Chelsea: Hey guys! It's Chelsea from The Financial Diet and today I'm here with someone very special and that's Maya, our own editorial assistant at The Financial Diet. And we're going to be talking about something very cool and interesting, at least in my opinion, and that is Obamacare! So unless you've been living in some kind of cave, which no judgement, chances are you've probably heard of Obamacare often in kind of a negative, scary way, but it's actually a pretty interesting and complex and nuanced thing that's different for everyone, but has for many millions of people provided health care where they didn't have any before. And as someone who myself has been uninsured at different points in my life when I was working for myself I certainly wish there had been maybe something like this around when I was flailing about as, you know, a wayward young person. So we're going to talk a little bit about Obamacare really is and how you get it and the things you might not know about it with someone who actually has it. 

So kind of just starting with the basics, like what is open enrollment and how do you do it?

Maya: So it's very simple actually, but it's not as well advertised, I feel like especially in the millennial generation, it's sort of like easy to miss if you're not looking for it, but open enrollment runs from November 1st to January 31st of 2016. And basically it's a time where you can go online to healthcare.gov and sign up for a plan without having any specific reason. Whereas if you were to do it at any other point during the year, you would have to say, like "Hi, I have a life changing circumstance. I lost my job. I lost my insurance" Something like that. 

Chelsea: So it's just basically a time where everyone's allowed to get insurance.

Maya: Exactly, but it's important to remember that if your spouse or partner has insurance through their company then it can be a little bit harder and there's a few more rules that come along with that. 

Chelsea: Gotcha. I actually have insurance through my domestic partner, who I became domestic partners with specifically to get insurance once I went freelance and I'll include a link to that article in the description to kind of explain how that works. So can you kind of tell us in, you know, generally how much you're going to pay in 2016 for your insurance and what that gets you, like what plan you have?

Maya: It's a bronze PPO, I do Blue Shield because that's what my providers are under and I'm going to be paying about $215 a month, but that doesn't include dental or vision so it can get up to almost $250. Like I'd say I'll pay just under that and that's for a bronze plan, which there's silver, gold, and platinum above it. But you are still getting quite a bit. You have 3 doctor visits where you don't have to pay copay at all and then it will be fairly good coverage in terms of, like, I can get birth control without having to pay, etc. 

Chelsea: And, so with that plan do you have a deductible or copay or any of that?

Maya: Yes, you do have a deductible and a copay, but the deductible is going to be fairly more reasonable than if you were to do, say, a catastrophic plan. And a catastrophic plan is if you are basically saying up front I want to pay less money monthly, but then you end up, if for example you break your leg, you end up paying quite a bit in your deductible if you were to go to, like, the hospital. 

Chelsea: Right. 

Maya: For catastrophic plan it's actually only available to those 30 and under. The only people that I know on it are freelance writers and editors who've decided to pay less monthly assuming that they have good health and won't have to go to the hospital or doctor's very often. 

Chelsea: So I think a general rule is like you really have to look at what you do medicine wise every year and be honest with yourself. 

Maya: Yes, and I personally- the catastrophic plan that I was looking at was coming in about at $190 which is $20 less a month and some people can get it less than that, but personally for me, I would be too anxious making that choice.

Chelsea: Right, and plus, like you know, it also discourages you from going to the doctor frequently, which is bad in general and also could lead to worse things down the road. Like you shouldn't be like, "Okay, I'll never see, you know, my gynecologist because too rich for my blood so let's just hope everything's okay..." So approximately what percentage of your income now is going to go to Obamacare?

Maya: Right, so I just calculated it and it's actually going to be around 7%

Chelsea: That's a lot/

Maya: It is a lot and to sort of give you the frame of reference for that, when I was working a full-time salary job, I was making entry level salary and I was paying about $40 a month for good benefits, vision, and dental. That about 1% of my salary that I was paying. It was actually like 1.5%, but you can see the increase there. And when I did look at other Obamacare plans for people in different tax brackets than myself, people can be paying up to 9% of their income, which is a lot. And it's true that we have come a long way, like when people were graduating in 2008, 2009 they were like 22, couldn't got back on their parents insurance. It's extremely stressful and now there's actually a penalty if you don't have health insurance at all. You pay it per every month that you don't have health insurance.

Chelsea: So as you mentioned, your... the cost out of pocket for you every month with Obamacare is actually a lot more than it was with your employer.

Maya: Quite a bit more and it's sort of going to be that way for everybody that transitions from that full-time salary benefits lifestyle to a freelance lifestyle. 

Chelsea: Is there a difference between Obamacare and private insurance?

Maya: Yes! There is and that was something so confusing to me. So the thing is, it's not necessarily more expensive because there is sort of a ruling that you can't offer this exact plan private and charge more money for it. 

Chelsea: Gotcha.

