The HILI Team on Health Insurance for Farmers and Small Business Owners / HealthChoice

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so hello my name is Jesse Kellerman I'm with University of Maryland extension and I'm gonna be joined by two of my colleagues and we're gonna be presenting today on health insurance options for farmers and small business owners and as I mentioned my name is Jessica Thurman I'm with the University of Maryland extension my family and consumer science educator in the western part of Maryland and I'll turn it over to my colleague

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Dorothy who can introduce herself and then Maria either I am with the University of Maryland and maybe those who are with us if you don't mind putting if you're from Maryland puts your county in the chat box or if you're from somewhere else in the some other state but that but I am in Maryland and I serve Howard Frederick in Montgomery County and I'm Maria pepitas and I work

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for the University of Delaware Cooperative Extension I am a County educator and County director and my focus is on financial management so thanks for coming Thank You Dorothy and Maria and so we're gonna start off with what our plan is and our plan for today is to know the important insurance terms related to small businesses and farmers

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we want to understand what you need to know about healthcare costs identify items to consider when selecting insurance and to know where to go for information about insurance options and that's our plan for today so to begin our session let's get to know one another I think Dorothy kind of started with these questions but if you could first put in the room you know with what

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county you're in and what state from just to give us an idea of where participants are from I see we have Prince George's County represented Baltimore City Silver Spring which is in Montgomery County we've got a representative from Georgia welcome welcome and then the second question that we want to get a sense of is essentially what are you representing today so are you a farmer and you're trying to gather

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information as a farmer or you're a small business owner and trying to gain information from that perspective or maybe you're someone that similar to us it's an extension or doing educational programs or consulting with with either farmers or small business so if you could kind of give us that whether you're a farmer a small business owner or just a participant in one of those other categories we would appreciate that and you can just put that in the chat box

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so we have an Extension educator someone thinking about starting a small business in the near future very good and someone that's a small business and startup good good and so others continue to type and I'm just gonna keep us moving forward because we do have a lot of content to cover today so we framed our program

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today is in terms of what questions does someone need to answer and so what we're gonna look at it from is why and when you look at why why do I need to plan for health insurance the what and we'll so what are my health insurance options what resources provide that information the how which is how do I choose a plan and if we can get those questions answered you're gonna be able to make a smart choice around health insurance

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and so first we're gonna start off with with why do I need to plan for health insurance in and I'm going to share with you a couple reasons that we came up with in terms of why you need to plan and our first one is we want to ensure that you have the coverage that you need to keep well so it you know one of the things with insurance is insurance can help us keep state keep and stay healthy and so knowing that you have the right coverage and the right plan you can you

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can keep keep healthy the other is to gain the most benefit from your insurance coverage so if you know what your insurance covers and you're using that insurance again it's going to go back to that first point you're gonna be able to keep healthy and well and again it's a service that you're paying for so you're gonna get the most benefit by knowing what your insurance does cover and does provide and then you know insurance does protects us financially from an unexpected health issue you know

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unexpected things do happen whether it's an act an accident or a chronic disease issue but you know having insurance does protect you financially from an unexpected health issue and then the other reason you need to plan for health care is you need to know what types of insurance options are available for individual situations so everybody situation is going to be a little different and you need to make sure that your your insurance meets your

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particular situation and so the next question we kind of want to look at is is the what instead of what are your health insurance options and what resources provide information about what your health insurance options are so there are some factors that you need to consider and so some factors that contribute to which health insurance plan you choose one is going to be the state in which you live so each state

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have regulations that apply to the the health insurance that's offered in that particular state so you need to kind of know what your state is and what the requirements are that state what the available health insurance policies and plans are your income and age is limits and those are going to be factors that that influence the insurance plan you choose you know depending upon whether you're looking at it from a family perspective or from a business perspective how many family members you

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have or how many employees you have will be a factor and then how you have your if it's a business how do you have that business set up is it set up as a sole proprietorship now I'll see or an S corp those are all things that you have to consider when you're choosing your health insurance claim and depending upon your situation you may need to consider multiple streams of insurance coverage to ensure the lowest price and the best coverage so now I'm gonna open

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up a poll and the poll is going to have these four options to choose from so we're going to kind of give you a definition and then you're gonna choose either Children's Health Insurance Program Medicare Medicaid or marketplace I mean move over here to polling feature and the poll should screen and you should

