Updates and Changes to Know About the Health Insurance Marketplace in 2023
If you are a Texan with no health insurance, you are not alone. Texas has the highest share of uninsured people in the country, with 16.6% of the population paying entirely out of pocket for healthcare. Many Texans are tired of paying too much for medical services, whether uninsured or not. Luckily, changes to the 2023 health insurance marketplace will make it more affordable to get coverage. However, other changes may make switching to a new insurance provider or plan the least expensive option. It all comes down to the type of plan you have, your eligibility for subsidies, and if you actively renew your policy. Are you curious about the latest health insurance market changes that could affect your budget this year? If so, keep reading this guide for answers to the most-asked questions about health insurance updates for 2023. Are Marketplace Premiums Going Up for 2023? Yes, marketplace premiums are going up based on national averages. Texas is not spared from these rate hikes. In fact, Texas is home to some of the most significant rises in lowest-cost monthly premiums in the nation. If you are worried about overpaying for insurance in Texas, Custom Health Plans can help you find the most affordable option. Benchmark Silver Plan Premiums Average silver plan premiums are expected to rise across the nation in 2023. Silver plans often serve as the benchmark for other tiers. If silver plan premiums go up, other metal tiers are bound to follow. In Texas, that increase will look like an average of $454 monthly in 2023. Compare that to 2022, when the average silver plan premium was only $415 per month, and 2018’s average monthly silver premium of $419. Insurance companies cite rising prices, inflation, and rebounding levels of medical service utilization as the main culprits for premium increases this year. However, this year’s enhanced subsidies (more on this in a moment) will likely offset these price hikes. Unfortunately, the same is not true for people with unsubsidized health insurance premiums. Unsubsidized Premiums The bad news is that people with unsubsidized premiums will feel the hit of the price increases we mentioned above. The good news is that this is only a minority group since nearly 4 in 5 individuals have subsidized health plans. This number has declined steadily since 2016, when the majority (56%) of individual market enrollees paid into unsubsidized health plans. If you have an unsubsidized policy and are worried about rising premiums in Texas, Custom Health Plans is here for you. We can help you find ACA-compliant health coverage to optimize your savings. Will There Be Marketplace Subsidies in 2023? Yes, marketplace subsidies will continue into 2023 and through 2025. This is thanks to the recently passed Inflation Reduction Act (IRA), which aims to reduce costs for families and individuals of certain incomes. Enhanced Marketplace Subsidies The cost breaks available to low-income families and individuals in 2023 are even better than the original ACA subsidies. Originally, policyholders within 150% of the federal poverty level (FPL) had to pay 4% of their household AGI toward health insurance. Note that 150% of the FPL equals about $20,000 for individuals and $42,000 for a family of four. The IRA (and the American Rescue Plan Act (ARPA) before it) offers even more savings. Now, families and individuals within 150% of the FPL do not have to pay anything for health insurance. Expanded Marketplace Subsidy Eligibility The IRA has also continued the expanded eligibility requirements set in place by the ARPA in 2021. These acts have approved premium tax credit eligibility for enrollees making over 400% of the FPL. 400% of the Federal poverty line equals around $54,000 per individual or $111,000 for a family of four. The updated eligibility guidelines restrict this group from paying more than 8.5% of their AGI to health insurance. The main goal of this update is to save older adults on age-adjusted insurance premiums. The Family Glitch The family glitch is a phenomenon that has caused increased health insurance costs for more than 5 million Americans. It blocked certain low-income families from claiming subsidies due to a household income calculation error. In 2023, there are new rules to prevent the family glitch from happening. What Are the New Marketplace Eligibility Rules for 2023? Aside from the expanded marketplace subsidy eligibility rules, the health insurance marketplace will also have more insurance options available to more enrollees. These new eligibility rules include: No longer allowing insurers to refuse marketplace coverage to policyholders who owed premium back-payments Enabling people who miss Open Enrollment to sign up for coverage due to a qualifying life event Not requiring documentation for people who experience certain qualifying life events and need to enroll outside of Open Enrollment Allowing year-round enrollment for households within 150% of the FPL These new rules should make it easier for people to obtain health insurance. Is Automatic Re-Enrollment Still in Place in 2023? Yes, automatic re-enrollment is still in place for healthcare plans in most states. However, experts recommend actively renewing your insurance plan this year to take advantage of additional insurance savings. Failing to do so may lock you into new premiums and out-of-pocket costs you are unaware of. If you do not investigate your options, you may end up overpaying for health insurance. Moreover, if the benchmark plan tied to your coverage changes, your marketplace subsidy may fluctuate, too. You may then have to pay the difference between the cost of your policy and the newly-enforced benchmark. Even if you do not intend to actively renew your plan, ensure you update your application for 2024. Your subsidy is based on your expected income and household data for next year. Failing to update this information on your application could prevent you from earning even more savings on health insurance. Or it could mean that if you qualify for less savings, you will owe the difference during tax season. We Can Help You Navigate the Texas Health Insurance Marketplace The health insurance marketplace is changing in 2023. Some people will save,
