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Published December 4th, 2013
Lynn's Top Five
National Health Care: What to think about now
By Lynn Ballou, EA, CFP(r)
Lynn Ballou is a CERTIFIED FINANCIAL PLANNER(tm) professional and co-owner of Ballou Plum Wealth Advisors, LLC, a Registered Investment Advisory (RIA) firm in Lafayette. Lynn is also a Registered Principal and Branch Manager with LPL Financial (LPL). The opinions voiced in this material are for general information only and not intended to provide specific advice or recommendation for any individual. Financial Planning offered through Ballou Plum Wealth Advisors, A Registered Investment Advisor and a separate entity. Securities offered through LPL Financial, member FINRA/SIPC.

As I write this column, much about the Affordable Care Act (ACA, also known as "Obamacare") is still unknown, not the least of which is whether or not it will be repealed! However, as one media personality so poignantly noted, it's like putting toothpaste back - once it's out of the tube, there's just not that much you can do except clean up the mess and move on!
Because there is so much information and misinformation flying around about this topic, l reached out to Colleen Callahan, an industry leader on this topic, with a local practice in Pleasant Hill (Colleen Callahan Insurance Services). She shared the following important considerations: "One piece that has often been overlooked in the media is that in 2014 a person really has two choices - buy coverage in the market place Covered California (through an agent) or through an agent directly with an insurance company that offers individual plans. There will be a few more options available outside the exchange and the network of doctors might be larger. Plans in the exchanges are offering narrow or skinny networks." As Callahan noted in our recent Webinar (you can access a replay at www.ballouplum.com) there is no additional cost to work with an agent, only the added benefit of their vast expertise.
Let's look at five different scenarios and possible courses of action, one of which might apply to you.
1) College (or Other Post High School) Student: If either of your parents have medical insurance through work or on their own , under the ACA you are allowed to be covered by their plan until you are 26 years old, although the cost of that insurance may not be paid for by your parent's employer. If available, you should strongly consider staying on your parent's policy. If you are in school, you may have access to student medical insurance through your college. If school insurance is available find out what it covers and how it would coordinate with any other coverage you might have. If you have no access to either, then it's likely that you can be covered under the ACA, which in California would mean the Covered California plan. You may be eligible for premium credits and/or a subsidy. And if your income is very low, then you will probably be qualified for Medi-Cal. If you don't want to be a Medi-Cal recipient, consult with an agent immediately about your options.
2) Young Adult: If you are on your own and not in school, and also not working for an employer who provides insurance coverage for you, then Uncle Sam wants YOU! You are the hope and the future of the Affordable Care Act because if you are young, healthy, and participate in our new national health care plan, your premiums for coverage as a participant in the plan will probably be relatively inexpensive. This helps offset the costs needed for those who might be older and therefore utilizing more expensive care. Check out the Covered California website for a description of the plans available for purchase. And keep in mind that it's very possible you will also qualify for premium credits and/or a subsidy.
3) Self-Employed: Those of you working and self-employed and not married to someone with employer provided coverage that you can tap into need to seriously review the choices now available to you through Covered California. However, it is quite difficult to navigate the site on your own, and also difficult to determine which options best suit you. Colleen Callahan noted, "I would always recommend seeking the guidance of a licensed insurance agent, different than navigators; a professional agent can give advice. They have annual education requirements, are regulated and carry insurance."
4) Working with Employer Coverage: Nothing for you to do for yourself, because you have coverage. However, if you are paying to cover your spouse or adult children who could be independent of you (but aren't 26 years old yet), you should review choices provided to you by Covered California. It's possible that the plan your employer provides is a cost effective option for you to continue to use in covering spouses and qualified adult children. However, this is a great example of a case where enlisting the help of a qualified agent gives you the opportunity to review all possible coverages and costs.
5) You Have a Plan, You Like Your Plan, You Want to Keep Your Plan: Many of you in this situation have received notices from your insurance companies that your coverage is being terminated. Because of the mess this is creating, President Obama has asked insurance companies to keep plans currently in place available to participants for the next year while the government works through the details of the ACA. Why is this important? Because most of you receiving these notices, who then go to the Covered California website, are finding that although insurance is available it's much more expensive than what you had in place and isn't giving you the same coverage you enjoyed having. One major reason this problem exists is that there is more coverage required to be included in plans than ever before, and insurance companies have increased premiums to pay for it.
One last thought for those of you age 65 and above; I didn't forget about you! For now, you are out of the fray and should continue to be covered by Medicare. One of my previous columns has covered what you need to pay attention to, not the least of which is the Dec. 7 deadline for Medicare Part D open enrollment if you have any changes in mind.
I hope this column has been helpful to you. In additional to reaching out to your own trusted advisors, here are some resources for you to use:
www.coveredca.com - the official website for Covered California
www.nahu.org has a 'find an agent' tool - this is available for people in every state
www.callahaninsurance.com to reach Colleen Callahan and her team

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