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have when your screen for questions you know you might see one or two but you can scroll down and answer those questions and the first question is which one is a federal health insurance program for people 65 and older and certainly younger people with disabilities so your your options are the Children's Health Insurance Program also known as chip Medicare Medicaid

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marketplace that's question one go ahead and put your answers in there with question one I'll keep talking through them as people are answering questions question two insurance program that provides free or low-cost health insurance coverage to some low-income people families and children pregnant women elderly and people with disabilities that's question two again

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the same answers are your options question three an insurance program that provides low-cost health insurance coverage to children and families that are too much to qualify for Medicaid but not enough for private insurance and question for a service that helps people shop for and enroll in affordable health insurance the federal government operates the marketplace in some states around their own marketplace and Maryland is one of those states that

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operates its own marketplace so like we have majority of answers and [Music] share the results and everybody should be able to see the results now and everyone has the correct answers there a federal health insurance program for people 65 and older in certain younger people with disabilities that's Medicare in an insurance program that provides free and low-cost health insurance

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coverage to some low-income people families and children pregnant women the elderly and people with disabilities that is Medicaid the insurance program that provides low-cost health coverage to children and families that aren't too much to qualify for Medicaid but not enough for private insurance that is the Children's Health Insurance Program also known as chip and a service that helps people shop for and enroll in affordable health insurance the federal government

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operates the marketplace some states around their own and everyone got that right that is the marketplace so we're gonna go into detail about these programs as we move forward here and so these are the options there's eight of them that we're going to be talking about today we're gonna talk about all farm employer-based health insurance and Association membership programs health

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insurance marketplace health insurance provider company skinny and short term plans also known as get plans those that are available to the militant military so Armed Forces health insurance Medicaid and Children's Health Insurance Program and Christian health care plans and health care sharing ministries and Medicare so we're gonna we're gonna share these with you we're not here to tell you what is your best option you're

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gonna have to kind of you know review each of those options but we're gonna provide you with an overview of those programs and I'm gonna be turn it over to Maria who's gonna lead that discussion so take it away Maria and we're gonna switch our presenter here so you might be a short break as we switch the PowerPoint around so Thank You Jessi

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we're gonna start off with off-farm employer-based health insurance and/or kind of relying on your spouse's health insurance right so this is the idea that you as a small business owner may be able to be incorporated or covered by your spouse's employer based health insurance and so an employer-based health insurance plan is going to offer

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group policy plans through that place of employment and oftentimes because of that they that employer can negotiate especially larger employers negotiate fairly decent costing health insurance plans and/or coverage again depending on the size of the employer and will often then offset the cost for the employee and oftentimes the spouse or other

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family members and so you know one of the benefits truly is that you're covered by health and car insurance and that if this is an option there it's usually less expensive than other alternatives and for some employers they're actually offering a couple of different options to choose from or plans to choose from so you know if this is something that you're thinking about you want to talk with the plan manager or maybe the HR director to really see

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if you would be covered by your spouse's employees sorry employers health insurance and to to you know do some comparison shopping right some employer based plans have kind of high deductibles but they also have the ability to do flexible spending accounts or other kind of pre-tax dollars set aside to cover some of those higher cost

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items and/or out-of-pocket costs so again it's sort of this idea of exploring that as an option because for some it may be the cheapest way to go I think the other piece though it is to think about you know assessing what are those healthcare needs that you have so there's a cost question and there's a you know what are the health care needs piece and see whether or not you'd be covered some employers allow spouses to

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be covered or family members to be covered other others don't so that's the first place to explore the other is Association membership and so it may be for example the Chamber of Commerce or Farm Bureau some of times those associations as a member of those associations they offer a health insurance plan again it is about comparison shopping the difference

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between being covered by an employer based plan an employer may actually offer to cover some of the cost of the premium where you're not going to find that in an association membership situation in the Association membership situation the idea there is let's pool the members and then kind of make because we have X number of members hopefully a large number of them then let's connect with a broker or a health

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insurance provider and see if we can negotiate cheaper rates so it's that idea of by combining membership numbers we try to kind of provide a plan that has a lower cost so that's how those two options may work so where do you find out some resources about those options it would certainly be in the employer based situation you're going to want to talk to the