The Best Health Insurance in Texas: How to Choose a Suitable Premium
Did you know that Texas has the largest number of uninsured residents? There were around 5.2 million Texans who were not insured in 2021. That number is unnecessarily high and we want to help change it. Unfortunately, finding the best health insurance in Texas isn’t easy. It’s expensive and many people often can’t afford it. That’s why we’ve created this guide to help you and everyone in the community find health insurance that fits any budget. Keep reading so you know what to look for in an insurance policy. Understanding Your Health Needs Before you start looking for Texas health insurance, you should assess your medical needs and those of your family. Each plan is going to have different coverage and costs. You don’t want to pay for extra services or coverage that you don’t need and vice versa. The last thing you want is to purchase insurance and not have access to the medical treatments you need. When you’re looking at insurance plans, think about any pre-existing conditions you may have, chronic illnesses, and ongoing medical treatments, if any. All of those factors contribute to the coverage that you need. Do you have any dependents? If so, you’ll need to take their age, health status, and medical needs into consideration before making your selection. You’ll also need to think about your preferred healthcare providers. If you’ve recently moved to Texas, then you may not have a preference. However, if you have established relationships with doctors or hospitals, you may not want to change. If that’s the case, you’ll need to choose an insurance plan within their network. Budget Considerations Your budget is going to be a huge determining factor when it comes to choosing your Best Health Insurance in Texas and there are several considerations that you’ll need to think about. One is the premium. This is the monthly amount that you’ll pay for the coverage. The higher your monthly cost, the lower your out-of-pocket cost will be when you receive care. The deductible is the amount you pay before your insurance coverage starts. The higher your deductible, the lower your premium will likely be. The out-of-pocket maximum is just what it sounds like. That’s the most you’ll have to pay in a year for covered services. Once you reach that amount, your insurance plan will cover the expenses. You can also ask about discounts and ways to save. Many insurance companies and agents understand that medical coverage can be a financial burden. They may be able to offer you rebates or discounts for maintaining a healthy lifestyle. Texas Health Insurance Plans The Health Maintenance Organization (HMO) is an insurance plan that typically requires you to choose a primary care physician. Then they’ll give you referrals to see a specialist. These plans will have lower premiums and out-of-pocket costs; however, there are limited provider networks. Preferred Provider Organization (PPO) plans offer more flexibility in choosing healthcare providers and specialists without required referrals. The downside is that these plans often have higher premiums and deductibles. The Health Savings Account (HSA) is an account that allows you to save money specifically for medical expenses. They are designed to work with high-deductible health plans. There are a number of tax benefits and it is a great tool for saving for the future. Utilize Online Resources When searching for the best health insurance in Texas, be sure to check online resources. Reviews and testimonies can be very helpful. A company’s website can also provide you with a lot of information, such as comparison tools that will let you see the different plans and prices. This will allow you to put in your budget and medical requirements and help you find the best available plans. They will also have information on their websites regarding their coverage, benefits, and costs. Professional Advice Consider seeking advice from insurance brokers or agents who specialize in health insurance. They can help you navigate the complexities of insurance terminology and policies. You’ll be able to share your budget and medical needs and they’ll help you find coverage that is affordable. Annual Review and Flexibility Even the best insurance plan is going to need to change over time. You may change jobs, get married, get divorced, or have children. Any of these changes could affect your insurance. Every year, take the time to review your insurance coverage. You’ll need to ask yourself if your health needs have changed or if your budget differs from the year before. Open enrollment is typically the best time to make changes, so be sure to set yourself a reminder. Read the Fine Print It may take some time, but it’s important that you read through the fine print. Health insurance policies are lengthy and include a lot of information. Reading through it will tell you exactly what you’re getting out of your insurance and what your coverage is. It’ll also ensure you don’t get blindsided in the future by hidden costs and fees. Best Health Insurance in Texas If finding a budget was only based on price, it wouldn’t be as challenging; however, there are many factors to consider, your health being the most important. Getting the best health insurance in Texas involves a careful balance between your health needs and budget. Take your time learning about the different payment options and plans available. Health insurance in Texas is an investment, but it’s worth it. Our team has decades of experience and we’re here to answer any questions you may have regarding the Best Health Insurance in Texas. Contact us here for a free quote!
