So instead of wasting your time with the banalities of my failures (12 so far and counting) any more I decided to instead try to make your own person journeys into this system as simple, straight forward and informed as possible by passing on some excellent information put together by my friends over at NPR (National Public Radio).
My blog yesterday covered some simple and common FAQ's regarding the logistics of the healthcare marketplace websites if you want to go back and check it out.
Today, I hope to give you a little insight into the "hidden" costs and pitfalls that are present in the process of trying to get the best coverage from your healthcare marketplace.
This information is adaptable to not only the Obamacare plan but even to corporate and personal plans if you have the option of using those avenues as well to obtain your 2014 health care insurance.
Most of today's blog is based on an insightful article that I found on the NPR website written by Magaly Olivero for the US News and World report in August of this year.
Obviously, I have added my own "insightfulness" and "opinions" and "temporal humor" as well because I just don't know how to act otherwise.
In theory and if it was working properly, the Affordable Care Act promised to expand access to health care by providing affordable coverage to millions of Americans.
But finding a policy that meets your health care needs and your budget requirements can be daunting.
With the "worst" of the start up problems hopefully behind us there should be good news: Shopping for health insurance (this is a link if you want to left click on it for more information) is about to get easier.
First, when functioning as designed, the new state-based health insurance marketplaces created by the Affordable Care Act will provide consumers with a "one-stop shopping experience to easily compare the costs and benefits of plans.
These marketplaces will offer "easy to obtain" tax credits and subsidies to people with low and moderate incomes.
"When comparing plans, think about the health care services you use or anticipate using and the financial ramifications of not having access to the services and providers you want," said Kevin Lucia, senior research fellow at Georgetown University's Center on Health Insurance Reforms.
Among the factors to keep in mind when shopping for an affordable plan:
1. Consider "cost sharing" expenses
Many consumers focus on premiums, but out-of-pocket expenses (also know as "cost sharing") can turn what at first appears to be an affordable plan into a financial burden.
While cost sharing charges vary from plan to plan, the Affordable Care Act caps out-of-pocket costs at $6,350 for individuals and $12,700 for a family in 2014. (Out-of-pocket maximums for some employer-based health insurance plans won't start until 2015.)
Determining your potential out-of-pocket expenses can be tricky because "the language of cost sharing - deductible, co-payment, coinsurance - can be confusing. but taking the time to calculate these costs is worthwhile.
The deductible is the sum you must pay up front for health care services before your policy's coverage even kicks in.
For example, a $1,000 deductible means you'll need to spend $1,000 before the plan starts paying for covered services.
You are entitled to preventive care – such as annual checkups, immunizations, mammograms, colonoscopy and blood pressure screenings - at no additional cost whether or not you have met the deductible .
Ellen Pryga, director of policy at the American Hospital Association, advises consumers to consider their money management style when deciding between a plan that has a low premium (but high deductible) or a slightly higher premium (but lower deductible).
"Some people have no trouble establishing a savings account to cover the deductible.
For other people, savings is more difficult.
They may be better off paying the slightly higher premium so they aren't tempted to touch that savings account for other reasons."
The co-payment is the flat fee ($20, for example) you pay each time you access care, such as visiting the doctor.
These little things can add up depending on how you use services.
For instance, co-payments can multiply quickly if you take several medications prescribed by various specialists who all require a visit to the doctor's office to renew a prescription.
Coinsurance refers to the percentage of the cost of a covered health care service that you must pay.
Let's say your plan comes with a 20 percent coinsurance.
An office visit that costs $100 leaves you with a 20 percent coinsurance payment of $20.
These costs can add up quickly, too, when you consider that 20 percent of an emergency department visit or a lengthy hospital stay can lead to thousands of dollars in coinsurance payments .
For example, the average cost for non-complicated pregnancy and newborn care can total more than $32,000.
Avoid the temptation to automatically select the policy with the lowest premium because you may pay more for your health care in the long run.
Premiums refer to the annual cost of an insurance plan (usually paid in monthly installments), regardless of whether you access health care services.
Plans with low premiums usually have high out-of-pocket expenses to cover deductibles, co-payments and coinsurance, so you may be saddled with bills you weren't expecting.
People over the age of 50 and some people with limited incomes can purchase catastrophic health plans that cover worst case scenarios.
While these plans generally have lower premiums than comprehensive plans, they come with very high deductibles and out-of-pocket costs so you'll need to be prepared to handle these expenses.
Make sure the plan covers the medical care you need, especially if you have a chronic illness (like diabetes, asthma, multiple sclerosis, arthritis) that requires ongoing care.
If you buy coverage just because it's cheap and it doesn't offer the services you need, then you have thrown your premium dollars down the drain.
The same holds true for prescription drugs.
Insures must cover at least one drug in every category and class of medications.
But your particular medication might not be on the list, leaving you with higher out-of-pocket expenses.
Look at the cost of your medications across various plans to determine which are reimbursed at a higher rate.
Find out if the plan's network of doctors and hospitals include your primary care physicians and specialists or you might get stuck with the bill.
Going outside your plan's network of providers can lead to a hidden cost known as "balanced billing.
Non-network providers will bill for charges that exceed the amount that your plan reimburses for a covered service.
Some plans also require a referral to see a specialist and insurer authorization before undergoing an expensive procedure.
This is always good advice and especially because even though the Affordable Care Act sets a minimum standard of care, known as essential health benefits, for 10 categories, insurers have leeway in the type and number of services offered in each category.
For example, insurers must cover mental health services, but plans will vary on the number of therapy visits allowed per year.
Don't fool yourselves, there are going to be numerous exclusions added into the new policies.
If you're still feeling overwhelmed about shopping for health insurance, take heart.
The government planners did try to set up some rudimentary resources to accommodate your concerns.
Help (although I use that term lightly right now) is available online at HealthCare.gov (or CuidadoDeSalud.gov for Spanish-speaking consumers) or by phone at 800-318-2596 round-the-clock.
If you have a sleeping disorder, give them a call at 2 in the morning.
You may get some answers to your questions while at the same time found a cheap way to make your self tired enough to go back to sleep.
The Affordable Care Act also set up a system of "Navigators" who are being trained and will be available on a one-to-one basis to educate consumers about their health insurance options and walk them through the enrollment process.
Right now your best support system for your questions is to become familiar with the following sites in no particular order and send your questions directly to their correspondents and bloggers:
www.ahrq.gov - The Agency for Healthcare Research and Quality
www.aoa.gov - The Administration on Aging
www.health.usnews.com - The US News and World Report Health Section
www.npr.org/sections/health-care/ - National Public Radio
Or, I would love to have you send your questions directly to me in my comments section and I will find out an answer for you.
Thanks for joining me......................................................