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Human Resources representative or the health insurance provider to kind of get a sense of what might be covered in terms of of covering healthcare needs but then also in terms of the cost that human your resource is representative it was the person to connect with they're on the side of the Association membership that would be the health insurance plan agent or the broker for that member organization right so whether it's you know far for Farm

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Bureau for example it's nationwide who offers their insurance for other for other associations it may be a different health insurance provider so connecting with them may also be another tool you can use to figure out costs and coverage the next one I want to talk about is the health insurance marketplace and this is the the health insurance options that

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was created under the Affordable Care Act back in 2010 that created a health insurance marketplace and plans and they are typically negotiated by the State Insurance Commission or Commission's office and as Jesse pointed out earlier in Maryland there the the state kind of runs that plan for the state of Maryland in Delaware we're actually a partnership program so

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that we partner with federal government to offer plans that are approved through our state and health insurance commissioners office so how many choices you have is oftentimes divided determined by the state and by choices I mean how many companies maybe offering plans and then how many plans are actually offered by each of those companies it's really easy to enroll you would go to healthcare.gov

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and choose your state and it will then bring you to the state look the state website so in Maryland it's called the Maryland Health connection you could also Google that write Maryland Health connection in Delaware it's choose health Delaware and each state has got their own website or kind of resource and information about what's available locally but if you go to healthcare.gov that's the federal website and it needs

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to be healthcare.gov not calm right healthcare.gov and choose the state you'll be able to get to your local your local marketplace and again the idea behind the marketplace was let's try to pool all these independent consumers and pull them together so that we can negotiate better rates with those health insurance companies so one of the benefits big benefits for the health

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insurance marketplace is there are tax credits and tax subsidies that are provided for people who are making less than 400% of the poverty level and so those costs really help those subsidies and credits offset the premiums and it can really bring the premium down for for families and individuals and so there's an opportunity can comparison shop for the most part most states have

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one or two health insurance providers at least offering plans and you can find plans for just yourself or for your family members and one of the other pieces another benefit is that most states have what they call navigators or sisters who are there to help you figure it all out they can't make the sitting for you but they can help you kind of go through the process of enrollment and and and filling out forms

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and things like that to kind of get you moving to get towards a choice so often times you know they're kind of the downside right is these considerations and one of the things that we know is there are typically fewer plan options and typically fewer health insurance providers offered through that health insurance marketplace so if you went to

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a broker or agent they may be able to say hey there's ten health insurance companies a licensed in our state they provide you health insurance but these two are the only ones on the marketplace in order to get those tax credits and subsidies you have to choose a plan that is offered through the marketplace you can't go to a broker and say I'm making less than 400% of the poverty level and

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I would like those subsidies and choose a plan that isn't offered on the marketplace so there are some trade-offs one of the things though that there there are some brokers and dealers who have been certified to also be able to sell the plans that are offered in the marketplace and you can find out the names or the the companies that those people work for through that marketplace

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website and Jesse has put the healthcare.gov website in the track Thank You Jesse so one of the other cool things that is on the healthcare.gov website certainly the resources for enrollment there's some really great explanations of how it sort of works but they also have what's called a subsidy calculator and so remember I mentioned that 400% of the

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poverty level or less so there is a little calculator where you can put in your number of family members and your income and it will kind of crunch the numbers for you to let you know how much of a subsidy you may be able to be eligible for and that's really important because if you just go to choose health Delaware or the Maryland Health connection and ask to look at their plans you're not going to you're going

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to see the plans and the information about the plans but they'll also see the cost of that plan without a subsidy and so you kind of have to do both in order to get an accurate number for how much that plan will actually cost you so now I'm going to switch gears here and talk a little bit about Medicaid and the Children's Health Insurance Program

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so Medicaid is a is a health insurance program for low-income families and it's based on income and based on family size and sometimes there's some other eligibility guidelines Medicaid is for non long-term care needs I'm sorry Medicaid is for non long-term care needs they also have a Medicaid long-term care program and often people kind of mix up

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because it's labeled you know they're both using the word Medicaid so when when you're applying for needing health insurance for your family for yourself for your family and you have limited income you may be eligible then for Medicaid that covers general health insurance needs there are other programs like the long-term care Medicaid program for when you are in