Is Texas Group Health Insurance Right for Married Couples?
Texas has a married population of around 49%. They say no marriage is the same, but married couples share some commonalities, including the importance of maintaining mental and physical well-being. Health insurance for couples plays a vital role in maintaining well-being in the US, so what are the best options in Texas? If you are self-employed, you may be surprised that Texas group health insurance is an option for you and your spouse. Read on to learn if group health insurance for couples is right for you. What Is Group Health Insurance? Group health insurance offers coverage for groups of people in companies or organizations. They are employee-sponsored plans, which can be for employees and their dependents. Group health insurance coverage and benefits can vary depending on the state. For example, Texan law defines a small employer as a business with two to fifty employees. Texas Group Health Insurance for Couples So, how does group health insurance relate to you and your spouse? One of the most common reasons that couples have group health insurance in Texas is because they are one or both are self-employed. If you have a business with non-family members, too, you may offer the same group health insurance to all employees. Group health insurance varies from a family insurance plan. Group health insurance options for couples usually are: Health Maintenance Organization (HMO) Preferred Provider Organization (PPO) A PPO offers a network of providers, including hospitals and doctors, as your health plan. Usually, there are lower costs to use providers from the network, with an additional charge for providers not in the network. Fees and premiums depend on the insurance provider. An HMO focuses on preventative care and maintaining well-being. Usually, they have lower premiums but less flexibility for using providers outside of the network without a referral. The networks can be more limited, and you typically must pick a primary care physician. Benefits of Group Health Insurance for Couples Without health insurance, you are at severe financial risk. Coverage improves access to care, but you also need to take the time to find the right insurance. There are several reasons why you should consider group health insurance for couples. Cost-Effective Premiums tend to be lower with health insurance for couples, as risk is shared, and insurers can help mitigate potential risk areas. You can also save money through the group health insurance policy you choose, such as an HMO. This is because insurers can liaise and make contracts with providers, so costs can be managed. There may also be tax advantages, depending on the coverage and policy. Consult with your insurance broker to determine whether you will receive this benefit. Different Options You may have a choice of the type of group insurance plan for you and your spouse. Choose between plans such as HMO and PPO, along with considering additional options to cover vision, pharmaceutical, dental, and other coverage needs. More Control Nobody wants to think about unexpected medical costs during a health emergency. Focus on recovery with a comprehensive group insurance plan that helps prevent unexpected expenses. Have a primary care physician to give you referrals when you need to see a specialist. Healthier Together Group health insurance can help you and your spouse stay healthy together. Nothing is worse than seeing your partner go through a health difficulty, but having the right insurance will help ensure they get the support they need as soon as possible. You can share a plan where you both understand the policy and the steps to take if any issues arise. One in five Texas residents has chronic diseases, with over 21% of all Texans having one or more. These include asthma, diabetes, and cardiovascular disease. A group health insurance plan can help provide the tools to prevent and manage different health issues. Cons of Texas Group Health Insurance It is essential to weigh up the pros and cons of different health insurance options. Texas group health insurance is not for all couples. Here are some of the main cons of this type of health insurance for couples. The Cost Texas group health insurance comes with costs, which may not be cost-effective for all. Different options are available to suit different budgets, but coverage and flexibility will also vary. It may be more beneficial to get an individual plan. Flexibility Not all group health insurance plans offer the flexibility a couple desires for their healthcare. There are also limitations to what couples are eligible for Texas group health insurance. It is best to consult with an insurance provider for your personal case. Tips for Finding the Best Health Insurance Finding the right insurance for you