 – January 15, 2025
Massachusetts
November 1, 2024 – January 23, 2025
Minnesota
November 1, 2024 – January 15, 2025
Nevada
November 1, 2024 – January 15, 2025
New Jersey
November 1, 2024 – January 31, 2025
New Mexico
November 1, 2024 – January 15, 2025
New York
November 16, 2024 – January 31, 2025
Pennsylvania
November 1, 2024 – January 15, 2025
Rhode Island
November 1, 2024 – January 31, 2025
Vermont
November 1, 2024 – January 15, 2025
Washington DC
November 1, 2024 – January 31, 2025
Washington
November 1, 2024 – January 15, 2025
Looking For Affordable Health Insurance?
The health insurance 2025 Open Enrollment Period is open from November 1 until January 15 (depending on your state), so now is the perfect time to reconsider getting a health insurance plan, or looking into your current one and making sure it’s got you covered. And if your plan doesn’t cover everything you need it to, it’s time to find a plan that does, so you can save as much money as possible.
If you’re shopping for a plan, your best bet is to speak to a licensed EZ agent. Our agents work with the top-rated insurance companies in the nation, so we can compare plans in minutes. We will not only find a plan that has all the benefits you’re looking for, but we will also make sure the plan meets your financial needs. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-694-0047. No obligation.
The Health Insurance Open Enrollment Period is coming up: starting November 1st, you’ll have around 6 weeks to find a plan that meets your needs. That means a lot of information about all the different health insurance plans available, and information about any changes to your current plan will soon be coming your way. You’ll have to sort through all of this while trying to figure out how much coverage you need, and what you can afford, which can feel like a lot. And this time is going to come and go quickly! That means it’s important to begin planning now, so you are ready and don’t feel rushed during the process.
Luckily, you won’t have to feel alone during this OEP, because EZ.Insure is here to help! EZ.Insure makes the enrollment process stress-free and simple. Our easy-to-use platform provides free quotes and side-by-side comparisons of all the available health plans in your area. We also have a team of dedicated agents who are always on hand to help guide you through the process or answer any questions, so you can leave feeling confident in your coverage. To help you feel even more prepared, we’ve compiled a brief list of helpful tips so you can tackle this OEP with ease.
EZ’s certified insurance agents are also always up-to-date on the newest healthcare plans.
1. Choose an Unbiased Agent
Who you choose to work with when looking for a health insurance plan is a very important decision, and plays a big part in finding a comprehensive, affordable plan. It’s important to work with a licensed, knowledgeable agent who is not connected to a certain type of health insurance plan or insurance company, so you can get an unbiased look at all available options in your area.
EZ’s agents work with the top-rated health insurance companies in the nation, and we guarantee that we will compare all plans in your area so that you can find the perfect plan. And not only are our agents independent, but they are also always up-to-date on newer healthcare plans, so they can provide you with all the information that you need before you make your decision.
2. Consider ALL of Your Options
After choosing to work with an EZ agent, you can simply ask them to research every option that you have, as well as help you weigh all the pros and cons of each plan. There are many different types of healthcare plans available, including PPO plans, HMO plans, or metal tier plans; if you’re not sure what’s best for you, an EZ agent will go over all of these different plan types, and will not try to limit you to a certain plan. We will lay all of your options on the table and review the coverage and cost of each one.
3. Ask the Right Questions
When it’s time to start searching for plans, think ahead of time about what you want to ask your agent, and what is important to you in a plan. In addition to asking about prices and coverage options, have a list of questions you want to ask, like:
Is mental health care (or anything else you’re interested in having covered) covered?
Is a higher deductible or lower premium plan better for you?
4. Find the Plan That Has the Most Value
People often choose the cheapest plan available, but this cheapest plan might not have the best benefits available for the price. A good health insurance plan will come from a quality carrier, provide comprehensive benefits, allow you to see the doctors you want to see, and have affordable co-pays. And remember, if you go for the cheapest plan available, you might end up paying more out-of-pocket when you use medical services. Our agent will review your medical needs and budget, and search for a plan that will check all the boxes for you.
Need Help? EZ’s Got You Covered
The health insurance Open Enrollment Period will be open from November 1st through January 15 (depending on your state), so now is the perfect time to reconsider getting a health insurance plan, or to look closely at your current one to make sure it will cover all of the above-mentioned costs. And if your plan doesn’t cover everything you need it to, it’s time to find a plan that does, so you can save as much money as possible.
