Who’s Afraid of Big Bad Medical Insurance?

Know what one of the best parts of being a financial planner is?  Making friends with other fantastic financial planners!  Today, I am excited to introduce you to Addie McHale, CFP ® of Moneyfull.  Addie is an expert on navigating the individual medical insurance market, among other talents.  Read on!


Q:  People are often afraid to leave their company’s employer provided medical insurance.  They worry about cost and complexity finding a plan that suits them.  What words of wisdom can you impart to calm these fears?


A:  With the Affordable Care Act (aka ACA) becoming law in 2013, you no longer need to feel tied to your employer just for your health insurance benefits. Now anyone can get health insurance on the individual marketplace when they leave their employer. And most importantly, there is no underwriting involved! Meaning, if you have a pre-existing condition, that is okay and it is not excluded. The ACA has many great provisions and this is one of the most important ones. In the past you may have felt stuck in a job that wasn’t ideal because you had no other options for your health insurance, but that is no longer the case.


As far as cost, the American Rescue Plan just increased the tax credit that families qualify for, meaning that if you didn’t qualify for premium assistance before, you might now, because the income limits just went up. And I agree that it is complex, so I definitely recommend finding a good health insurance broker who can help you choose the right plan for your needs and walk you through the income application, to determine if you qualify for a reduced premium.


Brokers understand the nuances of different plans as well as the network coverage, and it’s really not easy to navigate the system without one. There is no charge to use a broker — they get paid by the carrier — but do make sure they don’t have an agenda and that they put their clients’ interests first. Sometimes brokers can be incentivized by the carrier for so many enrollments and it’s okay to ask them about that and how they are paid.


One more note, Colorado has its own marketplace called Connect for Health Colorado {link is connectforhealthco.com}. ACA plans are almost identical on and off the marketplace (i.e. directly through the carrier), but you must buy your plan on Connect for Health if you want the tax credit up front or when you file your tax return.


Q:  How much advance notice do you need to find and execute a new benefits program for a client?


A:  You have 60 days to enroll in a new plan once your employer coverage ends. Nine times out of ten, if you leave your job mid-month, your coverage will end on the last day of that month. So it is 60 days from that end date. People often call me to get an idea of prices before they give notice to their employer to prepare ahead of time. Prices don’t change during the year, so you can count on that info to make your decision. 


Q:  In addition to helping people with insurance, you are also a full-service financial planning firm with expertise in helping people gain control over their finances.  Tell us more about that part of your business.


A:  First, I think I am the only CFP® in Colorado who is an active insurance broker. I fell into it in 2013 when the ACA was passed into law and one thing led to another. Financial planning is my primary job, but I do treat each health insurance enrollment as a mini ‘financial health plan.’ I love to learn about what someone’s needs are and then I can usually narrow down their choices to 1 or 2 plans very quickly.


When I have my financial planner hat on, I primarily help people with their finances on an hourly basis — usually financial plans, any kind of money decision, and I especially love helping people get on budgeting software and change their relationship with money!

Thank you, Addie, for being my guest blogger this week!


Addie McHale is a Certified Financial Planner™ who believes that the best financial planning happens every month by the spending and saving decisions you make with your income, and she teaches her clients how to master their cash flow. After building thousands of financial plans for a Fortune 50 company, she founded her firm Moneyfull, and her philosophy and tagline — Plan a richer life™— means YOU define your life, your values, and your goals.  Aligning your money with what’s important to you = your richest life!  You can find more on her website, moneyfull.com.



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