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need of continuous nursing home or assisted living care and that has different eligibility requirements that doesn't include the value of assets as one of the criteria so that's Medicaid chip is for just kind of covering children under the age of 18 so say for example you you work for an employer that provides only health insurance

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coverage coverage for you but you have children you could get chip health insurance for your children right in order to help get them covered and it typically covers medical and dental care costs of children and in some states it also provides coverage for people who are pregnant meaning they don't have children yet but they're about to write and income and family size eligibility

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can be different depending on the Medicaid program at program eligibility so in other words some states go by a hundred percent of the poverty level meaning if you have an income below that hundred percent of the poverty level you would be eligible for chip or Medicaid other states have done what is called expanded Medicaid or the chip and so they might say well if you have income

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at a hundred and thirty eight percent of the poverty level or below you are eligible for Medicaid or children's help the children's health insurance program so that's one of the reasons why we said at the very beginning where you of what state you're from may determine which programs you would be eligible for so the Medicaid and CHIP information can be found at also at the healthcare.gov

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website or you can call your local healthcare navigator or Department of Social Services in Delaware you can schedule an appointment with one of those navigators and they could help you kind of determine what you might be eligible for I know in both Maryland and Delaware if you go on to the healthcare.gov website and move towards

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your own state's marketplace the marketplace application is linked to your eligibility for Medicaid and tip so for example if I go to the marketplace and I put in my information and my income suggests that I am under a hundred and thirty eight percent of the poverty level it will automatically point me to who to connect with and

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begin the application process for Medicaid and or chip and so it's a seamless process then for both of those programs as it relates to also the marketplace and that can be kind of confusing but that's how how it works so oftentimes we get questions like what

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does that really mean in terms of income level right if I'm thinking about my own household where you know what are those income thresholds that may provide me some cost savings cost-sharing premium subsidies and/or eligibility for Medicaid and this is a chart that I pulled from the Delaware a Delaware situation Delaware website that helps

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articulate that a little bit and the way we would read this right is you would look at the number of people in your household and read down the column so in this case for example if I have three people in my household and I make between twenty one thousand three hundred and thirty dollars and fifty three thousand three hundred and twenty-five dollars I would be eligible

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for some cost sharing assistance when I purchase a premium sorry a plan a health insurance plan through the marketplace if my income is between that twenty one thousand and eighty five thousand I might also be eligible for those premium tax credits if my income is between twenty-one thousand three hundred and thirty and twenty nine thousand four

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hundred and thirty five I would actually be eligible for Medicaid for my family so I hope you can see from that sort of those those income thresholds this changes every year it you know there's sort of like a cost-of-living adjustment that goes along with this every year so you would need to check this every year but especially for start-up businesses where there may not be a lot of income

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in the beginning you may be eligible for Medicaid and and that may really help you how do I say this actually have some income from from your first few years as a business and health insurance coverage right that's the other important so here I wanted to just do a quick example that may be helpful to kind of

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look understand from the marketplace perspective so here we have a family Jim and Lynn they owned a sheep farm they have four children under the age of 18 all are non-smokers together they earn a hundred and six thousand dollars per year they live in Delaware and they are eligible for that advanced premium tax credit based on that subsidy calculator that I mentioned if you go to that

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healthcare.gov subsidy calculator they are living at the three hundred and four percent of the poverty level which is less than that four hundred percent threshold so for six people the premium would be around eight hundred and sixty four dollars the subsidy would be pretty significant of almost two thousand dollars and if it wasn't for the subsidy they may be paying up to twenty eight

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hundred almost twenty nine hundred dollars a month for health insurance the other URL on this page gives us a different calculator this is put forth by the Kaiser Family Foundation and they also provide a really great calculator to kind of help you figure some of this out as another example we have salmon Sally also with four kids under the age

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of eighteen all non-smokers and together they earned forty seven thousand dollars a year based on this they are eligible for Medicaid and CHIP because they are living at a hundred and thirty six percent of the poverty level so again you your income right really can impact your eligibility for some of these health insurance plans and frankly you know for many small business owners I

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know some of my farm families that I work with they are not earning that much and qualify for that Medicaid option so again here are some of the resources to kind of get connected to both Delaware and Maryland marketplace and/or Medicaid

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eligibility and application processes Maria can I just jump in for a second I'm putting some of those and Jessie's putting some of those links in the chat box but we will also send all these links out in a single document after the program's over so you have to click the blankets great thank you I appreciate that so one of the other things that's been interesting in the last ten years as as our health insurance community has