If you’re shopping for a plan, your best bet is to speak to a licensed EZ agent. Our agents work with the top-rated insurance companies in the nation, so we can compare plans in minutes. We will not only find a plan that has all the benefits you’re looking for, but we will also make sure the plan meets your financial needs. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-350-1890. No obligation.
Health insurance is an important component of financial and physical well-being since it allows people to obtain necessary medical care. However, not everyone chooses the health insurance provided by their employment or through government programs. Some people choose to look for alternatives, and one way to do this is to get a health insurance waiver. A health insurance waiver form will typically include information about your request to forgo access to a health insurance plan that has been made available to you.
Waiving Employer-Sponsored Health Plans
Company-sponsored health insurance plans can be a considerable advantage for employees. Especially when the company pays for all or a portion of the employee’s health insurance benefit. However, it is possible that a person will not require the medical coverage supplied by their work. Employees are not compelled to partake in perks such as health insurance, which is the best part. There is no penalty for refusing coverage.
When an employee does not want their employer’s health insurance, they waive coverage. Employees can also forgo coverage for a family member who was previously covered under their plan. Employees can only opt out of coverage during specific time periods. Here are some examples of when employees can choose to forego coverage:
When they first start their job and are initially offered coverage.
During an open enrollment period, which takes place once a year and lets employees enroll, change, or opt out of coverage.
If the company begins to offer a new plan.
If someone has a change to their family such as a marriage, divorce, or birth. This qualifies them for a Special Enrollment Period.
The health insurance waiver is frequently considered as an employee perk since some firms offer to reimburse the employee for the financial value of the cost of insurance by waiving insurance. However, because most employers do not cover the entire cost of coverage, there is less of an incentive to avoid providing those benefits.
Keep In Mind
Signing a health insurance waiver may no longer provide any advantage in terms of employee perks in the form of a wage “increase” because many firms no longer pay for their workers’ health insurance benefits as they used to. However, because you will be covered via an alternate plan rather than the employer plan, the waiver may still reduce the costs of payroll deductions for your insurance.
Waiving College or University Health Plans
Universities frequently offer health insurance waivers. Students who are already enrolled in comparable or better health insurance plans than those given by their college or university typically have the option of waiving the health insurance by completing a health insurance waiver form and presenting proof of comparable coverage elsewhere. The submission deadlines for these waivers correlate to school terms. This is a common choice for students because they are frequently covered by a family plan, and the cost savings from foregoing health insurance can amount to thousands of dollars each year.
Proof Requirement
You may also be required to give proof of the reason you seek to forgo health insurance coverage, depending on the organization or reason for your request. This is for the organization, business, or school that is providing you with the plan’s protection.
Before processing your health insurance waiver request, the organization may wish to confirm that you have adequate health insurance elsewhere. Health insurance waivers may need to be signed on an annual basis, and if your circumstances change, you may be required to notify your plan provider.
Why People Use A Health Insurance Waiver
There are numerous reasons why you might decide to forego your health insurance coverage, but before you do, consider the benefits of dual coverage or benefit coordination. If you have a lot of medical bills or specific needs, it may be more beneficial to use multiple plans. Always consider all of your alternatives. For example, you may wish to waive coverage if your employer’s or student’s health insurance plan is not necessary because you already have coverage via another plan. Other circumstances in which you may obtain a health insurance waiver include:
Spousal Coverage – Individuals who are qualified for health insurance through their spouse’s employer may choose to forego their own coverage in favor of the spousal plan. This choice may be influenced by factors including cost, coverage options, or personal preferences.
Government Programs – Individuals may be eligible for government-sponsored health insurance programs, but choose to forego coverage in specific instances. This could be because of a desire for private insurance, unhappiness with the government plan, or specific coverage needs that the public program does not meet.
Alternative Options – Some people may have access to other insurance options, such as individual or family plans, and opt out of employer-provided coverage in favor of these options. Cost, coverage scope, and network preferences may all have an impact on the selection.
Coverage Preferences – Individuals might have specific preferences regarding healthcare providers, networks, or types of coverage. Opting for a waiver allows them the freedom to choose a plan that aligns better with their preferences and needs.
