How to shop for a health insurance plan

Hi, everyone. I'm Ben Gonzalez. This is TDI. Well,  this is the time of the year when a lot of us are   looking at our health insurance for the coming  year. So we thought we'd offer some tips about   how to compare plans and shop for insurance.  And joining us is Mistie Hinote from our Public   Affairs office. Hello, Mistie. Hi. Well, the  open enrollment period for ACA plans starts in   November and runs through December 15th. But even  if you're getting your insurance somewhere else,   you need to know how to compare the plan. So what  are some tips...some things to remember, Mistie?   Right. Number one is you want to make sure you  know what you're buying. So, we're all used to   traditional health plans that provide the benefits  and the coverages that we use when we go to the   doctor and get medicine, but there are a lot of  different types of plans. If you're looking at   cost alone, there are a lot of cheaper plans, but  you also want to know what those plans are. Some   of them aren't traditional health coverage, some  of them are discount plans and different types   of plans. So, you just really want to know what  you're buying. So, with all those different kinds  

of choices out there, how do I know I'm getting  the right thing for me or me and my family?   Right. You definitely want to ask  questions of yourself. So, you want to know   your doctors and your medicines. Because when  you're looking at a plan, you want it to be able   to pay for the doctors you see and the medicine  you use. So, when you're looking at the plans,   the agents and companies should be able to  tell you what doctors are in their networks,   if they have a network, or if they don't. You  want to ask that too. So, if you have some medical   conditions and you see a certain specialist or a  certain doctor, you don't want to change plans and   not be able to see those. So, you want to ask  about your doctors. You want to ask about your   medicine. If you have certain medicines that you  take and you really need those medicines still,   of course, you're going to want to ask  if the plan cover those medicines. So,   there's just some questions you need to ask for  yourself and your family. So, you start off by   asking yourself what's important to you and then  you can ask others if that's what's in their plan.   So, I guess one of the big things, of course,  for a lot of us is how much is this going to   cost me? So, on that front, is there...I  guess it depends on what you choose, right?  

Right. Exactly, yeah. There's a wide array of  costs, so when you start shopping around, if you   go to the website or if you get a quote, you're  probably going to see that one premium amount.   And that's probably the first thing  that's going to catch your eye. And   that is important because that's what you're  going to be paying every month for that plan.   But you also need to know that there's other  costs that go into that plan. So, when you go   to the doctor, there's going to be a co-pay.  Probably you want to know what that amount is.   There might be a deductible - that's the amount  you have to pay before your company starts paying,   so that's important. And then there's co-insurance  - that's the amount you have to pay if you get   a procedure, you go to the hospital, you  have to pay a certain amount of your care.   So, you just want to really know, other than a  premium, "What are costs that are coming out of   my pocket?" And then you'll also be able to tell  if you have a low premium, a high deductible,   a high deductible-low premium. Just know that  there's probably some give and take there.   If you see a low premium, look at that deductible.  Because there's a good chance that's going to be   high. And that might be fine for you. If that's  the choice you want to make, to save on premiums   and have a high deductible, you know, talk to your  agent, talk to your company if that's the choice  

you want to make, great. But just be aware of the  cost. Yeah, and I guess ultimately the lowest cost   stuff is probably is going to have cover less,  and there may be some limits to it as well.   So whenever a lot of people are looking for a  product, there's going to be somebody that wants   to try to take advantage of it. So what can we  do to avoid any scams that are out there? Right.   So, one of the biggies is an agent or company  that can't answer your question. If these agents   and companies are selling plans, they should  know inside and out how their plan works - what   it costs, what it covers. And you should be  able to ask that of any agent or company. So,   if they don't know that, that's a big red flag.  You also want to look out if an agent or company   says "limited time offer." You have until December  15th to buy a plan. Don't let anyone rush you.   You should be able to take all the time you need  to decide, to compare, to ask questions. So don't   let anyone rush you. Those are all big warning  signs that maybe you want to try a different   company. There's a lot of companies out there, so  don't feel pressured to use one or another. Those  

might be some signs to start looking elsewhere.  Move on to the next one on your list. Move on   down the road, yeah. You also want to watch out -  if you're looking for an Affordable Care Act plan,   you want to make sure that's one you're getting.  Those ACA plans have benefits that are required   by law. So, if that's the plan you want, great.  But you want to make sure that's the plan you're   paying for. So, watch out if you see plans that  say bronze, gold, silver. Make sure those are   ACA plans. Because a lot of companies might use  that marketing, and it might not be an ACA plan.   And then, finally, you want to watch  out for callers. If you get a call,   and it might come in from a certain company,  you might look at your phone and say, "Oh,   that's the company that I'm, you know, buying  from." But they're also able to spoof phone   numbers. So, even though that's the company  number coming in, that might not be the company   that you want to talk to. So maybe, you know,  pick up the phone and ask the person, you know,   "What's your name?" and then call them back  on the number that you have. So, watch out   for those numbers too. Yeah. You just got to be  careful. You can't even trust caller ID anymore?   Well, that's a lot of stuff to keep track of.  

Yes, it is, it is. But on our website, that's a  good place to start. On our TDI website we have   a great shopping guide. So we try to condense  it to one page, and have some of the major   questions - some of the stuff I went over today  - and more. So just things to keep in your mind,   and to ask your agent or company. So check out  our website for that shopping guide. For sure.   OK, thanks Mistie. And you can find that  shopping guide on our website: tdi.texas.gov You can just put in shopping for health  insurance in our search engine at the top   or you can call us on the helpline: 1-800-252-3439 We've got people there during weekdays, ready to answer questions for you. So for Mistie Hinote, I'm Ben Gonzalez. This is TDI.