If you bought an individual or family medical insurance plan in Wisconsin for 2016, did you know that you’ll automatically be re-enrolled in the same (or similar) plan for 2017?* If you like your medical insurance and it fits your needs, this might be the right choice. But what if the cost of your insurance is going up? What if the similar plan isn’t exactly what you want?
Considerations in Choosing a Different Medical Insurance Plan in Wisconsin
Cost
Because of the Affordable Care Act (ACA), medical insurance companies must publicly explain any rate increase of 10 percent or more before raising your premium. Rate changes are submitted every year to healthcare.gov. You can find these on the Rate Review Submissions Page. Here, you’ll see what price changes have been approved. You’ll notice that some plans show final rate increases and others actually drop.
However, the premium cost is only one part of your cost when you buy medical insurance. Out-of-pocket costs are what you pay in addition to the premium. These include copays, coinsurance, deductibles and other goods and services not covered by the medical insurance plan. Many of these costs are regulated by the government. Generally, the higher your premium, the lower your other costs will be. These costs may be reduced if you qualify for subsidies. Then you may be able to get a plan with low premiums and low out-of-pocket costs.
If you don’t qualify for subsidies, it’s even more important that you understand what type of medical insurance fits your needs. Knowing how you use health care can help you figure out what plan is right for you.
- If you’re under 26, find out if you can get on or stay on your parent’s medical insurance plan
- If you’re under 30, check out catastrophic plans
- If you’re over 30 and healthy, check out High Deductible Health Plans paired with a Health Savings Account
- If avoiding changes in your budget is important, explore gold and platinum level plans. Premiums will be higher, but out-of-pocket costs will be lower
Network
Be sure to review the network of any plan you’re considering. Some medical insurance companies use “Narrow Networks”. That means that you may only be able to use 25 percent of the physicians that practice in an area.
Always check the network to make sure you have guaranteed access to the hospitals, doctors and specialists you may need.
