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Deciding on the right health insurance plan

11/29/2018

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By Dr. Sarah Stelzner
Eskenazi Health pediatrician

Ordinarily we focus on specific injuries or illnesses in this column, but one of the most vital and controversial aspects of health care these days is health insurance, and it’s important to know how to choose the plan that’s right for you and your family.

Most Americans receive health insurance plans through their employers. For everyone else not old enough to qualify for Medicare, the best advice to find the lowest premiums is to shop Indiana’s Affordable Care Act Marketplace or the Federal Marketplace. Start by going to www.HealthCare.gov and entering your ZIP code. The open enrollment period for 2019 runs through Dec. 15.

Outside of this period, enrolling in a plan can only be done if you have a particular life event such as marriage, a birth of a child or change in health insurance coverage. Once entering the website or a state exchange, you’ll find four different levels – bronze, silver, gold and platinum. The less valuable the metal, the more you will pay for deductibles and other items. The more valuable metal levels have more comprehensive coverage but higher premiums.

It’s always important to look at a summary of benefits while comparing plans. Online marketplaces usually provide a link to the summary and show the cost near the plan’s title. A provider directory, which lists the doctors and clinics that participate in the plan’s network, should also be available. If you’re acquiring your health insurance through an employer, be sure to ask a benefits summary. There are many options when it comes to health coverage, and it can be confusing.

Eskenazi Health has a dedicated staff of navigators to assist you with health insurance enrollment, and a toll-free phone number – 1-855202-1053 – is available to connect with staff who can answer questions and provide assistance in using the online marketplace. Covering Kids and Families (www. ckfindiana.org) also has navigators to help make this important decision.
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