By Steve Dorfman
A lot has changed since 2010, the year the Affordable Care Act passed into law.
What hasn’t changed much is the state of public knowledge about the ACA, popularly known as Obamacare. The Affordable Care Act remains the subject of misinformation and misunderstandings, some offered in good faith and some not. The situation is such that one of the most common questions health insurance experts hear today is shockingly basic: does Obamacare still exist?
It’s a fair question. And it’s just one of many that arise out of the myths and half-truths characterizing the healthcare industry in the post-ACA world.
Let’s take a closer look at it and five other myths, plus four “truths” that far too few healthcare consumers take to heart.
1. Myth: Obamacare No Longer Exists
Despite administrative and legislative changes to the structure of the Affordable Care Act, the law’s framework remains in place. You’re still entitled to many of the same benefits and protections, and you can still buy individual insurance policies on marketplaces run by state and/or federal authorities. Indeed, if you’re in the market for health insurance, you have more choices than you probably realize.
2. Myth: You Need to Pay Your Deductible Before You Can Use Any Health Services
Health insurance isn’t like car insurance. You’re not required to pay out of pocket before you can avail yourself of any of the financial benefits of your policy. For instance, many health insurance policies with relatively high deductibles nevertheless fully cover preventive care visits at in-network providers. Depending on your provider and network, this could easily save you hundreds of dollars per year.
3. Myth: You Can’t Get Coverage If You Have a Pre-Existing Condition
The ACA outlawed discrimination on the basis of pre-existing conditions, a once-common insurance industry practice. This was a huge victory for society’s most vulnerable — and those with routine “conditions,” such as pregnancy. While enforcement of this provision has changed over the years, it’s simply not true to say that you can’t get coverage if you have a pre-existing condition.
4. Myth: Employer-Sponsored Plans Are Always Better Than Individual Plans
Provenance is no guarantee of quality. Some employer-sponsored plans come with high premiums, limited networks, and benefits that don’t align with every patient’s need.
“Before you accept any plans your employer might offer, be sure to check what’s available on the individual markets.” — Steve Dorfman
A seasoned health insurance industry expert can help.
5. Truth: You Can Find Coverage That Fits Your Budget
his is another happy truth about health insurance: no matter how tight or expansive your budget, you can find a health insurance plan that fits your budget without sacrificing the coverages you need.
6. Truth: You Can Find a Health Insurance Plan With Superior Provider Choice
Oh, and you shouldn’t have to compromise on provider choice, either. Even if you live in a small town or rural area, you can likely find a plan with a broad-based provider network replete with primary care providers and specialists alike.
7. Truth: You Can’t Predict the Future
Lastly, remember the old adage: you can’t predict the future, try as you might.
The very concept of insurance is premised on this fact. If we knew exactly what would happen tomorrow, next month, or next year, we’d have no need to carry insurance until we really needed it. Which, of course, would upend insurance markets.
Even if you feel great right now, you never know what’s around the corner or down the road. You might need quality health insurance when you least expect it. And you’ll be grateful you took advantage of the good times (no matter how iffy they feel) to secure it.
What other health insurance questions are keeping you up at night? Are there any other myths you still need dispelled?
Bio: Steve Dorfman is the founder and current CEO of two Florida-based firms: Simple Health and Simple Insurance Leads.