TALLAHASSEE, Fla. – The Florida Office of Insurance Regulation is encouraging Floridians who will be shopping for a new health insurance plan or looking to renew an existing health insurance plan on the Federally-Facilitated Exchange (Marketplace) to be informed about what they are buying and to look at more than just how much the plan costs.
With multiple insurance companies offering different health plans options on the Marketplace, making the right decision will be critical for consumers and their families. Although all health insurance plans on the Marketplace have the same essential health benefits and cover pre-existing conditions, they are not all created equal. There are a variety of options based on level of coverage, deductible amounts and provider networks, so it is prudent to know and consider a few key things when making the important selection of a health insurance plan for the coming year.
· Expected Costs and Out-of-Pocket Expenses
Understand how much the health insurance plan will cover for health care costs and what your out-of-pocket expenses will be for deductibles, copayments, and coinsurance. There are four main coverage levels on the Exchange and each provides a specific percentage of coverage. These include Bronze (covers 60% of expected costs); Silver (covers 70% of expected costs); Gold (covers 80% of expected costs), and Platinum (covers 90% of expected costs). Consumers should be aware that federal premium tax credits are available to those who qualify at all plan levels purchasing policies through the Marketplace while cost sharing assistance is available only to those who qualify and are enrolled in a Silver plan through the Marketplace.
· Provider Networks
Provider networks will vary by plan -- with some offering more freedom of choice than others. Before selecting a health insurance plan, look at the provider network of available doctors and hospitals for access to care.
Health insurance plans may have different lists of medications that are covered and at what level they are covered. Be mindful of this when evaluating health plans.
There is also assistance available to help with the shopping process. Consumers may want to consult with a licensed insurance agent, who can provide recommendations based on their individual circumstances. An insurance agent will not only assist the consumer at enrollment, but is also there to provide year-round service.
Marketplace enrollment begins November 1, 2015 and runs through January 31, 2016. With these tips, Florida consumers will be better prepared to find a health insurance plan meeting their needs. For more information, visit www.healthcare.gov.