Five Things to Know About Health Insurance

Make sure to keep your information updated 

If you are enrolled in a Marketplace insurance plan, keep your information updated throughout the year. Some events, such as getting married, qualify you for a Special Enrollment Period. Having a change in income or household size may affect your eligibility for PTC’s or cost-sharing reductions. Make sure you report these changes to the marketplace. In some instances you may qualify for additional assistance but in others you may find yourself paying back advance PTC’s on your next federal tax return. Visit for more information on how to update your plan.

Pay attention to the details 

When shopping for insurance, don’t just look at the premium and deductible. It’s important to understand the out-of-pocket maximum. The out-of-pocket maximum is the amount of costs you’re expected to pay throughout the year before the insurance company begins to pay 100% of covered costs. Pay attention to the details, such as how much you would pay for things like a surgery or a hospital stay. If 20% is your responsibility, a $50,000 surgery would cost you $10,000. Also, you’ll want to make sure your doctors are network providers. If you use a provider outside your plan, you will probably have a higher co-pay or they may refuse to pay the bill all together. 

Find the best deal for YOU 

Even if you have a group plan through your employer, it doesn’t mean it’s the best deal for you. If you’re not happy with your current plan, or just want to see what else is out there, shop around for a local health insurance agent who can help you find a plan that better fits you.

Review your current plan 

Pay attention to plans that auto-renew. Plans change and so do your circumstances. Review the insurance plan and options before re-enrolling to ensure it is still the best option.

Do your Research

If you lose your job, don’t automatically sign up for COBRA. Your employer will no longer be paying any premiums they may have paid before, so COBRA can cost you a lot. Research Marketplace insurance plans. Find a local health insurance agent to request quotes. Just remember, the right plan for you is in the details.

Content Prepared by Rana Kory, Worley Erhart-Graves Financial Advisors