Alternative Health Insurance Options
If you decide to pass on health insurance offered by your job or school and choose to buy individual health insurance it’s important to know your options. There are several types of plans that all cover care in different ways. So it’s easy to find a plan that fits exactly what you need.
Health Maintenance Organizations (HMO)
HMOs offer you the option of choosing from a local network of participating physicians, hospitals, and other healthcare providers and facilities. As part of these health insurance policies, you must choose a primary care physician (PCP) from this network. Your primary care physician (PCP) will get to know you and help you organize all of your medical care. They are also responsible for referring you to any specialists; without this recommendation, your HMO would not cover a specialist visit. Out-of-pocket payments for an HMO plan are frequently lower than those for other types of health plans as long as you stay in-network.
PPOs offer very vast networks of participating providers. So, you can choose from a wide range of hospitals, clinics, and other healthcare facilities and experts. Unlike HMOs, PPOs provide some coverage for providers outside of their network,. But not as much as they would for an in-network provider. Another significant distinction between PPOs and HMOs is that you are not compelled to select a PCP and can see a specialist without a referral.
EPOs also provide you with access to a network of participating providers from which you can choose. The majority of EPO plans, with the exception of emergencies, do not cover care received outside of their network. As a result, if you visit a provider or facility that is not part of the plan’s local network, you will most likely be responsible for the full cost of services. You may or may not be needed to select a PCP depending on the plan. In either case, you will not need a recommendation from a PCP to see a specialist. As long as they are in the network of the plan.
PPOs and HMOs are combined in POS plans. A POS plan’s provider network, like that of an HMO, is often smaller than that of a PPO plan. And in-network care expenses are typically lower, as with a PPO. In POS plans, you must choose a primary care provider (PCP) from a network of physicians and other primary care specialists.
If you need to see a specialist, you must acquire a referral from a POS. However, like with PPO, you can choose to see in-network or out-of-network experts. However, if you visit an out-of-network provider, your part of the costs will be higher. And you will be responsible for submitting any claims if you visit a physician who is not in the plan’s network.
An HRA, or health reimbursement arrangement, is a form of health expenditure account provided and owned by the employer. Because they own the HRA, your employer is the only one who can contribute to it. They can also determine if you can roll over unused cash into the next year. The money in it is used to pay for eligible expenses. Including medical, pharmaceutical, dental, vision care, and as defined by the employer.
The Bottom Line
Health insurance waivers give people the freedom to choose how they want to be covered for medical care based on their own needs and circumstances. Even though they give people some freedom. People who decide to not have coverage should carefully think about the risks and other options. In turn, employers and schools have to deal with the paperwork side of health insurance waivers. Making sure they follow the law and encourage open communication. The use of health insurance waivers is still a moving part of the larger conversation about healthcare access and personal freedom, even as healthcare changes.
There are numerous sorts of health insurance plans to choose from. So it all comes down to you: your requirements, your budget, and your overall health. When looking for the best plan, the greatest thing you can do is compare the features of various plans. As a result, you can obtain the most coverage for the least money. Even if you are normally healthy, health insurance is a vital component of life. You never know what can happen, and it’s always better to be cautious than sorry. To begin, enter your zip code into the box below or call one of our qualified representatives at 877-670-3557.
Because of the constant yearly rise of health services and health insurance premiums, healthcare has become a large portion of everyone’s personal budget. However, as these costs have increased over the last few decades, medical savings accounts have come into play to help offset them. There are a few different accounts you can choose from to help you save money towards your healthcare, but we’re only going to be looking at 2 of them: Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). Both HSAs and FSAs are savings accounts that allow you to save specifically for medical expenses. Aside from that fact, the two accounts differ in a number of significant ways. In this article we’re going to compare and contrast them so you get an idea of what they are, how they work, and if one of them would be beneficial to you.
Health Savings Accounts (HSAs)
Health Savings Accounts are not typical savings accounts, and they are only available to people with a high-deductible health plan (HDHP). As of 2023 an HDHP is defined as any plan with a minimum deductible of $1,500 for individual coverage or $3,000 for family coverage with an out-of-pocket maximum of $7,500 and $15,000 respectively. An HSA is a triple tax advantaged account that can be used to pay for qualifying medical expenses. It’s known as “triple tax-advantaged” because your contributions to your account are not taxed, the money in the account is never taxed while it’s in the account, even if it earns interest or investment returns.