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evolved is that you know we've always had broker dealers out there who are representing health insurance companies and then they can pull from a variety of plans or a variety of companies to try and figure out which might be the best plan for you but more recently health insurance providers the companies themselves are selling directly to to you and to cover you and your family

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members and so some of them are if they are offering a health insurance marketplace plan they may be able to enroll you directly in that plan so it's important though to kind of pay attention to who is allowed to be selling health insurance in your state and so you might want to check the insurance Commission's office and their listing of those resources and so check out that State State Insurance Commission and also the healthcare.gov

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if you've been active or retired member of the Armed Forces you may eligible to use health insurance through the Armed Forces and TRICARE is the big example there and then there may be some services through the Veterans Administration that you would be eligible for and so there are some resources there you can connect with to find out more about that and then Medicare so this is a biggie right Medicare is really for people who are

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over 65 and or if they have some sort of disability and it provides health insurance coverage for what they call hospitalization which is part a doctors and medical services and equipment which is Part B and prescription drugs which is Part D and so when you pay in Social Security and Medicare taxes you contribute to Medicare throughout your working lifetime then you are eligible

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right and then you get the benefit of not paying a premium for Part A but paying a premium for Part B that is fixed and this year it's about a hundred and thirty-five dollars a month which is a bargain right so how much you so how do I want to say this you have to have revenue and your business in order to pay those employment taxes that's that's FICA taxes when you're paying this FICA

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taxes you are paying those Medicare and Social Security taxes when you put in those forty quarters or roughly ten years worth of contribution then you are eligible for getting Medicare at that really reduced rate if you haven't paid into the system you can still get Medicare you just are not you're paying a higher rate right in terms of Medicare you need to sign up within that seven month period around your 65th birthday

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or birth month right so three months before three months after plus the months in which your your turn 65 and you want to do that it's different than Social Security right many of us don't get officially our Social Security benefits or full retirement age is not until 67 but for Medicare doesn't matter it's always 65 and Medicare pays roughly 80 percent of

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the healthcare costs so many people then are purchasing Supplemental or Medigap insurance in order to wrap around the costs that Medicare doesn't pay and then there's these other things that have been around for a while called Medicare Advantage plans and they are Medicare's version of an HMO and it usually provides medical dental and vision coverage it's not available in all areas but when you move to that age 65 that's

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when you'll start looking at those plans and seeing what would be available for you and basically the medicare.gov website is excellent in terms of providing information about medicare if you're employed and you have an employer based plan and that you can keep that employer based plan when you retire that may be the plan that wraps around Medicare when you turn 65 all right I'm

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gonna briefly talk about Christian healthcare plans or healthcare sharing ministries they are not really health insurance they are not an insurance plan but they kind of work like an insurance plan in that you are paying a premium it gets it's it's managed by an independent organization there's usually thousands of members who agree to share the cost of all the members medical bills there's usually a personal deductible typically

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as a member you're paying your out-of-pocket costs or not even that you're paying the full cost and then turning around and applying back to the membership that the health care ministry plan to say can you reimburse me for some of these costs and there's typically an elegy ability melt membership you know you usually have to be a Christian who it's not using tobacco or drugs or alcohol or or you know use prescription drugs and moderation and have a very healthy

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lifestyle so there are kind of costs and benefits to this type of plan in that you know payment is not guaranteed it really depends on the on the group how solvent the group is and also the kinds of things you're trying to get covered in terms of medical expenses I briefly I want to talk about skinny plans and short term plans and basically these

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skinny plans are limited benefit plans they are less expensive than the health insurance marketplace but they don't cover the same kinds of services they don't have to provide what are called the essential benefits and Dorothy is going to talk a little bit more about what those are in a minute they can deny coverage to consumers who have some pre-existing conditions and there's really a limited medical benefit in terms of paying mostly for routine care

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and not paying for catastrophic care and there may be limits on how much get paid gets paid out easier so those are skinny plans the gap plans typically are those that are short term you know are covering a gap so say you have lost your job and you're wanting to have a little bit of coverage before you start your next next place of employment and it's a

