Carolinas HealthCare System

If your employer offers health insurance plan options, there’s a good chance changes in the healthcare landscape have also prompted changes in your benefits. Whether you’re participating in a group plan or considering purchasing insurance on the Health Insurance Marketplace, you should research your options thoroughly before selecting a care plan.

Selecting the right care plan can be tedious, but it’s extremely important that you choose the best plan for yourself, your family and your budget.

Below, we’ve included some general guidelines to keep in mind during open enrollment.

Group Health Plans

The Health Insurance Marketplace

What you need to know about job-based health plans and other group health plans.

Some things to keep in mind during open enrollment:

Is my current provider included in my plan's network?
Check your current plan to ensure your provider of choice is covered in your group plan for 2014. Read more...

What will my out-of-pocket expenses be?
Pay close attention to the plan's deductible – the amount you pay before insurance kicks in – as well as maximum out-of-pocket costs. Read more...

Are my prescriptions covered?
Check the plan's formulary, or preferred drug list, to see if the plan covers your prescriptions.

Is my employer's plan the best fit for me?
A group plan through your employer often grants you benefits at reduced or no cost. Make sure you research the plans your employer offers to select the best one for your needs.Make sure you research the plans your employer offers to select the best one for your needs.

What am I really paying for?
Make sure to look at more than just the premium (monthly cost) of the plan. Oftentimes, a lower premium means higher copays and more out-of-pocket expenses when you need care.

Does the plan offer accounts that have tax advantages?
There are three common types of tax-advantaged accounts that can help you pay for medical costs. Read more...

Is your plan grandfathered?
"Grandfathered" plans are exempt from many changes required under the Affordable Care Act. Read more...

Shopping on the Health Insurance Marketplace? Here's what you need to know.

What is the Health Insurance Marketplace?

The Health Insurance Marketplace, also referred to as the "Health Insurance Exchange," is a new way to find health coverage that fits your budget and meets your needs. The Marketplace can help if you don't have coverage now or if you have it but want to look at other options.

You can learn more about your coverage options by calling us at 866-412-0000 or by answering a few questions on

What if I already have health insurance through my job?
If you have job-based health insurance and you're happy with it, you obviously have the option of keeping it. Any job-based health plan you currently have qualifies as minimum essential coverage, which means you will not have to pay the penalty that uninsured people will be required to pay in 2014. If your employer provides a health plan and you choose to buy a plan on the exchange instead, your employer is not required to make a contribution to your premiums.

Can I qualify for the marketplace (and potential savings) if I already have access to a job-based plan?
Whether you qualify for lower premiums and out-of-pockets costs will depend on what kind of coverage your employer offers. If your job-based coverage is considered affordable (no greater than 9.5 percent of the annual household income) and meets minimum value (designed to pay at least 60 percent of the total cost of medical services for the standard population), you won't be able to get lower premiums or out-of-pocket costs in the Marketplace.

Here's how to make the most of the Marketplace during open enrollment.

  • Ask your employer if it plans to offer health insurance during 2014
    • If not, your employer may be issuing a stipend to shop on the Marketplace
  • Learn your options and information
  • Gather basic information about your household income
  • Set your budget
  • Learn about the different types of health insurance. Visit for a comprehensive guide to the different types of health insurance plans
  • Make a list of questions prior to choosing your health plan
  • Find local help. Navigators, application assisters, certified application counselors and other resources are here to help. Visit to find help in your area.

The Kaiser Family Foundation calculator can give you a rough estimate of how much health insurance may cost in 2014, but you won't be able to get your exact costs for a specific plan until you fill out a Marketplace application after October 1, 2013. You should expect that your final cost will be different from the rough estimate provided below.