Additionally, as long as you use your HSA funds for qualified medical expenses, your withdrawals will also never be taxed. However, if you use your HSA funds for anything besides qualified medical expenses you will have a 20% tax penalty. Another great thing about HSAs is that you can actually invest your funds as well, similar to the way you would a 401K. This lets your HSA actually make you money, if you invest properly you could end up with a nice health savings account keeping you from having to pay for little to any of your healthcare.
How HSAs Work
If you open an HSA with your HDHP, you will deposit money into the HSA that you can use to pay for qualified medical expenses that your health plan does not cover. Which are any services that the IRS recognizes as a eligible medical costs these expenses include:
Acupuncture
Ambulance services
Birth control/contraceptive devices
Blood pressure monitors
Blood sugar test kits/test strips
Chiropractic therapy/exams/adjustments
Contact lenses
Copayments
Dental care
Dermatological services
Diagnostic services
Eye exams
Eye surgery
Flu shots
Gynecological care
Incontinence supplies
Infertility treatments
Insulin and diabetic supplies
Laboratory fees
Lactation expenses
Legal sterilization
Laser eye surgery/ LASIK
Menstrual care products
Nasal strips
Obstetric care
Over the counter (OTC) treatments containing medicine (i.e., cold treatments, pain relievers, sinus medications, etc.)
Physical exams
Pregnancy test kits
Smoking cessation programs
Therapy or counseling
Treatment for alcohol or drug dependency
Vaccinations
Vision care
Wrist supports/elastic straps
X-ray fees
You can use the HSA funds to pay all your medical bills until you reach your plan’s deductible, and then you can use them to cover your coinsurance or copayments until you reach your annual out-of-pocket maximum. Additionally, unlike other health spending accounts, HSA funds will never expire. Your funds roll over into the new year, every year so you don’t have to rush to spend the money in the account. One thing you should note though, is that HSAs do have a contribution limit, these limits change annually but as of 2023 if you have an individual plan you can only contribute up to $3,850 for the year. For family plans the limit is $7,750.
Flexible Spending Accounts (FSAs)
A Flexible Spending Account, sometimes called a Flexible Spending Arrangement, is a type of savings account that offers you specific tax advantages. You don’t actually set these accounts up, instead they are set up by your employer. FSAs let you contribute a portion of your pay into the account. Your employer can also choose to contribute to the FSA on your behalf, sort of like when your employer matches your 401K except the employer decides exactly how much they contribute. The FSA funds are then used to reimburse you for eligible medical and dental expenses.
How FSAs Work
An FSA is a voluntary plan that allows employees to contribute up to $3,050 a year (as of 2023) to pay for eligible medical expenses that are not covered by their health insurance plan such as:
Health insurance copayments
Doctor’s visits
Coinsurance payments
Dental work
Vision expenses
Prescriptions
Therapy and counseling services
Chiropractic care
Acupuncture
Hospital fees
Surgery costs
Diagnostic services
Allergy testing
If your employer offers group health insurance they can also offer these FSA plans as an additional employment benefit. Your employer can choose to also contribute to your FSA, they can choose to match your contributions or decide to pay a smaller amount. They are not required to contribute though, so some employers might not add into your FSA at all. If your employer does choose to contribute, their contribution typically won’t count towards your yearly limit no matter how much they contribute.
The Differences
You can’t have both of these plans at the same time, so if your employer offers an FSA but you’re also considering an HSA, you’ll want to keep these key differences in mind when you’re making your decision.
Qualifications
Compared to FSAs, HSAs have stricter eligibility requirements. To qualify for an HSA, you must have an HDHP. The HDHP has to be your only health insurance. Additionally if you are eligible for Medicare or are a claimed dependent on someone else’s taxes you can not open an HSA. On the other hand FSAs have to be set up by your employer, which automatically excludes self-employed or unemployed people. Your employer does have some qualifications they have to meet to be able to offer FSAs. For example they can only contribute to employee FSAs if they own less than 2% of the company. However, if they already offer these plans then there’s no other eligibility requirement on your end, all employees are eligible even ones without health insurance plans.
