What is the best health insurance plan?

mejor seguro de salud

After series of extensive research, our conclusion of the best health plan is a high deductible silver plan available on the health insurance marketplace. This is possible because the plan is eligible for an HAS (Health Savings Account), the premium Tax Credits and cost Sharing Reductions subsidies. Though, the high deductible may seems discouraging at first when compared to its counterparts offering the low deductible, the benefits accrued to an HAS certainly goes far beyond having a lower deductible.

Please note that “high deductible” is accompanied with several ranges of deductible (check out different types of silver plans below). After comparing the high deductible health plans, we had nothing to say against its flexibility. Silver plan is the only qualified plan for all cost assistance types! Isn’t that amazing? In fact, if you are not yet qualified for cost assistance, a marketplace plan enables you to claim tax credits if that changes throughout the year. One major challenge of the silver plans is their narrow networks. Naturally, most wide network plans comes in a premium package. Of course, it varies from region to region, so try to compare silver plan networks.

Most importantly, your choice of the right plan requires having the prior knowledge of your family medically needs. Honestly, there is no perfect solution that fits all, but if you want to be on the winning side, then go for the HAS eligible silver plan.

hsa miamiThe Different Types of Silver Plans

HSA eligible Silver plans are in different sizes and shapes. You need to choose the right option that fits into you and your family medical needs. Some will prefer to go for the old 2016 higher end silver plan that hardly meets the $1,300 deductible as an individual and a $2,600 for a family’ s requirement. Others would go for something close to the $6,450 individual / $12,900 family maximum deductible.

Individuals need to think about how much care they need and value of things like copays (which kick in before the deductible is met) and coinsurance (which kicks in after). They should also try and consider the doctor, drug network and overall- the insurer. Some will go Gold, Platinum, or Bronze based on their needs to get the best value. Some will pick what is best in the short term and sacrifice long term value. Despite the benefits of a Silver plan under the ACA, this is just based on personal choice.

Why we pick A High Deductible Marketplace Silver Plan as the Top Health Plan under ObamaCare (the Affordable Care Act)

Unless they qualify for Medicare, Medicaid/CHIP, or employer coverage most people will get the best value out of an HSA eligible high deductible Silver plan purchased on the Health Insurance Marketplace.

Here is why HSA eligible Silver plan gained on the Marketplace is such a smart buy:

  • They are HAS eligible which means that you can contribute tax free dollar to a health savings account to pay expenses considered as “out of pocket” including vision and dental.
  • A plan is qualified to be a high deductible plan if its annual deductible reads more than $1,300 for self only recovery or over $2,600 for family coverage after cost assistance. The HAS holder 55 and above are eligible to contribute an extra $1,000.
  • The amount contributed by each member to an HSA changes over each year, so there’s no use it-or lose-it”” rule applies.
  • If you make an annual full funding of your HAS, while you always shop in-network, you might never find yourself in situations of un-payable medical bills and this is because of the new limits on out of pocket maximums.
  • Your contribution to the HAS reduces your modified Adjusted Gross Income (MAGI). Reduction in your MAGI could qualify you to project less income upfront for better assistance, avoid issues of repaying excess tax credits or even claim more net tax credit on your tax return. In fact, you can become qualified for a lower tax bracket.
  • The annual contribution limit for your HSA is $3,350 for an individual and $6,650 for family.
  • Silver plans are the only plans that qualify for both Premium Tax Credits and Cost Sharing Reduction subsidies.
  • Silver plans are only offered on the Health Insurance Marketplace (although a qualified non-marketplace insurance agent can help you Enroll).
  • Silver plans are the only plans that allow you to adjust both out-of-pocket and premium cost assistance if you gain or lose income during the year (other Marketplace plans only qualify for tax credits).
  • Silver plan is the only place where you can claim tax credits on your return. This is particularly helpful for those expecting a high income, but end up claiming less on their taxes.
  • Majority of the Silver plans, at most cost assistance levels, are HSA eligible. Note that, making any form of adjustment to the cost assistance in the course of the year (which lowers your deductible) may make you ineligible to contribute to your HSA, but this doesn’t mean you can’t use whatever amount of money from previous contributions.

Some other great choices include  types of HSA perfect  eligible plans for the high earners (as they promises no need for cost assistance) as well as the higher premium plan that features low coinsurance and copays for individuals who needs numerous drugs and medical care. This will not lead to annual savings, but instead restrict the amount you spend at one time.

To say it all, the only factor left for consideration are networks and benefits. If you travel, go with a multi-state PPO, this is highly advisable if you have no idea who your care providers will be. Go for the HMO if you have the prior knowledge of your care provider. Before you enroll, ensure to double check your plans drug network and provider network. If you can’t find it in network, then it is simply not covered.

When should we say a Silver plan is “no Best Plan”?

The more money over 400% of the Federal Poverty level you make, the less your chances of utilizing the Silver plans cost sharing reduction subsidies, even in vilest case scenarios. For the young and healthy, the cheaper bronze plan is preferable as a form of “catastrophic coverage”. If you use care, you’ll pay a lesser amount up-front, and owe more during the year. This still pairs with an HSA for tax benefits. If you need the care and a lot of drugs for your family, but on a specific budget, then a more generous plan will make sense.

Things that could inspire a family to buy a Gold or Platinum plan would be having a great income, needing a lot of very detailed care (networks), and needing expensive drugs (some higher end plans can have more generous cost sharing on drugs). On the long run, it is important you compare plans on the basis of your income and medical needs. But, for most people, they’d prefer to go for the HSA eligible Marketplace Silver plan after comparing with most plans inside or outside of the Marketplace.

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