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Health Care

In the event of a serious illness or catastrophe, not being adequately covered can lead to financial disaster. Having the proper health insurance helps ensure you and your family are covered. Finding insurance became a very different experience for many Americans in fall 2013, the first open enrollment period under The Patient Protection and Affordable Care Act (ACA). If you were in the market for health insurance back then, either for independent or employer-sponsored health coverage, you started to see big changes. Luckily, resources are available to help you make informed decisions.

Choosing a Health Plan
Whatever your age, health circumstances or wherever you live or work, it's important to make time to study the best health insurance options available to you on an annual basis. It's a good idea to review your current benefits before Open Enrollment so you can make smarter selections for the coming year.

Here are some questions to ask yourself before you enroll in a health care plan:

Has my life or health changed in the last year or will they change in the coming year? Maybe you've recently married, divorced or had a baby. Maybe you or a member of your immediate family has been diagnosed with a particular health condition requiring specific evaluation, procedures or prescriptions. If your family or health situations have changed, the health coverage you choose should address those needs.

How much can I afford to pay each month for health care? If you're not sure, check your budget, or make a budget for the first time.

Who requires coverage under my plan? Am I insuring myself, my spouse or partner or other dependents?

How often do I or others on my plan need to visit the doctor? If chronic illness or special needs are a consideration, this affects the plan you will choose.

What about accidents or unscheduled surgery? It's important to consider how the plans you're evaluating would cover particular forms of accidents that require surgery or other intensive procedures.

What is the maximum deductible you could afford to pay? To keep monthly premiums low, the Kaiser Family Foundation reports that many individuals choose plans with higher deductibles. However, before you go with the lowest-possible premium, evaluate all potential out-of-pocket costs – from deductibles to co-pays as part of any health insurance plan you select.

Is it better to enroll in my employer's health insurance, my spouse or partner's plan or to buy my coverage independently? Buying health insurance is not just about the lowest monthly premium, it's about finding the best coverage to fit specific needs so an accident or illness won't decimate your personal finances. Because the ACA requires insurers to cover you no matter what your health history, many individual coverage options could match or exceed what your employer offers. Consumer Reports has an all-purpose checklist and glossary to help you evaluate any health plan you consider. Also consider that many employers have dropped or changed coverage for working spouses, so that might affect the future of that option.

Where do I get help? Many people complete their insurance evaluation with a quick call to their health insurance broker or benefits director at work. While those professionals may provide great expertise and speedy answers to your questions about specific plans, remember that qualified financial planners and tax advisors can provide more personalized advice about these decisions. For example, participating in tax-advantaged programs like flexible spending accounts and health savings accounts available with certain plans might have significant tax and money-saving advantages. And depending on how much out-of-pocket spending is necessary in certain health situations, it is advisable to seek counsel from qualified financial, tax and estate advisors expert in such matters.

How well do I take care of myself? The ACA mandated that checkups, cancer screenings and immunizations be fully covered regardless of deductibles. But staying healthy is generally a good idea financially and many employer plans offer reimbursement for health club memberships or weight-loss programs. If you haven't investigated those perks, do so.

How do I plan coverage around retirement or future self-employment? Big work transitions usually mean major health insurance transitions. If you're planning for retirement or self-employment, it's wise to plan that transition as far ahead as possible – bring your company's benefits experts and personal financial advisors into the picture.

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