Annual contribution limits
Since contributions to these accounts are tax free they lower your taxable income. Because of this the IRS has placed limits on these plans. For FSAs the contribution limit is $3,050 as of 2023. For HSAs it’s $3,850 for individual plans and $7,750 for family plans.
Rollover rules
One of the biggest advantages of an HSA is that your funds roll over, meaning there are no time restrictions on using your funds. Since the account belongs to you, you get to decide when and how to use the funds. However for FSAs it’s not as simple. Unused funds are not automatically carried over into the new year. Since your employer owns the plan they decide what happens to the funds. Employers have 3 choices when it comes to rolling funds over:
Forfeiture – This means any unused funds will not roll over. Instead, they will be transferred to the employer.
Grace period – This is a 2 ½ month period after the plan year ends to use the last of the fund in the account, after this time frame, the funds then go to your employer.
Carryover- This allows employees to take $500 of the unused money over to the new year’s plan. Any funds left in the account after the $500 is carried over goes to the employer.
Changing contribution amounts
This is another point where HSAs are simple. You can contribute any amount you want at any time, you don’t have to keep the same contribution every time. Whereas with FSAs your contribution amount stays the same through the year. You can only change your contribution amount 3 times. First at open enrollment, when the plan renews you can decide to change your contribution amount for the new year. Next is if there is a change to your family situation such as a marriage, death, or birth you will be allowed to adjust the amount. Lastly, if you change employers when you enroll in your new employer’s health plan, assuming they offer one, you can select your new contribution amount since it’s an entirely new FSA.
Keeping your account when changing jobs
Unlike FSAs, HSAs follow you no matter how many times you change jobs because your account belongs to you. With FSA’s, they belong to your employer so unless you qualify for COBRA, you will no longer have access to your FSA if you leave your job.
Which Is Better?
If you qualify, the higher contribution limits and contribution rollover of HSAs make it the better option overall. HSAs are more flexible than FSAs, allowing you to save money over time for potential medical expenses. However, unless your job allows you to roll over $500 annually, your FSA balance will not build up over time. Depending on your employer’s decisions, unused funds are generally forfeited to your employer at the end of this year, meaning if you didn’t have many medical expenses for that year you could be losing money.
However, most of the time choosing between them is more dependent on your situation rather than which one you actually prefer to have. This is because the decision will depend if your employer even offers an FSA and whether or not your health insurance plan is an HDHP.
Getting Help With EZ
Both of these options can be excellent tax-free ways to save, invest, and pay for medical expenses, and EZ can help if you’re interested in HSAs. If you choose an HDHP, open an HSA as soon as you are eligible and begin contributing. Since these accounts continue to be one of the most effective ways to reduce expenses and improve your overall financial standing. To begin saving immediately, enter your zip code in the box below to receive free instant quotes. Or, contact one of our licensed agents at 877-670-3557.
Has shopping for health insurance left you confused and frustrated? Don’t worry, we’ve got you. Shopping for health insurance can feel about as easy as getting home during rush hour traffic, but understanding your options and how to choose plans is important. To help we’ve put together a list of questions for you to ask while choosing a plan. These questions can help you sift through the various plan details and help you decide which ones are best for you, your family, your health, and your budget. Think of it as your health insurance cheat sheet.
With these questions in your pocket, you’ll be able to confidently compare health plans. Whether you’re selecting a plan for the first time, or if you’re thinking about changing your current plan, these questions are important to keep in mind.
How Much Does the Plan Cost?
You’ll want to carefully look over plan prices, not just the premium, you’ll want to know how much the other out-of-pocket costs will be as well. Premiums, deductibles, copays and other costs of health insurance all vary from plan to plan and state to state. So, comparing is key here to make sure you get a plan that fits within your budget. We’ve gone into a little more detail about each of the costs you’ll want to research below.
Your Premium
This is the monthly fee you pay for your insurance company to provide you and your family with coverage. The cost of your premium will vary depending on a few factors. First, the majority of insurance companies will underwrite you before they insure you. Meaning they will collect all of your health data and use them to determine your “risk factor”. Other variables include your age, your lifestyle, and sometimes even where you live.
