Northeast Wisconsin
  • Northeast Wisconsin
  • April 2017
Written by 

Health insurance changes

Higher health insurance costs require us to know more about premium and out-of-pocket costs to help us determine which insurance coverage is best for us.

Below are three different health insurance plan examples to review:

 

Plan 1

Plan 2

Plan 3

Monthly premium cost:

$200

$400

$600

Annual cost:

$2,400

$4,800

$7,200

 

Out-of-Pocket Cost:

Deductible:

(Annual)

$6,000

$4,000

$2,000

Co-insurance:

(After deductible)

50/50

70/30

80/20

Co-pays:

(Before deductible)

N/A

N/A

$35

Maximum out-of-pocket:

(Annual/calendar year)

$7,150

$7,150

$7,150

 

Total costs:

(Annual premium + MOOP)

$8,400

$11,950

$14,350

More people are looking for greater premium savings to offset higher out-of-pocket costs.

Plan 1 offers $4,800 premium savings each year compared to Plan 3. When you apply the premium savings, the $6,000 Plan 1 deductible becomes $1,200.

This is lower than the Plan 3 deductible of $2,000. Your $35 office visit is not offered in Plan 1, but more people are moving to higher deductibles to access the monthly premium savings.

When you have greater control of your money, you can do more to access the health care you want and need.

Since 2014, the Affordable Care Act offers everyone access to health insurance. It also offers affordability to lower income households below 400 percent of the federal poverty level (FPL). In 2017 that number is about <$47,000 for a one-person household and <$65,000 for a household of two.

The best plan for you will depend on many considerations, such as your current medicines, doctors, medical care needs and household income.

As the market moves to higher deductible plans to lower premium cost, we need to know more about our health and what we can do to avoid expensive medical care.

Changes in health care and insurance make it more important than ever to work with a licensed health insurance broker to review your options.

 

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