Navigating the Health Insurance Marketplace


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With the introduction of the Affordable Care Act, and the already intimidating nature of insurance, navigating the health insurance marketplace can be a confusing, intimidating and even scary experience. If the world of PPOs, premiums and deductibles leaves you scratching your head, take a look at the tips below to help you make the best health insurance decisions for your own situation.

Watch out for agents, brokers, or websites that claim to offer you a “special deal” on health insurance.

Joel J. Ohman, CFP® CERTIFIED FINANCIAL PLANNER™, founder of the website warns that there’s no such thing as a “special deal.” “Whether you purchase health insurance by calling a toll-free number on or working with a licensed agent or broker – the price will be the same. The agent or broker is compensated directly by the insurance company so the price you pay will be the same no matter who you choose to work with. No one can offer you a “special deal” on health insurance like a used car salesperson could.”

Beware of unsolicited “cold call” type approaches to sell you health insurance.

On that same note, Ohman warns against taking “cold call” offers. “The best approach is to investigate your options on and then speak with a local licensed health insurance agent or broker that can help explain all of the various options to you.”

Pay attention to the details of the plan.

Eric Stauffer,, LLC, warns consumers to always look at the details. “Consumers often focus on copays, deductibles and premiums when looking at plans because these are the most forward-facing pieces of an insurance policy. Understanding maximum out-of-pocket costs, maximum lifetime benefits and separate deductibles for things like prescriptions is extremely important, as they can add sizable, unforeseen costs.”

Get help if you need it.

If consumers are confused by the options, Ohman advises getting help. “There are a number of different avenues that a consumer can investigate when it comes to getting personal help: offers online chat support, toll-free number support, and other options, but, the best place to get help will be a local licensed insurance agent or broker.”

Get a Health Savings Account.

Consumers should definitely look into HSAs, Ohman says. “One of the single biggest things that people can do to save money on both monthly premiums and on future health care costs is to start socking money away pre-tax into a Health Savings Account (HSA).”

Actually sit down and do the math using hypothetical scenarios.

Stauffer recommends putting pen to paper to get a realistic look at what your plan will cost you. “Understanding what your annual costs could look like in different situations is extremely important. A small premium plan may look appealing at first, but what would happen if you broke your leg? Pick different numbers (like $5,000, $10,000 and $25,000) and act as if you needed health care that cost that much. Run these numbers through each plan to get a clear view of what your actual out-of-pocket costs could look like. This exercise also helps you to understand the different aspects of an insurance policy that you may have been unfamiliar with before.”

Keep contributing to your HSA.

Finally, Ohman reminds consumers that they should continue contributing to their HSA. “If you own a health savings account it is important to note that you can contribute to an HSA all the way up to your tax return due date (4/15) and have the contribution count for the previous calendar year (up to the IRS limitations). This is a great way to get an added above the line deduction even after the tax year is over.”



Briana Fabbri is head of marketing for NetCredit.