The three-month open enrollment period for Affordable Care Act insurance started on November 1. Early retirees who are too young for Medicare can now obtain health insurance through their state's health insurance exchange regardless of their pre-existing conditions, and might qualify for federal subsidies to help pay for it. Here's how to navigate the enrollment as efficiently as possible:
Estimate your 2017 income. The enrollment process at Healthcare.gov will be more productive if you compile several pieces of information beforehand. To start, make sure you have the names, dates of birth and Social Security numbers for everyone in your family. You will also need a good understanding and estimate of what your 2017 household income will be. This information will help determine if you qualify for tax credits that could offset the cost of the insurance premiums. As an individual, you qualify for a credit until your income exceeds $47,520, and for couples and families it depends on how many people are counted in your household. For a family of four, the credits phase out once your income exceeds $97,200.
Collect medical information. Compile a list of primary care doctors, specialists and prescriptions for all members of your family. This data will help you navigate the complexity of ensuring that the doctors and prescriptions that you count on will still be available to you in the coming year. The same insurance company may offer different in-network plans. If you shop only on price, you may not be able to see the doctor you choose. It is best to input the doctors you work with to ensure that they are available within the plans you are reviewing. If the exchange website shows that your doctor is not covered by any of the policies you are considering, give that doctor's office a call. Your doctor's office might be able to provide advice about the plans he or she accepts. It is worth a phone call to make sure you have a complete understanding of which doctors and hospitals will be available to you in 2017.
Consider whether a plan can be used with a health savings account. Contributions to health savings accounts are tax deductible, they grow tax deferred and they are completely tax-free if used for medical expenses. Your HSA balance carries over from year to year and could be used to help pay for future medical needs in retirement. Only some plans on the exchange are HSA eligible. The exchange website allows you to refine results to locate plans with a HSA option.
Get outside help. It is easy to become overwhelmed with all the health insurance choices and options. If you would like to find someone nearby to help you navigate and apply, HealthCare.gov has a tool that can direct you to local resources.
Be an advocate for yourself and your family. Several insurance companies have left the marketplace. So, some parts of the country have fewer health insurance options than others. However, since this is a major issue nationally, there is also an opportunity to be an advocate for your family. If you find that major hospitals and service providers in your area are completely excluded from the current health insurance options, then consider reaching out to your elected officials and local media outlets. For example, in Nashville the largest hospitals were considered out-of-network for all exchange insurance options, but a call to the hospital yielded the information that the hospital is actively trying to get added to the approved networks.
Navigating the new health care landscape is not easy or seamless, but a little bit of preparation can often help you find a plan that meets your needs. And if you do find yourself in a situation with limited options and losing your trusted providers, start to advocate for yourself and share your concerns. With enough interest and dialogue, you just might be able to inspire some tangible change.
Brian Preston and Bo Hanson are fee-only financial planners who host the podcast, "The Money-Guy Show".
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