Your Deductible
Before your plan will cover your medical expenses, you have to first meet your deductible. For example, say your plan carries a $1,500 deductible and you need a surgery that costs $3,500. You will have to pay $1,500 and then your company should cover the remaining $2,000. Keep in mind, your premium will not count towards your deductible. The things that will count towards it are any bills you pay for hospital stays, surgeries, lab tests, anesthesia, doctor visits that aren’t covered with a copay, and medical devices such as pacemakers.
Your Copay or Coinsurance
When you visit the doctor or fill a prescription, you’ll pay a copay upfront. It’s a flat fee, typically between $10-$30. Each part of your health services may have different copays such as $30 per doctor visit or $20 per prescription, but each of those services will always have that same copay. For instance, if you injure your back and visit the doctor, or if your child’s asthma medication needs to be refilled, the copay amount – for that visit or medication will remain the same.
Coinsurance is the portion of medical expenses you are responsible for after your deductible has been met. Coinsurance is a way of saying that you and your insurance company each pay a portion of the eligible costs that total 100%. For instance, if your coinsurance is 20%, you are responsible for 20% of the cost of your covered medical expenses. Your health insurance will cover the remaining 80 percent.
What Kind Of Coverage Do I Need?
After deciding your budget, the next question is about coverage. Do you have health conditions? Do you know you see the doctor often? Are you healthy? There’s a large variety of plans that will give you more coverage if you aren’t healthy, or less coverage if you are healthy. That way you don’t pay for coverage you don’t need, and you know the things you do need will be taken care of.
Health Maintenance Organizations (HMOs) provide access to doctors within their network, whereas Preferred Provider Organizations (PPOs) provide access to a larger network at a higher cost. There are also 4 plan tiers available: Bronze, Silver, Gold, and Platinum. Each tier has varying prices with varying coverage. If you want a low monthly premium and are healthy, a Bronze or Silver plan is your best option. While Gold and Platinum plans have higher premiums but lower deductibles. Making them ideal for anyone with medical conditions that need more care.
Is My Current Doctor In The Plan’s Network?
One of the most common concerns while searching for health insurance is whether or not you can keep seeing the doctors you already have. If you have ongoing medical conditions, or simply just like your current doctor, the last thing you want to have to do is switch doctors. It means having to explain your entire medical history and probably retake tests you’ve already had done. It can also bring up an issue if your new doctor doesn’t agree with your old doctor’s diagnosis or treatments. Your doctor is definitely one of those situations where familiarity is important. When you’re shopping for health insurance, find out what the plan’s network looks like. The network isn’t just primary doctors either, it’s also hospitals, facilities, and specialists as well. You don’t want to find out too late that the hospital closest to you doesn’t accept your insurance.
Are There Extra Benefits or Perks?
This may seem small, but it can be the selling point between one plan over another. Some plans will offer things like dental and vision discounts, telehealth, gym memberships, etc. You’ll want to decide if you want the bells and whistles or if you don’t really care for them. These perks can be offered as “free”, but keep in mind the more benefits a plan has the more expensive your plan is likely to be.
Will My Plan Travel with Me?
If you travel frequently, whether for work or leisure, you should make sure your plan has the freedom and flexibility you’ll need, regardless of where you are when you need it. You’ll want to look at the network again, and the budget. Will you pay more for out-of-network facilities and doctors? If you do pay more, can you be reimbursed? If it’s Christmas and you’re four states away visiting family and you need the emergency room the last thing you want to do is worry about a giant medical bill.
Is My Medication Covered?
Two-thirds of adults in the U.S. use prescription medications, so there’s a good chance you will too, if you don’t already. It’s not uncommon for you to get caught up in the other details of your health plan and forget to look at the prescription drug coverage. These costs can rack up quickly, so be sure to look at the plan’s drug formulary before you enroll. The formulary is a list of prescription drugs that are covered as well as their associated costs. That way you can better budget for any medications you currently take, as well as any antibiotics you might need in the future.
Will This Plan Cover Alternative Therapies?
If you’re interested in alternative therapies (alternative medicine) you’ll want to make sure those will be covered as well. Some alternative medicine would be a chiropractor, having a home birth, or getting acupuncture. Different health plans handle these types of services differently. In some circumstances they can be covered similarly to your other health care. On the other hand, some plans might have minimal or no coverage for alternative therapies. If this type of care is important to you, make sure to look closely at the plan’s benefits in detail.
Who Can I Call With Questions?
