How health reform affects those who already have insurance

Maybe you already have health insurance through your employer, but are concerned that your plan is going to change.

Maybe you work part-time and are not eligible for your employer’s insurance.

Or maybe you’re about to turn 26 and will no longer be eligible to stay on your parents’ insurance plan.

The point is, health care reform means different things to different people depending on their current situation.  In my next few blog posts, I’m going to discuss some different situations that many people may be facing, and some approaches they may want to consider when making decisions about their health care.

Let’s start out with a discussion of some different scenarios for people who already have insurance:

• My employer offers health insurance, but I want to know my other options.  State marketplaces offer a new way to get insurance.  But if your employer’s plan meets government standards and is affordable, it’s likely that you won’t qualify for government financial assistance – meaning individual marketplaces probably won’t help you save money on a plan.


• My employer offers me health insurance, but I need coverage for the rest of my family.  If your employer does not offer coverage for spouses or children, your spouse and children can buy coverage separately, directly from an insurance company or agent, or in the Individual Marketplaces.

Health reform does provide potential government financial help for people to pay toward the premium for a plan purchased in the Individual Marketplaces. Subsidies are based on household income and family size, so you'll want to complete an application for the Individual Marketplace, to determine whether or not you and your family qualify for financial help.

• I like the plan I have through my employer.  Is my plan going to change?  In most cases, the best choice is to continue getting coverage through your employer. Many employers pay part of the cost for the plan, and this can be a big help to you.

Under health reform, you can expect your old plan to offer new protections. For example, your plan can't limit the amount it will pay per year or over your lifetime for essential health benefits. And you can't be denied coverage or charged more because of a pre-existing condition.

To help control rising health costs, many employers are choosing high-deductible plans which allow employees to set up an HSA or health savings account to help them pay for health expenses with pre-tax dollars.  For more about these plans review the following video:

If you want to learn more about different approaches to health care for people who may already have insurance, here’s some helpful information.