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great way to kind of have major medical policy coverage and a short-term safety net and so you really want to look at and connect with those local insurance commissioners to see who is allowed to be selling in the state and the kinds of things that there are selling plans are selling all right so what about if your health insurance options

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for an employer and you want to try and cover employees so here are some of the ways that we can do this and we're gonna do a quick poll actually yeah so health insurance tax credit health reimbursement accounts health savings

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accounts flexible spending accounts are an arrangement through your employer that lets you pay for many out-of-pocket medical expenses with tax-free dollars so which one of these right is an example of an arrangement through your employer that you pay for out-of-pocket medical expenses with tax-free dollars

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this must be a confusing one all right there we go hmm question two is an employer funded group health plan from which employees are reimbursed tax-free for qualified medical expenses up to a fixed amount per year where 3 is a tax credit you can

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use if you qualify to lower your monthly insurance plan when you enroll in a plan through the marketplace right and the last one is a medical savings account available to you if you have a health savings account or qualified high deductible health insurance plan this account allows you to save pre-tax dollars for qualified medical expenses all right let's see how we did so uh huh

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an arrangement through your employer they lets you pay for many out-of-pocket medical expenses with tax-free dollars so the answer to that right his is is the flexible spending account right and it may also be the health savings account so we've got kind of two right answers but most of the time it's a flexible spending account because that's an arrangement through the employer

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right an employer funded group health plan from which employees are reimbursed tax Frant tax-free for qualified medical expenses up to a fixed dollar amount and this is usually the health reimbursement account all right let's see a tax credit you can use if you qualify to lower for your monthly insurance when you enroll a plan through the marketplace and that is that health insurance tax credit and lastly a medical savings account

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available to you if you have a hsa-qualified high deductible health insurance plan and this account allows you to have to save pre-tax dollars for qualified medical and that is the health savings account right great so you did pretty good it's a little confusing there's a lot of terms out there so quickly we'll talk a little bit about the shop and the shop is kind of

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the it's available through the health insurance marketplace it was designed to help employers offer plans to their employees a farm or non-farm business must have 1 to 50 employees in order to be qualified to use the shop and you may be eligible for some tax credits as the employer that can help you offset the cost of providing insurance usually there's one plan one

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or two plans and the state offers that you can then sort of choose and offer that plan to your employees or you can kind of you can offer employees flexibility by letting them choose from multiple plans right so then they would pick the plan that best works for them but it only covers health health care

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costs and although dental is also offered so you could choose how much you want to pay towards your employees premiums and whether to offer coverage their dependents and how long I knew employees must wait before enrolling so there's lots of opportunities to kind of create a plan that works best for you another option is to go to an agent broker and talk with them and they can help you figure out which plan works best for your situation and help you

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shop around between different health insurance company providers and then there's ways to just help cover health care costs so there's this idea of a health reimbursement account and so as an employer than what you might say to your employees is I will put X amount of dollars aside that will help them cover those out-of-pocket health care costs so they have to be there I there are a are

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s rules around this it can only be medical expenses that are allowed by the IRS and so those funds would pay for medical expenses until they're exhausted by the employee so as an employee I would go out and choose my plan as an employer I might help offset some of the costs from that plan so that's one tool the other tool that people have used

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is you know paying people a higher salary right and that and then allowing them to use that money to buy health insurance but the downside is is you don't know whether they're really gonna spend it on health insurance so at this point there's some really great resources in this IRS Publication this can gives you the ins and outs in terms of these options for covering health

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insurance costs by for your employees and and so that would be the the place to go for more information there and now I am going to turn this over to Dorothy who's going to provide some more information alrighty thanks Maria I'm going to take this home um the question is where like I mentioned earlier we will send you a

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and follow up with many of these links that where else can you go for information about your health insurance coverage especially when it concerns you are a particular policy that you already have um and so we have three vers resources now up on the screen um one is the to the left the healthcare.gov website make sure that link and share it again after the program wealth of information they're organized I'm quite well um the other document that you see on the right is your evidence of

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coverage that um if you have traditional health insurance insurance that you either purchase separately or purchase um get through your employer you receive um usually a booklet sometimes it's online um you can request the paper copy if you choose you receive this each year of when you renew your policy and if you get it and you file it or you recycle it definitely keep it it has its the agreement between you and your insurance company and then it has all the information that you need to turn to if