Most people agree that, when it comes to health insurance companies, the worst part is the lengthy phone calls. There is typically a customer service line, but you’ll most likely deal with a lot of transfers or possibly be placed on hold for long periods of time. Some have direct numbers for agents to speak to you directly or chat services where you can virtually ask your questions. Most will even have a discussion forum where you can find the answers to some of your questions. The worst systems are the automated phone systems, where you have to listen to several menus and hope what you need is on the list. There’s a way to avoid all of that hassle and uncertainty though: giving one of EZs agents a call.
EZ.Insure provides highly trained agents in your region who can answer all of the above questions and then some. You get to speak with a real person, -skip the automated line, and get all of -the information quickly. The best part? It’s free! We will assign you to your own personal agent who will search and compare all available plans in your area at no – cost. We make sure to find you plans that fit within your budget without sacrificing coverage needs. To get your instant free quotes today simply enter your zip code in the box below or give us a call at 877-670-3557 to speak to an agent directly.
If you’re looking for a health insurance plan, you probably feel like you’ve had a lot of terminology to learn. Especially when it comes to the out-of-pocket costs that you’ll be responsible for with your plan. It’s true that there’s much more to plans than just monthly premiums. You’ll most likely have to think about copayments, coinsurance, and annual deductibles, as well. And it’s this last expense that we’re going to look at here. Your annual deductible is the amount that you will have to spend on covered medical expenses before your health insurance plan begins to pay its share.
And when it comes to deductibles, you actually have choices. You can choose a high-deductible health plan (HDHP) or a low-deductible health plan (LDHP). But what’s the difference between these types of plans? This article will guide you through the specifics of HDHPs and LDHPs. As well as how to determine which type of plan will serve your needs most effectively based on your needs.
High Deductible Health Plans
A high deductible health plan (also known as a HDHP). As the name implies, is a type of health insurance policy that has a higher annual deductible than other types of healthcare plans. This difference can even be in the four-figure range. Meaning that you will most likely have to pay thousands of dollars out-of-pocket for medical care before your plan will begin to cover any expenses.
With that being said, monthly premiums for these plans tend to be lower than for other plans. And you will still have routine preventive care covered in full before you meet your deductible. As with any ACA-approved plan. The actual deductible you will have if you choose a HDHP will vary depending on your plan and insurance company, but there is a minimum deductible amount for a plan to be considered a HDHP, which changes each year. For 2023, the minimum annual deductible for individuals is $1,500, while the minimum for families is $3,000.
Advantages of HDHPs
As mentioned above, if you choose a HDHP, you will have a plan with a high deductible. But lower monthly premiums. This means that if you know that you will most likely only use the plan for preventive care rather than more extensive medical treatment. You could save money by going with a HDHP.
Other than lower monthly premiums, there is one other big advantage to HDHPs. You can open a health savings account (HSA) in conjunction with a HDHP; in fact, in order to have an HSA, you must have a HDHP. HSAs can be a great way to help pay for your out-of-pocket medical expenses. They are tax-advantaged accounts that can be used to pay for qualified medical expenses that your plan doesn’t pay for. Such as acupuncture and dental expenses. Your contributions to your health savings account are not subject to income tax. And they can be used to reduce the overall cost of your high deductible.
Disadvantages of HDHPs
The high cost associated with these plans is the most significant and obvious disadvantage of HDHPs. If you have a higher deductible, it means that you are responsible for paying a greater portion of your healthcare costs out-of-pocket before your plan begins to contribute. This may put a significant dent in your financial resources. Particularly if you are forced to deal with unanticipated problems relating to your health.
Low Deductible Health Plans
One of the most significant differences between a HDHP and a LDHP is that a low deductible plan typically has a lower deductible. But a higher monthly premium payment.
Because of their lower deductibles, this type of plan is typically chosen by people who see their doctor more regularly. And who need more medical care. If this is the case for you, you might find that the higher amount you’re paying in monthly premiums is balanced out by the low deductible, since once you meet this lower amount, your insurance company will take care of your remaining costs. That could mean you’ll actually end up paying less out-of-pocket. In addition, LDHPs do not qualify for a health savings account (HSA), which is another difference between the two types of plans.
