Take time to find the best coverage for you
By Barbara Pierce
“The average cost of health insurance in New York State is $701 per month,” Sterling Price said. “Premiums here are 42% above the national average!”
Price, research analyst at ValuePenguin, specializes in health and life insurance. ValuePenguin and its parent company, LendingTree, empower consumers with information and resources to make better informed financial decisions.
In a recent health insurance survey Price found:
Compared to the rest of the U.S., we have stunningly high rates to purchase a private health insurance plan, second highest in the U.S. To determine this, ValuePenguin gathered rates and plan details from every county in the state, then averaged the rates and sorted them by metal tier, age and family size.
The survey also found that half of us have huge gaps in our knowledge of health insurance concepts.
Some basic concepts important to know:
A premium is the regular payment you make to pay for your health care insurance. A higher premium usually means lower deductibles. A deductible is the amount you pay out-of-pocket for health care before your health insurance kicks in. Copay is what you pay the health care provider for each service after meeting your deductible.
If you need health coverage or wish to change your insurance, you have until the end of this month to find the plan that works best for you and enroll in that plan. Gov. Andrew Cuomo extended the open enrollment deadline to March 31. (The set dates when you can buy or change your health insurance are called Open Enrollment Period.)
All New York State residents are mandated to have health insurance, and it is one of the most important decisions you make. If you are not covered by your employer, choosing the right health insurance is an important decision.
Most health insurance plans fall into one of four categories called metal tiers. They are named after metals – bronze, silver, gold, platinum. The tiers aren’t related to the quality of medical care. They refer to the out-of-pocket expenses you will have.
All plans are required to cover essential health services: visits to your health care professional, labs, pediatrics, emergency services, hospitalization, maternity, mental health, substance abuse, rehabilitation, prescription drugs.
“Although the metal tier classification is supposed to make the decision easier, it’s confusing,” Price said. “We need to do a better job of explaining what it means.”
“Health insurance is a complex product,” he added. “If you don’t get it from your employer, it can be daunting.”
“Employee plans are more expensive overall, generally,” he continued. “But employees will pay less because their employer shoulders much of the premium costs.”
If your employer does not offer health insurance, it is available through many providers. From private to public options, there are many different types of health insurance to choose from. Each plan has pros and cons, and costs can greatly range, depending on the deductibles, copays, and premiums.
How to choose?
Making the best choice depends on your values and preferences, and some good luck predicting your future health.
Few of us are good at predicting what health care needs we’ll have in the coming year. Picking an ideal health plan requires combining all of these features – knowing what you might use, what it might cost you, and how those expenses combine with the plan’s monthly premium.
“Look at your medical expenses. Gauge what the general numbers are,” Price recommended. Then, review the premiums and deductibles for each metal tier.
The difference is how much you choose to pay each month as a premium, your upfront cost. A lower premium (bronze) usually means you’ll pay a higher cost of care (copay) for each visit to a health care professional. A higher monthly premium (platinum) generally means you’ll pay less for each visit.
The best policy for you will depend on the plans available in your area, as well as your medical and financial situation. This means that it covers the basics, but also covers you if there is a serious medical emergency that ends up being expensive.
If you have an emergency savings account, and don’t expect to have significant medical expenses, then a lower metal tier plan with more affordable premiums would make more financial sense.
“For a family, I recommend they start with Silver, a middle of the pack plan,” Price said. “It has expensive premiums but attainable deductions.” silver plans are best for people with low income or average medical costs.
If you’re very healthy, bronze may be best in terms of cost-effectiveness. Gold and platinum plans often have the most expensive monthly premiums but lower deductibles. They can be the most cost-effective for people with higher medical costs, as you would reach the deductible quickly.
If your income is below a certain level, you may be eligible or free or low-cost state sponsored plans to help pay.
“Take the time to inform yourself,” Price advised. “It’s a complex product.”
For the complete survey, see: www.valuepenguin.com/best-cheap-health-insurance-new-york.