VIDEO: “Every Artist Insured: Navigating the Affordable Care Act with Renata Marinaro.” Produced by the CUE Art Foundation, with support from the Joan Mitchell Foundation.
As the March 31 deadline for enrollment in health insurance plans under the Affordable Care Act approaches, we wanted to share a few resources for artists who are trying to choose the right plan for them. You can watch the CUE Art Foundation video above, in which Renata Marinaro of the Actors Fund walks you through the process of selecting a plan, or read on for tips from our friends at the Freelancer’s Union.
Check out the plans on HealthCare.gov
This is where you can shop for health plans that are available through the Health Insurance Marketplace, also known as the health exchange. The website asks for your household income and number of dependents so you can compare plans and find the one that meets your budget and wellness needs. Since you might qualify for lower costs, we encourage you to start your insurance search on the exchange. You can use this online calculator to find out if you’re eligible for tax credits or subsidies.
Look beyond the premium
There are more costs to consider than just the monthly bill. Depending on your health situation, a plan with a higher premium could be more cost effective when other parts of the plan are taken into account. For example, if you plan on using covered services frequently, a plan with a higher premium but lower out of pocket costs might save you in the long term. Plan details to look at:
- Copayment. A copayment is a set amount that you have to pay for a covered service. For example, you might be responsible for a $50 copay each time you visit your physical therapist.
- Deductible. The deductible is what you’ll have to pay for health services before your plan will cover anything. So if a plan’s deductible is $3,500, you have to pay $3,500 of your own money before your insurance begins covering costs. Important note: the deductible doesn’t apply to everything. Certain services, like preventative care, are covered from the start and not subject to the deductible.
- Out-of-Pocket Maximum. The out-of-pocket max is the most you’ll have to pay out of your own pocket for health services in a plan year. Once you reach your out-of-pocket max, your health plan has to pay 100% for covered services. On this year’s health exchange, the out-of-pocket max for an individual plan can’t be more than $6,350 for an individual plan and $12,700 for a family plan. Remember, the higher your monthly premium, the lower your out-of-pocket maximum will be, and vice versa.
Don’t forget about your prescriptions
Prescription drugs can be pricey, so if you or a family member takes medications, make sure you understand how they’re covered. Find out how your prescriptions are classified (generic, brand formulary, specialty, etc.) because classification means a huge difference in price.
How big is your health care provider network?
It’s a good idea to find a plan that suits your lifestyle. If your freelance career requires travel, you should look for a plan that can travel with you. Does the plan you’re looking at offer nationwide coverage or are you only covered in your state? Are your preferred providers considered in-network? Does the plan offer any out-of-network coverage? These are all great questions to answer while you’re plan shopping.
If you’re in New York, check out Freelancers Insurance Company
FIC’s plans were designed with freelancers’ needs in mind. They include flexible, nationwide coverage, as well as some out-of-network coverage for freelancers on the go. Plus, you can get free unlimited primary care services at the Brooklyn and Manhattan Freelancers Medical offices, which also offer free yoga, acupuncture, and health coaching.
You don’t have health insurance. Do you have to buy it?
Yep—or pay a fee. This year, the fee will be $95 or 1% of your income, whichever amount is higher. It’s also important to note that the fee is per person, not per household, meaning any uninsured dependents will be charged as well. The Tax Policy Center has a helpful online calculator if you want to figure out your total fee.
When is your next chance to sign up?
The current open enrollment period closes on March 31, 2014. After that, you can’t sign up for a plan (except in case of life events such as a birth or loss of coverage) until the next enrollment period, which is scheduled to begin on November 15, 2014.