Maya: It's just that there's more options with private insurance so if you have highly specified medical needs than a lot of people tend towards private insurance just because they can get, you know, their doctor covered, their dermatologist covered, their gyno, their therapist, whatever it is and it's hard to find sort of an all encompassing plan on public insurance, or at least it had been when I've been looking for one. 

Chelsea: Gotcha, so if you're the kind of person who is maybe getting a lot of specialty things, whether it's dermatologist visits or orthodontist visits or things like that, uh, you probably will have a hard time getting that covered under Obamacare?

Maya: I would say it's fairly likely that it will drive up your price pretty quickly so some people prefer to just go get a full package with private insurance and call it a day. 

Chelsea: So if someone has the time they can go to an office near them and we'll include a link about how to find the representative near you so you can get an in person consultation because at least speaking personally when I think about things like Obamacare, the scariest part is like, what  website do you even go to, like, how do you navigate it? Is there a bunch of, like, really weird contracts that you have to read, like that kind of thing. So if you do have those concerns and you'd like to go have a representative explain it to you, like a 5-year-old, which is how I would like it explained to me if possible, definitely check that out. And again we'll include the links. So obviously we have the different types of plans, you know, the bronze, silver, gold, even platinum, and then the catastrophic one, but then you also have 2 acronyms that I don't understand at all, but I hear a lot, which are HMO and PPO. Just quickly can you tell us, like, what those are and why you chose the one you chose?

Maya: Yes, so I specifically am choosing a PPO and that's mainly because the benefits that I used to have through my company were PPO and it involves using a provider network, it involves your primary care physician referring you to other doctors that will be covered in your PPO. So, the doctor's that I had used and that I had been referred to are all within, for me, a Blue Shield PPO and that's the one that I chose. And the other one that I considered was a HMO and that's Health Maintenance Organization. So it's basically a small sect of providers and it's specific to your location and those would be your go to's, etc. 

Chelsea: Gotcha, so if you have the doctors, you have your primary care physician and you have the doctors that you know and want to stay with, it may be best for you to get a PPO?

Maya: Yes, in my experience and I've also noticed that a lot of people that are using their, like, company's insurance have PPOs. That the most common one offered and that's why I'd say people stick with it. 

Chelsea: Well, we'll include a link in the description to help you figure out if you should be going for an HMO or a PPO depending on your specific circumstances. Is there cost assistance for Obamacare because I know for a lot of people, probably the primary concern is "I just can't afford it!"?

Maya: So there is and it becomes if you are an individual and you have no dependence, you might qualify for a cost assistance plan if you make under $46,000 a year. 

Chelsea: Okay.

Maya: And then for a family of 4 if you make under $95,000 a year, but it's not guaranteed. So for example, I could qualify and actually don't. It wasn't explained to me why I don't. I've read articles that say I should, however, there's a chance that at the end of the tax year, they can go back and say "Actually Maya, we're going to give you a cost assistance" and then I would just get it on my tax refund.

Chelsea: So you just reimbursed for the money that you paid too much. So just kind of to give people a better idea because obviously you're coming at this from California with your specific income and all of your specific constraints. Do we have an example of, like, if someone else were to do this? Like, we're in New York, maybe someone in New York? 

Maya: Yes, okay so there's a fairly good health care calculator that you can go on and we can include that link as well and you can plug in this is how much I earn or projected to earn in 2016, this is where I live, this is how many dependents I have, what am I going to be paying. And I've plugged in, if you're making $35,000 a year and you're living in Queens, you can get a silver plan for $279 however, that plan comes after a $90 tax assistance. If you're making $35k in Queens, you would going of this calculator be getting that assistance, but even after that assistance was applied you'd be in the 270s range. That's for silver so you could probably bring that down a little 250 if you were going for a bronze plan. 

Chelsea: Gotcha, so to recap pretty quickly on what we've kinda of learned here today, there are several things to consider if you're thinking about Obamacare or terrified of Obamacare or wanna learn more. Biggest one, obviously, is to find out how much it would be for you, and you can either do that by using the calculator that we'll provide for you online or seeking out a representative in your area who can really kind of explain things to you in a way you can understand, tailored to your individual circumstance. Also, you are going to want to check and see which plan works for you, sort of which level of coverage depending on the kind of coverage you have, how many times did you go to the doctor each year, what kind of doctors you go to, etc. Your also gonna want to check if an HMO or PPO is smarter for you and why. And make sure to look at your monthly budget and see if that is the kind of cost that you can take in to account because obviously Maya and her circumstance didn't have things like student loans, but when we're talking up to maybe $300 a month that's definitely something that you'll need to plug into your budget and see how it affects your over all month to month. So hopefully Obamacare feels a little bit less scary to you now, I know it certainly feels a little less scary to me and thank you so much for kind of sharing your experience with that

Maya: Your welcome! 

Chelsea: And thank you, that was awesome. And as always don't forget to subscribe and to go to thefinancialdiet.com for more. Bye!