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Budgeting

It can be hard to predict medical expenses for a given year. A good place to start is reviewing last year's costs and activities. Did you visit the doctor often or less than you expected? Are you retiring or planning a surgery?

Also factor in monthly premiums, deductibles and copays, and be sure to budget for the unexpected, like a trip to the emergency room. It's important to remember that accidents happen. 

Budgeting for health insurance looks different for everyone, but spending a little time upfront can help you benefit financially.

Plan options and financial assistance

People looking for comprehensive coverage and/or financial assistance may choose one of Wellmark's ACA-compliant plans issued by Wellmark Health Plan of Iowa and Wellmark Value Health Plan. Coverage is guaranteed to all who enroll and includes all the essential health benefits required by the law.

Members who purchase their plan through HealthCare.gov may apply for financial assistance, sometimes called subsidies, to help pay for premiums. This is a more affordable option for people with lower incomes.

What is a metallic tier?

Metallic tiers make it easy to compare plans and answer the question, How much will my plan pay vs. how much will I pay? In a nutshell, the ACA categorizes plans for individuals and small groups in four tiers:

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Metallic Tiers to consider are Bronze, Silver, Gold, and Platinum.

  • Bronze: member pays 40%; insurance plan pays 60%.
  • Silver: member pays 30%; insurance plan pays 70%.
  • Gold: member pays 20%; insurance plan pays 80%.
  • Platinum: member pays 10%; insurance plan pays 90%.

Enrolling in an ACA plan

Iowa residents may purchase a Wellmark ACA-compliant plan with the help of an authorized Wellmark agent or by visiting Healthcare.gov. When you enroll you will need:

  • Your Social Security number
  • Spouse's Social Security number
  • Birth dates for you and your dependents
  • Tobacco status
  • Medicare status
  • Other health insurance status