Avera Medical Minute: What to expect from the health insurance o - KSFY News - Sioux Falls, SD News, Weather, Sports

Avera Medical Minute: What to expect from the health insurance overhaul

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Starting in January, 2014, the new insurance plans of the Affordable Care Act will go into effect. However, open enrollment gets underway in a few short weeks. So what do the changes in health care mean for you?

"It's nice to be able to love what you do for living." Said Nick Chrisopulos.
Chrisopulos is his own boss. With a leap of faith he started "Woodworks by Nick." But by leaving his previous employer he's now on his own for health insurance.

"Evidently there's going to be a lot of changes coming up effective in January and I really have no idea what that could be. Is it gonna be for the better for the worse I really don't know." Said Chrisopulos.

What Chrisopulos is worried about is the Affordable Care Act and the changes it will bring to the health insurance world.  

"My biggest question is how is it going to affect my policy? Is my price going to go up? Am I going to get any assistance as to where it balances out and keeps my payment lower? Again the co-pay issue, how is it going to affect that?" Said Chrisopulos.

Most people are like Chrisopulos and don't fully understand the insurance lingo, or can't tell you the difference between a premium and a deductible. So how do you know what's best for you? 
Well, starting in October, shopping for insurance will be like shopping for an airline ticket.  
On the insurance "Marketplace" of healthcare.gov you'll be able to pick and choose the plan that works best for you.

"So people will be able to say, well I want a high deductible or low deductible, or I want a lower monthly premium or maybe I'm willing to take a higher monthly premium and it'll be a lot easier to compare." Said Debra Muller, the chief administrative officer for Avera Health Plans.

The biggest overhaul of health care is actually ensuring patients receive care, so every plan in the Marketplace will provide essential coverage regardless of your pre-existing conditions.
Meaning things like emergency services, any hospitalizations, maternity and newborn care, prescription drugs, rehab services, and pediatric doctor visits, will all be covered by insurance; just to name a few.

"Some of the good news is that those doctor visits that you have with co-pays as Nick mentioned those co-pays now accumulate toward your out-of-pocket maximum which they currently don't do in today's world." Said Muller.

For small business owners and people who qualify, there are also tax credits available to help reduce premiums to help ease the financial burden.

"For folks who have a concern if they lose their job, if they want to be in entrepreneur like Nick and go out on their own they can get insurance and they know that the insurance is going to cover them when they need that insurance." Said Muller.

Let's face it, health insurance, like filing taxes, is a confusing topic and it doesn't hurt to shop and ask around.

"I would recommend that you research as much as you can and just get as educated on the topic as you can." Said Chrisopulos.

"I always tell people go to your trusted broker or agent somebody you know, they exist in all communities in South Dakota so there'll be a lot of resources to help answer these questions." Said Muller.

Working with drills and saws, it's very easy to lose a finger or two, luckily Chrisopulos has only had a few close calls. But with the coming changes, insurance is the last thing he has to worry about.  

Avera Health Plans are just one of the providers listed on the Marketplace. If you have any questions about the changes to health care or what plan works best for you, You can speak with an insurance expert by calling 855-MY-AVERA or simply click here.  


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