Here are some important questions to consider as you are choosing a Marketplace plan. If you have a question that doesn’t appear on this list, contact a BJC Marketplace Counselor at 855.747.4994.
- Which Marketplace plans include my doctor? My hospital?
Every insurance plan has its own network of providers. A network is the group of facilities, providers and suppliers your health insurer has contracted with to provide health care. These providers may also be called “preferred providers” or “participating providers.” Some plans include an option to use out-of-network providers, but you might pay more for their services because of it. Some policies will not pay if you have visited an out-of-network provider for certain services. Be sure to carefully review each plan’s network before you choose.
- What will my out-of-pocket costs be?
Choosing the lowest-premium plan doesn’t always mean spending the least amount of money on health care. You must also consider deductibles, coinsurance, copays and other costs. (See 5 Marketplace Terms You Should Know for more information.) Lower-premium health insurance may not allow you choose your or your family's preferred doctor or hospital. Lower-premium insurance may also have higher out-of-pocket costs, especially for services provided by non-network doctors or at non-network facilities. A BJC Marketplace Counselor can help you determine which plan will cost less overall, based on your unique health care needs.
- How can I make sure I am maximizing my savings?
When you apply for coverage in the Health Insurance Marketplace, you’ll find out if you qualify for a “premium tax credit” that lowers your premium – the amount you pay each month to your insurance plan. The amount of your premium tax credit depends on the estimated household income for 2017 that you put on your Marketplace application.
If I was enrolled in 2018, isn't it easier to use automatic re-enrollment? If you don't update your application and enroll in a plan by December 15, 2018, you may be automatically enrolled in a 2019 plan. Automatic enrollment is a good fallback. But the best way to make sure you have a 2019 plan that works for you is to investigate all your plan options for 2019 by making an appointment with a BJC Marketplace Counselor.
What if I have never enrolled in a Marketplace plan before?
If this is your first time looking for a Marketplace plan, you'll find many resources available to you. The Marketplace website, healthcare.gov, contains helpful tips on preparing to enroll, exploring your options and calculating your possible costs. Free help is also available from the Certified Marketplace Counselors at BJC HealthCare. Call 314.747.4994 or 855.747.4994 to make an appointment.
How can BJC HealthCare help me?
BJC recognizes that great health care can be expensive and we want to help you afford the costs of choosing better medicine. If you’re worried about paying your out-of-pocket costs, BJC may be able to help. When we send you a bill for your care, we’ll include information about our Financial Assistance Policy. You can also read about it, and even apply, through our website.
Free help is available from BJC HealthCare
Call 314.747.4994 or 855.747.4994 from 8 a.m. - 5 p.m. to make an appointment with a Certified Marketplace Counselor.