NEW YORK (MainStreet) — Whether you have health insurance or not, standing still and waiting for 2014 and the full implementation of health care reform could be a big mistake.
Health insurance industry professionals say that millions of Americans will likely “hold off” on making big decisions on their own health insurance needs, but that could lead to missed opportunities.
Carrie McLean, a licensed agent at EHealthinsurance.com, a Mountain View, Calif.-based online health insurance provider, offers tips for insured and non-insured consumers alike before health care reform rolls in at full capacity next year:
If you don't have insurance:
Remember the changes are noot retroactive. McLean points out that if you turn ill or are injured, there is no waiting until 2014 for Uncle Sam to pay any of your 2013 medical bills. “Even in 2014 when your application for insurance cannot be declined for any reason, you won’t be able to apply for a plan in the emergency room and expect to have that E.R. visit covered,” she says.
Get at least some insurance. McLean says a single visit to the hospital emergency room can cost more than $10,000 — thus the need for some health insurance for the otherwise uninsured. If not, you’re taking a “huge financial risk,” she says.
You can still get pre-existing health insurance. Contrary to popular opinion, uninsured health care consumers can get pre-existing condition health insurance for as low as $200 for a typical middle-aged adult. “Shop around online and see what’s available,” McLean says. “If you can’t qualify because of a pre-existing condition, know that Obamacare created Pre-existing Condition Insurance Plans for people like you. And you can shop for those online as well.”
Go for short-term insurance. Health insurance plans actually can have a short shelf life — even as short as one year. That can build you a bridge in to 2014 and full implementation. Even better news: You can get short-term insurance for as low as $67 per month or accident insurance for as low as $19 per month, McLean says.
Get “telemedicine” insurance. The non-insured can get access to a doctor or a nurse either online or over the telephone for as little as $19 per month. It’s called “telemedicine” insurance, and it’s widely available.
If you do have insurance:
Review your plan. Under Obamacare, U.S. firms with fewer than 50 staffers don’t have to provide health insurance to employees. Even larger companies can avoid offering health care insurance by paying a $3,000 per-employee fine, McLean notes. “Consumers should be aware that they could lose insurance from an employer if they have it, or that their employer could switch to a 'defined contribution' model next year, wherein they get a flat dollar amount from their employer — say $5,000 — to buy their own health insurance,” she adds.
Coverage could change in 2014, so know how to act in 2013. If you have the option to undergo surgery or some other costly medical procedure today or in 2014, what should you do? A simple way to help with that decision is to look at your current deductible and compare it with what your deductible might be next year.
“Load up” on a health savings account. McLean says that if you don’t have a health savings account, it might be a good year to grab one. “A health savings account is a tax-advantaged medical savings account available to U.S. taxpayers enrolled in high-deductible health insurance plans,” she explains. “If deductibles go up and you have an HSA, you’ll have more money to pay those out-of-pocket costs and receive a tax break.”
Plan for subsidy help in ’14. If you’re buying new health care insurance this year or there is a chance you’ll lose your current policy next year when Obamacare kicks in, check to see if you’re eligible for financial help from the federal government. “The federal subsidies are available to individuals and families earning less than 400% of the federal poverty level" or about $45,000 a year for one person, or $85,000 for a family of four in 2012 dollars, McLean says. "Depending on your income, the subsidies will make sure you pay no more than 3% to 9.5% of your annual income on health insurance premiums.”
McLean says that getting complacent about your health care ahead of 2014 may be understandable — but it certainly isn’t helpful.
“It’s easy to get distracted by the big changes coming in 2014, but you can’t afford to do 2013 on auto pilot,” she offers. “When you go without health insurance, even for a year, you leave yourself open to dangerous financial liabilities. A single serious illness or hospitalization could destroy your financial well-being. And even if you’re currently insured, now is the time to educate and prepare yourself for how your coverage options may change in 2014. What if your employer stops offering coverage? Will you be eligible for subsidy assistance to purchase coverage on your own? Those are the sorts of questions you need to answer in 2013.”