The objective of this post is to explain “Obamacare” and the changes in the health insurance marketplace.

I will start off by saying: Whether or not you agree with the recent changes and the political stances that come with it, I don’t necessarily care because I have my opinion too, and it is probably similar to yours. 🙂

Back in the day (last year), you weren’t required to have health insurance. Now, its required. By required, it means you get penalized for not conforming (penalty is the greater of $325 or 2% of your yearly income).

So here we are…whether we agree or disagree with this requirement, it doesn’t matter, we have to do the best with what we have.

One of the main changes is that the government is basically offering to pay for your health insurance premiums (Obamacare). If you make too much, you will have to pay 100% of your premium. If you make too little, you get thrown into medicaid, where your doctor/hospital options are slim.

If you make somewhere in between too much and too little (most of us), you will be eligible for a “premium tax credit.” The government will be paying a % of your health insurance premium.

A website that roughly determines your subsidy % is as follows:
*Note: this tool gives an estimate, not exact figures.

Now, you don’t have to take the premium tax credit to pay for your premiums…you can choose to pay your full premium and receive the tax credit when it comes tax season.

Another change in the health insurance market involves pre-existing conditions. Before this year, you would get denied for having certain diseases or cancer. Or they would exclude the certain illness and anything associated with it. Underwriting was tough.

Now you can get coverage no matter your health status, the price is based off your age, zip code, and tobacco use. The important factor nowadays is your income, which determines how much you’ll have to pay, since the government is paying for a portion of it.

Normally, what people do (more often than not), is they go on, type in their info, and choose the cheapest plan.

The consequences of doing this won’t become apparent until you go to USE the health insurance. The last thing you want to do is go to the doctor when you’re ill and realize your doctor or hospital is out of the network. Also, its important to choose a plan that best reflects how often you go to the doctor, and what prescriptions you are on (prices for drugs vary depending on the plan).

Usually for auto/homeowners insurance, you pay a little extra to have an agent (it’s built into the price). For health insurance, the cost is the exact same whether you have an agent or not. 

Therefore, I am here to field any questions and help you through the enrollment process.

November 15th – February 15th is the next “open enrollment period” where you can purchase a health insurance policy. You can only buy one before that date if you have a special life event (loss of coverage, move state to state, have a baby, etc). This upcoming “enrollment” is basically a period where you can get a policy for 2015.

If you are wondering about your situation, I would like to set up a casual, informal meeting to figure out:
a) if you need to do anything at all
b) what plan best fits your situation
c) what type of subsidy you should expect when purchasing a plan

Upon learning what you need to do, I can then email you the plans to look over, and we can go from there. I’ve been trying very hard NOT to flood Facebook with insurance crap. However, this is an important topic and I think everyone should be educated, since no one seems to know anything about health insurance (even people in the insurance industry who bury their head in the sand versus learning about it).

I’ve been selling health insurance since 2011, along with auto, homeowners, and life insurance. We are indepedent agents representing 30+ companies including Progressive, Safeco, Travelers, and MetLife. We are located at 225 North Main Street in Edwardsville, next to the courthouse.

I appreciate the time it took for you to read this post. If just one person learns anything from reading this, then I consider it a success. I look forward to being a resource to my friends in the future and wish you all best of luck moving forward.

Cody Sailor
(618) 659-1495