HealthCare: You Can Do It!

But you only have until December 15th!!

 

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One of the most important things you can have is health insurance, and up until 2013 it was a novelty for those in the arts and self employment industry. Something both esoteric and expensive AF. For college students, you just didn’t have it. For artists, you just didn’t have it. Until just 4 years ago, you either needed to be in the military, had a 9 to 5 with coverage, married to someone with it as a dependant, or be a pregnant woman living beneath the poverty level JUST to have insurance.

So many self employed folks would cut the expense of coverage to increase their revenues and plans were so limited that it was more expensive to be insurance. In 2013 most of that changed. And it is in your BEST interest to use it, or lose it.

Since January 2017, Congress has tried to pass 3 different ACA repeal programs working in the wee hours of the night to befuddle American citizens in an oppurtunity to life. Is the system perfect? FUCK NO. Is Health insurance expensive, FUCK YES. But so is having untreated chronic and acute illnesses. So is using the Emergency Room as a Primary Care when no one has the option for preventative anything.

 

*The only way to qualify for insurance outside the timeframe is if you qualify for Medicaid, or if you want your coverage to start after Jan.1, 2018. Here is a chart for Medicaid income levels for all states.

 

Step 1: Organize

Before going online and looking at plans, make sure you have the following information: what medications you are on, possible medications you’re interested in taking, how much you’re currently spending on insurance, a general idea for how often you see a PCP or specialists and what changes are you expecting for 2018.

 

Check and make sure your Rx drugs are covered. See if there is a specialists you love and make sure that they’re in network. Know what you need first before looking at the prices for premiums and deductibles. A lot of the lower cost plans have small networks and high deductibles or EXTREMELY high copays. Don’t know what those words are?

 

Step 2: Know these definitions.

 

Deductible: The amount you have to pay out of pocket each year before the plan does anything (Just like in car insurance, you need to pay this before the company pays for anything. It doesn’t have to be all in one go and yes, you still have to pay a monthly premium while paying off the deductible).

Monthly Premium: The cost you pay monthly to have a plan. (Think of it like a car payment)

Out of Pocket Max: The MOST you’ll have to pay for “in network” expenses.

In network: The doctors and health facilities that have agreed to work with your insurance company and are listed under “Covered Providers” or “In Network Service Providers”

Out of network: Providers that don’t work with your insurance plan.

*It’s important to note that up to twice a year, Providers have a choice to either stay with their networks or they can drop networks which means if you don’t check regularly you could be charged an out of pocket expense.

Providers: Those who service, ie Doctors, ARNPs, Therapists, etc.

Here is a link to the glossary from Washington Healthplan Finder for more information.

 

 

Step 3: What is your family?

Make sure you know your income and family size. If you’re signing up as self employed, you’ll use your tax information from your most recent tax submission. Have saved copies of proof of income in case you need to submit anything via mail or fax. Some states require people to go in person to their local department of social services and finish registration and they inform people of this via email, so use an active email account.

 

Step 4: Go!

 

Enter in your zipcode to see how you’ll apply for benefits in each state. Because I live in Wa, I was sent to Washington Healthplanfinder. Some states, like Texas, don’t have a separate site and you will continue to complete the forms on Healthcare.gov.

From here, you shop for plans. Also, make sure you’re shopping for plans and not applying for Medicaid. The language is similar and it can kill 30 minutes.

 It's important to know what you're applying for before starting. 

It's important to know what you're applying for before starting. 

I know the sticker shock is crazy at first, but this is where it’s important to know about your health and what coverage you need. For example, circus artists may need PT and reasonable coverage with ER visits in case anything ever were to go wrong. (We hope it doesn’t but just in case, a broken hand can cost $25,000). For myself, I take a specific psych med and if I ever were to be self employed (fingers crossed 2019!) I would need it to be listed. Take the time to look at plans and their copays as opposed to just signing up for the cheapest monthly premium. 

 You're doing great!

You're doing great!

 

So here you go! If you have any questions, feel free to comment and I’ll try to point you in a direction of answers. You can also call the toll free lines listed at the button of every website because every state has a customer service representative to help you apply.

And when you're finished: get cozy and be proud of yourself, like this smug ass cutie mc cuter face. 

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*ALL of this information is to be used as a guideline and is in no way a government approved or funded manual. Good luck out there and CALL YOUR CONGRESS PEOPLE TO KEEP THE HCA.