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Identify the Best Health Insurance Plan

Your opportunity to apply for health insurance coverage through the Health Insurance Marketplace, also known as the Affordable Care Act (ACA) or healthcare.gov, happens during the open enrollment period of Nov. 1 through Dec. 15.

At any time, you may be eligible for a special enrollment period (SEP) if you experience a qualifying life event.

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Find the Best Health Plan for You

Before you apply, review these tips to help you find the best health plan option for your needs:

  1. Look beyond the premium payment.
    Find a monthly premium that works with your budget. Also review and compare the co-pays, coinsurance, deductible and out-of-pocket maximums to see how the overall plan will affect your family finances. The benefits within the plan will make a difference when it comes to seeing your doctor.

  2. Understand how much you'll pay for a doctor visit.
    Co-pays and coinsurance affect the amount you pay when you visit the doctor. Co-pays are fixed amounts you pay when you receive a service. Coinsurance is a percentage of the cost for services that you're also responsible for paying.

    With a high deductible health plan, you pay the full amount for the visit until you reach the out-of-pocket maximum specified in your plan.

    Remember, no matter which plan you choose, most preventive services, such as screenings, are free.

  3. Identify a deductible and out-of-pocket maximum you can afford.
    The deductible is the amount you pay for covered health care services before your health insurance begins to pay. Your out-of-pocket costs include expenses - such as deductibles, co-pays and coinsurance - for services that are not reimbursed by insurance.

  4. Choose a plan with a wide network to get the best and most cost-effective care.
    When health care providers and health insurance carriers work together, they will find the best pricing to reimburse you for health care services or procedures. That means you'll pay less for the care you need - which is exactly what you'll enjoy with an Avera plan. Even if you find a lower monthly premium with another health insurance carrier, unless they have a wide network of providers who understand the benefits of working together - such as those affiliated with Avera Health - you'll end up paying more.

  5. Look for additional perks with your health plan.
    Ask your agent what makes one plan stand out above the others. Because no two people have the same health insurance needs, Avera Health Plans believes you should have choices.