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you have a particular question including um what's covered what's not covered what your deductibles are and what's your coinsurance you what do you do if you have a to speak with your insurance company and and so much more so that's all in that evidence of coverage booklet I'm an exception is that if you have Medicare all of the information is on the website and you do not receive a paper copy or separate evidence of coverage so all of these three are great resources the healthcare.gov if you have your insurance on the marketplace

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um provides good information or you are here evidence of coverage from your individual insurance company so the last question we're going to address is the how how do I choose a health insurance plan on the we'll walk you through a couple of considerations and resources um the first is to review what um is even covered under your health insurance plan so if you purchase health insurance

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on the marketplace or if you receive most plans that are under the Affordable Care Act Robert governed under the Affordable Care Act it your insurance policy has to cover ten what are called essential health benefits they'll list them here make it easier there we go so these are the ten categories of services that are mandated under the Affordable

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Care Act um there on the screen but I'll just I'll read through them so you have them for them starting from the left preventative and wellness services lab tests hospitalization prescription drugs services and devices for injuries disabilities or chronic conditions I'm on the right outpatient care maternity and newborn care mental and behavioral health treatment pediatric care and emergency room services now of course this does not mean these services are free on most of these have some type

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some component of on either deductible or out-of-pocket expense to go with it the exception of certain preventive and wellness services it's important to look at what's covered because Maria mentioned skinny plans it's a term for some what are usually short term plans I'm short term being typically 18 months or fewer that don't necessarily cover all of the essential health benefits often the two that are left off are mental and behavioral health treatment

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or maternity and newborn care but it is important when you're considering what insurance to purchase to look to see what benefits are being covered does it cover all essential all of the ten categories of essential health benefits or are there some that are left out so what resource can you use to to sit down and estimate what your needs are what your uses are how do you plan um we provide a resource um it's a it's a booklet our smart choice smart use health insurance workbook and we'll also

55:31

send this as a PDF when the program is over and it's a great resource to help you walk through some of the decision-making process without leaving out important important details so I'm going to show you that some sample pages from the booklet you can look through it yourself in more detail when it's sent out but for example um there's a section that helps you determine what your health insurance needs are what what doctors do you see how frequently do you go see them and there's a list on the

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left hand column for the people and your family so that it's a good reminder of what services you actually use before deciding what policy you need to cover those services because you want to make sure if they're healthcare providers that that are important to you that you continue your care with them that you choose a policy that will include them so there's a health insurance needs worksheet there's then a plan comparison section where you can look through different plans but obviously you can

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comparison shop between plans that are available to you I mean I do see there's some items in the chat box I'll take a look at that momentarily the last boat that was the own pages in the booklet we have one more page coming up but you can see some sample pages from the booklet including an explanation of terms um the booklet is not necessarily just for farmers or small businesses it's fear toward individuals but of course everyone making the decisions whether

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it's whether you are with a business or your farm owner or you're going you're taking the same approach to determine your health insurance needs so this booklet really is for everyone so let me see it is six o'clock we are about out of time so I think we won't do this last poll here as far as the terms um will quickly cover four

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tips that we've come up with for managing your health insurance costs so you can see them here there's four suggestions for some four strategies one is to review your health insurance documents to understand the plan and its cost their plans can vary significantly in cost especially once you start to use them so looking to see what the deductibles are on the out-of-pocket costs are relative to your use um is is important um you can depending on what plan the

58:09

cheapest plan what them with the cheapest deductible isn't always the best plan the cheapest plan ultimately when it comes to how much you use your insurance and what you use it for them so number one review health insurance documents to understand your plan and its cost um two is to review the co-payments coinsurance and deductibles meant to make sure those fit within your personal financial situation but may be better for one individual to choose a plan with

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higher monthly payments and and have smaller deductibles and advice or vice versa so number three calculate how much to set aside to cover out-of-pocket costs up so you can factor that into your annual spending plan of your budget and lastly shop around for health dental and drug insurance plans each year just like you'd shop around for baby clothes or your grocery shopping for your insurance as well what plan that's that's good at one point in time might not always be the best plan for you moving forward

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you

The HILI Team on Health Insurance for Farmers and Small Business Owners

Table of Contents

More in Lectorium

SMALL BUSINESS

SENIOR PRESCRIPTION COVERAGE

DENTAL COVERAGE

SENIOR VISION COVERAGE