and your partner will provide a range of long-term benefits. Sharing a health insurance plan, such as group insurance, benefits married couples for various reasons. However, not all plans offer the same coverage and benefits, so here are some tips to help your search: Discuss your health insurance goals with your partner Make a list of questions for the health insurance provider Check the insurance provider’s reputation and credentials Ask how many providers they work with Compare plan costs It is important to communicate with your partner from the beginning of your health insurance search so you are both on the same page. It is vital to work with a reputable and accredited insurance provider who works with various providers. Ask for a written quote and compare costs to determine if group insurance is your most cost-effective choice. The Best Texas Group Health Insurance Texas group health insurance offers benefits from employers, employees, and married couples. If you’re looking at group health insurance for married couples, it is time to speak to a professional health insurance provider. You want to pick the best option for you and your spouse, so have a professional look over your case. Custom Health Plans is a full-service Texas health insurance provider committed to providing health insurance solutions for couples, families, the self-employed, individuals, and businesses. Request a free quote to get started.
Common Health Insurance Mistakes to Avoid During Open Enrollment
Open enrollment for 2021 Texas health insurance ends on December 15th. Before then, you’ll want to have secured an excellent health insurance plan that covers all your current and potential medical needs. While selecting a comprehensive Texas health insurance plan is a wise decision, not every choice made during open enrollment is the right one for you. People often make mistakes while trying to get insurance and it always costs them in the end. Making one of these common mistakes could result in a costly 2021 that doesn’t even have you completely covered. Here are the top health insurance enrollment mistakes to avoid this open enrollment season. Entering a Plan Without Knowledge of Health Insurance Terms No, you don’t have to search for insurance with the knowledge of a local Texas health insurance agent, but since there is no cost to use a Broker and they know the landscape like the back of their hand, why not use a Broker to help you navigate this maze. Plus, it’s helpful to understand some of the most important terms of the industry. Once you understand some of the basic terms of the trade, it becomes clear what you’re about to pay for and if it’s truly a health plan that you can afford or will work for you. There are several government resources that cover terms like: Premiums Copayments Deductibles Out-of-Pocket Maximum. We suggest doing research before making a decision in order to ensure that the choice you make is an informed one. Jumping into a Plan for Low Premiums Alone Low premiums look excellent on paper, but until you understand what it means for your health coverage, they are terms to generally avoid. The monthly payments you pay to your health insurer are only a fraction of what your entire coverage would cost should medical attention be required. With lower premiums and no research behind your selection, you could end up paying larger copays or even worse, exorbitant deductibles. Completely Missing Your Chances of Enrollment Simply waiting until the last minute or missing the open enrollment window altogether means that your healthcare could be in jeopardy. Not only are affordable Texas health insurance plans closed off to you, but in the case that something does go wrong with your health, unless you apply for short-term health insurance in Texas, you’re going to be paying out-of-pocket for all of your medical expenses. Not Working with a Qualified Insurance Broker Your health is something that should always take priority, and that starts with selecting an appropriate health insurance plan. Unfortunately, healthcare is a tough road to navigate. A professional insurance broker can help you overcome all the hurdles involved with finding an affordable healthcare plan in texas . At Custom Health Plans, we take your pre-existing conditions, age, and more into account when we hunt down opportunities that are the best option for your health. Secure Affordable Health Insurance Today, With Custom Health Plans, Inc! If you know that you need health insurance but aren’t sure where to start or what exactly you need, Custom Health Plans, Inc. can help. We are a team of experienced Texas health insurance brokers who can guide you towards the right coverage at the right price. Don’t miss out on open enrollment this year! Contact us today to schedule an appointment with an agent.
