
While I don’t have either a rant or rave to entertain you with, I have done enough research on health care and general health care delivery systems to know these two simple truths: (1) selecting health care plans was complex before the ACA, and (2) the ACA does not change the fact that you need certain specifics about your health care/insurance plan regardless of who you buy it from.

Within these plans, you may or may not be able to use a Health Savings Account (HAS) or Health Reimbursement Arrangement (HRA). What you don’t know about your plan can — and most likely will — hurt you!
One of the first things that you need to know about your health insurance plan is how much you will pay out of your own pocket, i.e., your premium plus your deductible plus any co-insurance you must pay (up to your out-of-pocket maximum) plus any co-payments equals the most you will pay for health care each year (for covered services).
How you reach that out-of-pocket maximum is based on how much you pay for your medical care upfront. This depends on your deductible and co-insurance percentage. The higher your deductible, the lower your monthly premiums will be, because you are willing to pay for some of your care upfront.
The next thing you need to know about your insurance plan is how it works. Using an example from Blue Cross Blue Shield, let’s say you clobber a moose while driving the speed limit on I-95. The bad news is the moose didn’t make it; the good news is you did. The not-sure-how-Ifeel about-this news is you’ve accumulated $50,000 in medical expenses. If your deductible is $5,000 and your co-insurance is 20 percent, that means you have $6,000 of out-of-pocket expense. Does this work for you and your budget? What if you are out of work while on the mend? Do you have short- or long-term disability? How will your family survive without your income?
These two suggestions and questions above are really just the tip of the iceberg on answers you should be seeking. Other answers to questions you should know include: Do I want basic or more comprehensive coverage? Is my doctor or hospital covered by the plan? Does the health insurance plan cover me if I travel? Does the health insurance plan cover services that are important to me? Does the plan work with a health savings account (HSA)? and Are prescription drugs covered under my health insurance plan?
Remember, it wasn’t the tip of the iceberg that sunk the Titanic, it was the part no one saw. The parallelism between the effect of a sinking ship and understanding what unanticipated health care bills can do to you and your family should be taken seriously.
At the end of the day, I humbly submit to you that regardless of what side of the Affordable Care Act you fall on — or, maybe you’re like me and don’t pick sides — health care costs and health care insurance plans are complex. Don’t make the mistake of not fully knowing what protections are afforded to you and your family. I highly advise you find a trusted adviser, ask them hard questions, and get the educated answers you need to know. If you don’t have an adviser, go to the chamber’s website, www.midcoastmaine.com, or call us at (207) 725-8797 for assistance in finding one.
UPCOMING EVENTS: Tonight, the Maine State Music Theatre and Joshua’s Tavern host Chamber After Hours, 5 to 7 p.m. Experience the best networking at regional Chamber After Hours. Takes place at 22 Elm St., Brunswick. Make new connections, gather business leads and reconnect with business owners. Chamber members, their employees and guests are all invited. The event is free to attend.
“Engaging Your Multi-Generational Work Force” is the topic of the Nov. 6 Business Success Seminar. Presenter is Susan Stacey from Manpower. The seminar and networking are 11:30 a.m. to 1 p.m. at the Topsham Public Library, 25 Foreside Road. Feel free to bring a brown bag lunch.
Hiring Maine’s Heroes Job & Resource Expo will take place at the Knights of Columbus in Brunswick on Nov. 13 from 10 a.m. to 2 p.m. This event is open to all veterans, family members, and members of the public. Area employers are also invited to attend — if you have job openings, you exhibit for free. Contact president@midcoastmaine.com for more information.
The Joshua Chamberlain Award presentation and Veterans Gala will take place at the Bath Golf Club on Nov. 13 from 5 to 7 p.m. Admission is $25 and includes light finger foods. A cash bar is available.
Please go to the chamber’s website (www.midcoastmaine.com), scrolling the calendar for more information and to register for all of these events. For some the seating is limited. Don’t miss out.
MEMBERS IN THE NEWS: Discover more about chamber members at www.midcoastmaine.com or download MyChamberApp for use on your mobile phone or tablet.
The chamber proudly serves 760 businesses and organizations in the following communities: Arrowsic, Bath, Bowdoin, Bowdoinham, Brunswick, Dresden, Edgecomb, Georgetown, Harpswell, Phippsburg, Richmond, Topsham, West Bath, Westport Island, Wiscasset and Woolwich.
Comments are not available on this story. Read more about why we allow commenting on some stories and not on others.
We believe it's important to offer commenting on certain stories as a benefit to our readers. At its best, our comments sections can be a productive platform for readers to engage with our journalism, offer thoughts on coverage and issues, and drive conversation in a respectful, solutions-based way. It's a form of open discourse that can be useful to our community, public officials, journalists and others.
We do not enable comments on everything — exceptions include most crime stories, and coverage involving personal tragedy or sensitive issues that invite personal attacks instead of thoughtful discussion.
You can read more here about our commenting policy and terms of use. More information is also found on our FAQs.
Show less