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Health Insurance & Affordable Care Act

Five Things To Know About Obamacare Premiums: A Guide For The Perplexed

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Comparing apples to apples is virtually impossible.  The first thing to understand is that policies that will be sold to individuals and small businesses in online marketplaces are brand new and must cover a range of essential benefits that were not always covered in the past. That includes prescription drugs, hospitalization and maternity coverage. Consumers cannot be turned away or charged more because of health problems, as they can now in most states.  Women cannot be charged more than men. In addition, the amount you'll have to pay out of pocket will be capped at $6,350 for singles or $12,700 for families. Currently, almost a third of individual policies have caps that exceed those amounts, according to a report by Kaiser Health News and U.S. News & World Report.   "You have to compare apples to apples, to the extent you can. But those apples don’t exist," said Joseph Antos, an economist at the conservative American Enterprise Institute. "There isn’t a good way to do a comparisons."

Look for which premiums state regulators are using for their comparisons.  Under the health law, coverage sold through new marketplaces to individuals and small businesses include a range of types, from the lowest-cost bronze plans that have the highest deductibles to higher-premium platinum or gold plans, where you pay fewer out-of-pocket costs.  But premiums are just one part of the cost of health insurance.  When considering a report on rates, ask which type of coverage was highlighted and how much the deductibles and co-payments are.  Was it the low-cost bronze plan price, the slightly higher priced silver plans or the highest priced platinum or gold? Or some combined average?

You are not average.  Many of the estimates are based on averages, which really don’t reflect what any individual consumer will pay. Premium prices will vary based on a person’s age, where they live and the insurer they select.  Generally, younger people – especially  those few who are buying high-deductible coverage now -- may see an increase in premiums, while older or less healthy people may see their rates go down.

Thu, Aug 01 2013

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