CORPUS CHRISTI, Texas — Let's talk about health insurance, especially taking into account the effects of the COVID-19 pandemic.
A local health insurance agency manager tells us the average cost of a hospital stay due to COVID-19 is $50,000.
Only about half of local businesses offer private health insurance to their employees, so what other choices for health insurance do you have?
These are the 10 Essential Benefits of healthcare. Coverage you must be guaranteed with any plan, and your choices for health insurance are the Affordable Care Act, also known as Obamacare or the Marketplace; or insurance provided by your employer.
Ten Essential Benefits of Healthcare
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1. Ambulance
2. Emergency Room
3. Hospital Stay
4. Maternity
5. Mental Health
6. Prescription Drugs
7. Rehab
8. Lab Services
9. Preventative Services
10. Pediatric
Will Heavin is a local insurance manager who says "if the employer is offering a plan, then the employee cannot buy an Affordable Care Act plan and get a subsidy."
In other words, you can't double dip.
And what's the subsidy he's talking about? It's the difference between the cost of the ACA plan you choose, and what the government will pay.
One difference between the plans, Obamacare and employer-provided coverage, comes when choosing a doctor. On the employer plan, you can often choose from a vast network of doctors.
"Whereas a plan in the Marketplace," Heavin points out, "only uses an HMO. Much smaller network and they have to choose a primary care physician."
Heavin reminds us that Open Enrollment for either plan is just two months away; November 1 through December 15, and it won't be available again until next year.
"That can be overwhelming because they know that they only have six weeks to look at the plans, recalculate their subsidy, and enroll with an effective date of January 1st," Heavin told us.
It can also be overwhelming because you have 51 different coverage plans to choose from before making a choice, and that could be a big reason so many people just aren't willing to take the time to make an informed decision.
"If I go look online at healthcare.gov and there's 51 different options, literally, how do I know which plan to pick for my family. So they just give up."
Throughout the month of September, Andy Liscano will be talking with local experts about the many insurance choices you have, and offering suggestions to help you make an informed decision. All to help you protect your money.