Advantages of LDHPs
Having a plan with a low deductible means you’ll have less to pay out-of-pocket if you need to access healthcare services more frequently, or if you have a true emergency or a catastrophic illness or injury, both of which can be very expensive. People who are older or who have a medical history that includes chronic conditions or illnesses may find that selecting a plan with a low deductible is the better option for them. Others who might benefit from this type of plan include:
Women who are pregnant or who have the intention of becoming pregnant
People who undergo a variety of specialized treatments or need expensive medications, such as those with cancer or on dialysis
Any individual who is contemplating undergoing a surgical procedure within the next year
Disadvantages of LDHPs
Plans with low deductibles tend to have higher monthly premiums, since insurance companies will only cover a greater percentage of your care if you pay a higher premium. These premiums can feel like a burden each month, and if you don’t end up using your plan as often as you thought you might, you could start to feel like you’re wasting money.
Who Should Choose a High Deductible Health Plan?
As we pointed out above, a HDHP might be a good choice for you if you are healthy and anticipate having few to no healthcare expenses. In these circumstances, the lower monthly premiums that you would be paying for your “just in case” plan (which will also cover your preventive care), would save you money over a more expensive plan.
In addition, if you can’t afford a low deductible health insurance plan, you can still get yourself at least some level of coverage with a HDHP. And it’s important to have a plan, even if it has a high deductible, because health insurers negotiate rates with providers. This means you will pay less overall for products and services related to your health if you have health insurance than if you do not have health insurance.
In addition, your high-deductible health plan (HDHP) will pay for necessary medical care, such as preventive services, if you purchase the plan on the individual market. But even if you have enough money to pay for a low deductible health plan, it may be worthwhile to consider a high deductible health insurance plan. Remember that if you have a high deductible health plan (HDHP), you can help to offset your out-of-pocket expenses with a health savings account (HSA).
Who Should Choose a Low Deductible Health Plan?
Again, a health insurance policy with a low deductible is likely to be beneficial to you if you are an older person, if you are not in good health, if you have a chronic condition. If you are planning to start a family, or if you simply make frequent use of your health benefits.
If you have costly health issues, purchasing a LDHP could save you money over the course of the year. Even with the higher premiums. If you switched to a HDHP, the amount you would save in premiums would be a much smaller fraction of the total amount you would pay in deductibles with your HDHP. And, frankly, many individuals find that it is simpler to pay a slightly higher amount on a monthly basis as opposed to a much larger sum all at once. Getting a low deductible health insurance plan might be the best choice for you if you don’t want to deal with the stress of potentially expensive medical care.
How to Choose
It is difficult to make a direct recommendation for a plan without knowing your unique financial situation and your health status. But we can offer the following advice to help you make a decision. Your best bet, though, is to speak to an EZ agent. Who can take your specific circumstances into account and find the best plan for you.
1.Look for discounts
You might be eligible for assistance with your monthly premiums or cost-sharing expenses, depending on your income. So, before you write off a type of plan as too expensive. Ask an EZ agent if you qualify for subsidies or tax rebates.
2.Narrow down your choices
Think about the maximum amount of money you are willing to spend each month on your premium and go from there.
3.Look at additional features
When it comes to shopping for health insurance, deductibles are just one of many factors to take into account. Consideration should also be given to the size of the plan’s network, out-of-pocket maximums, and the structure of the plan. As well as the types of costs that are covered. After you have made a comparison of your expected medical costs for the year with the coverage options available to you. Look more closely at the plans you are considering. Ensuring that they provide the appropriate type of coverage for the amount of money you anticipate spending on healthcare.
4.Set your priorities
Your choice between a high deductible plan and a low deductible plan may come down to what you value more. The ability to save money on premiums if you are fortunate enough to not have many medical expenses. Or the peace of mind that comes from knowing that you won’t have to pay a deductible if you do end up needing more medical care. Doing some number crunching before making your decision might make things simpler for you.
Let EZ Help You
Do you need assistance comparing different plans and choosing the one that is best for your budget and healthcare needs? EZ.Insure is here to help! We will connect you with one of our dedicated, highly trained agents. Who will discuss all of your options with you and assist you in selecting the insurance policy that meets your needs, all at no cost to you. That’s right, there are no hidden fees associated with any of our services. EZ.Insure makes the entire process simple, easy, and quick. To get started, simply enter your zip code in the bar below. Or you can speak to an agent by calling 877-670-3557.
