Advice from an expert: Get help choosing your healthcare plan

Jan 28, 2015

The Family Health Center in Columbia provides free help to Missourians looking for health insurance.
Credit fhcmo.org

  It’s no secret that health insurance can be a confusing topic.

“There's not a ton of health insurance literacy,” said Aaron Swaney, Outreach Enrollment Specialist for the Family Health Center in Columbia. ”But that's true from people who have never had health insurance before to people who work in the healthcare field.”  

  

Swaney is what most people call a health insurance navigator: someone who works with individuals and families to find the best plan in the marketplace. He said the average consumer is not expected to understand every detail of their plan. Instead, he focuses on the most important numbers:

“Know what it's going to cost to go see a primary care doctor, know what your deductible is, know what your premium is and know what doctors and hospitals in town that you could go to. Those are really the important things,” Swaney said.

But that teaching can only happen if the consumer comes to see him. The problem is a lot of people think they know enough about health insurance. According to a 2013 survey from the American Institutes for Research, three out of four people felt confident about their knowledge of health insurance. But that same study found only one out of five of those surveyed could actually calculate their out-of-pocket costs.

Swaney said a lot of people come to him after they realize they’re in over their heads.

“I run into a lot of people who try to do it on their own and then they have all these issues and then I get called by them,” Swaney said. “My suggestion is unless you're certain that you'll be able to do it on your own, to go get help from somebody who knows all of the ins and outs of all the plans because there's a lot of little details involved with all these plans and all this health insurance that won't necessarily be self-evident when you're going through it on your own.”

This lack of understanding is not the only factor keeping Missourians from finding the right plan. Swaney said a consumer’s political opinions on the Affordable Care Act can prevent them from researching their options on the marketplace.

“I've signed up people who said 'I never thought I would have gotten one of those Obamacare plans,' which I kind of laugh at because that's all she had to say,” Swaney said. “She didn't have anything to say about paying $900 a month less for her insurance. It's a really interesting thing in terms of the lack of information that's out there and kind of the resistance to it on some people's part.”

Regardless of their political stance, many people might have to consider enrolling through the marketplace to avoid the penalty for not having health insurance. This is the first tax season that individuals without insurance will pay a fee on their income tax return. The penalty for not having health insurance in 2014 is $95 or one percent of income - whichever is higher. And people have until February 15 to enroll if they want to avoid an even higher fine next year.