Things to Consider When Buying Family or Individual Health Insurance in Texas
Having health insurance comes with great advantages , such as financial protection in the event of medical emergencies or catastrophic event’s like a Heart attack or a bad diagnosis. If you’re ready to take the leap into getting family or individual health insurance in Texas, there are some things you need to consider before simply picking the cheapest plan. Keep reading to learn more about what you need to think about before getting health insurance for yourself or your family. Considerations for Family Health Insurance in Texas First, let’s look at some of the things you need to know about before getting insurance for your family. Out-of-Pocket Costs The most important thing to consider is how much your deductible is. A higher deductible will typically mean paying less on your monthly fees but it also means you’ll be paying more out-of-pocket when something does happen. Once your deductible is reached, your medical costs will then be primarily covered by your insurance company though you may continue to pay part of the fees. Family Versus Individual Deductibles Family insurance plans often have both individual and family deductibles. Pay attention to these as well. If one member of the family reaches their individual deductible, their medical bills are covered for the rest of that year. If any members of the family collectively reach the family deductible, all members will be covered from that point. This works well if you have one family member who frequently needs medical care because they’ll quickly reach their deductible and may even reach the family deductible so everybody can save on healthcare. With each plan you look at, be sure to check these deductibles to ensure they’re going to work for your family. Plan Flexibility and Family Planning For those who are planning on adding a member to the family soon, you’ll want to make sure your plan offers flexibility in this. You’ll also want to check on what family planning, pregnancy, and birth options are available to you. Although it seems like a lot to think about now, it could help you have the best possible outcome in the future. Considerations for Individual Health Insurance in Texas The good news for individuals looking for health insurance is that there are fewer things you need to think about while shopping around. However, there are still a couple of things to consider. Your Health If you’re young, healthy, and can’t remember the last time you visited the doctor, there’s a good chance you can get away with health insurance that has a high deductible and a low monthly payment. This can help you save money as long as you’re able to continue to avoid needing medical care. However, if you do find yourself visiting the doctor or emergency rooms more often than the average person, you may need to choose a plan with a lower deductible and a higher monthly fee. When you quickly reach your deductible, you’ll save money when your insurance plan kicks in and starts covering most of your costs for you. Your Piggy Bank The other option to consider is a High Deductible Health Plan or HDHP . This is a great option if you are looking for a plan with a low monthly cost and a high deductible. With money set aside for medical emergencies, it’s safer to take this type of plan. However, if your savings account is looking a little bare, you may want to reconsider finding a plan with a lower deductible. Keep in mind that these funds will also need to cover basic living expenses if you find yourself without work thanks to a medical condition. Tips for Anyone Searching for Health Insurance The following tips will work for anyone who’s shopping for health insurance whether you’re doing it for yourself or your entire family. Shop Around The most important thing you can do is shop around and carefully consider what each health insurance company will actually cost you throughout the year. Figure out about how often many medical needs you or your family will have during the upcoming year. Then, use those numbers to determine what each plan will cost. An even easier way to do this is to talk with one of our brokers and let them know what you need. Stay Healthy It may seem obvious, but staying healthy is one of the best ways you can save on health insurance. After all, if you’re in good health, you won’t need to use it. Take steps as an individual or as a family to live a healthier life. Eat more whole foods, get more exercise, and look at your family’s medical history to know what conditions you should work to prevent. Join a Club There are many clubs and associations that can help you save money on health insurance. Look into your local farm bureau to see if the health insurance savings are worth the annual fee. And you don’t even need to be a farmer to join! Open an HSA A Health Savings Account is a great way to take out a high deductible plan without worrying about how you’re going to pay if you need to use it. This account has certain restrictions, so you’ll first have to check that you qualify. However, it also comes with a number of advantages so it’s worth checking out if you want to save money on health insurance As well as Tax Benefits and deductions. Negotiate with Extras Most insurance companies cover a wide variety of services and many include extra incentives. Like negotiated or contracted rates the Insurance company has with the provider. These discounts can be up to 55% of your out of pocket expenses before you meet your deductible. So make sure you ask the provider if the cost included the negotiated rate from the Insurance company. However, if you’re not planning on using an acupuncturist or a weight loss program, you may be able to negotiate a lower price for your plan
