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Affordable Care Act is Finally a Reality

by Vanessa Jones on January 2, 2014 at 4:42 PM
 Affordable Care Act is Finally a Reality

Now that the Affordable Care Act is a reality according to the mandates all applicants are assured of health insurance - where age, gender or pre-existing illnesses cannot be discriminated against by insurance companies. There are some mistakes regarding health insurance a person can make and they are choosing their cover.

1. When you are young and healthy you feel you don't need coverage but the truth is medical bills can make a person bankrupt. If you have an unexpected illness or accident, you may have to foot the entire charges and continuing care will also be very expensive without health insurance. Even if you get treated at the Emergency Room you will be billed.


2. You feel you have a high deductible so you will not save money by buying health insurance. Actually if you stay within your insurers network of providers you will end up saving thousands of dollars as the insurer will negotiate rates for you even before they start paying bills for you.

3. Each insurer has a network of medical providers including doctors and hospitals. When you make an appointment it is necessary to check if the provider is covered by your insurance company as the rates are then negotiated by the insurer. When not in the network the provider can charge as they feel fit and even though your insurance company will pay part of the amount you will have to pay the remainder.

4. Make sure your medicines are on the insurer's drug formulary. Each insurance company has a formulary, or list of prescription medications that they will pay for, and a tier of charges. If your medications are not on the list, you will have to request special coverage, or pay the full price. It pays to check the insurer's list to see if your regular medicines are covered, and at what price.

5. When you think you can always sign up later if and when you fall sick is a big mistake. There are fixed periods of enrollments and when you miss them you have to wait for 6 - 8 months at times. There are exceptions which may be checked out.

6. At times you feel that coverage for certain circumstances will suffice. It is always better to think ahead and cover all the essential eventualities.

7. Never pick a plan based on low premiums. It is very important to check whether you can get coverage where your preferred doctors and hospitals are on the network of the insurer. Check the deductibles and co-pays and also what prescription drugs are covered.

Health care is expensive and you should try to make the most of the insurance plan you enroll for.


Hannah Punitha (IRDA Licence Number: 2710062)

Amy Dillon, January 2014

Source: Medindia
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