Chances are good you’re in a life transition. You’ve got your first job, aged out of your parents’ health insurance, or maybe you’ve lost a job and are in the process of job hunting. Regardless of the situation, you need to find quality health care coverage – preferably quickly.
Finding the best health insurance for you and your family doesn’t have to be overwhelming. Check out these five tips to make finding your best health care option a breeze.
1. Health Care Lingo
Like other specialized fields, the health care industry uses several terms you probably won’t see anywhere else. Understanding these terms will empower you to make sense of your research when looking for health insurance!
- Premium – What health care insurers charge you each month.
- Deductible – How much you pay for your health care each year before your insurance starts to cover your costs.
- Copayment – How much you pay for health care after meeting your deductible (this means care isn’t entirely covered by your insurer, but they will “copay” with you).
- Coinsurance – What percentage of costs you pay after meeting your deductible (your part of care payments will vary depending on the total cost of your health care).
2. Where To Get Health Care
In America, many people receive health care as part of a benefits package at their job. However, if your employer doesn’t offer health care or you’d prefer to use a different option, you can also purchase an Individual Health Care Plan (also known as a Personal Health Care Plan).
You can access health care plans in America in two ways: through the state and federal government marketplace or by working with individual health insurance brokers. Marketplace health care plans typically have restrictions on when you can apply, while individual brokers will work with you all year round.
Marketplaces show you different health insurance plans available in your area, and they vary by state. If a state doesn’t have its own marketplace, you can access the federal government’s marketplace instead.
Some of the larger insurance companies you’ll see in the Marketplace are Aetna, Blue Cross Blue Shield, Cigna, Humana, Kaiser, and United.
3. Types And Categories
Whether you work with the Marketplace or individual insurance companies, you’ll find that healthcare plans are divided into several types, each available in four categories:
Each kind of health insurance plan comes with different benefits and drawbacks. Main types include:
- High-deductible health plans (HDHPs), which may be linked to health savings accounts (HSAs).
- Preferred provider organizations (PPOs).
- Health maintenance organizations (HMOs).
- Exclusive provider organizations (EPOs).
- Point-of-service (POS) plans.
According to a survey conducted by the Kaiser Foundation in 2020, POS and HDHPs cover 76% of insured workers in America. However, you should learn more about each type before deciding what will serve you best! Employers also have options when it comes to what they can offer their employees.
Most health care organizations only work with certain hospitals and doctors. For that reason, you’ll need to check that the plan you’re considering covers the providers you want to see. Otherwise, you may have to pay out-of-pocket even if you’re insured.
The four health care categories are named after metals and indicate how you and your insurer will share costs. Here’s a quick breakdown to show how this works:
- Bronze – The insurance company pays 60% of costs, and you pay 40%.
- Silver – The insurance company pays 70% of costs, and you pay 30%.
- Gold – The insurance company pays 80% of costs, and you pay 20%.
- Platinum – The insurance company pays 90% of costs, and you pay 10%.
4. How Much You’ll Pay
There’s no way to know exactly how much your health insurance will cost until you start looking. However, there are a few things you can consider to get a reasonable estimate:
- If you have a low household income, you may qualify for government assistance with your health care.
- Research your area. Because each state has different health care laws, costs will vary depending on where you live.
- Consider your age and health. In many cases, young, healthy people will pay less because they have fewer risk factors.
According to the Kaiser Foundation, in 2020, workers insured through their employers paid $104 a month for personal coverage and $466 a month for family coverage. Their employer typically covered 73-83% of their monthly health care premiums.
However, recent estimates show that workers pay between $273 and $648 a month for individual health care plans outside of employment.
5. Think For Yourself
While it’s tempting to accept whatever health care plan comes along first, don’t commit until you’ve done your research. Even if your place of employment offers an easy opt-in plan, still consider other options. It could be the best plan for you – and it may not.
Consider your options, and think outside the box. What are your priorities? What can you do without? Can you combine different types of plans to cover everything you need for less?
For instance, some people use short-term plans to cover them until they can apply to the marketplace. Others combine high-deductible health plans with health savings accounts to save taxes. Some even choose low-cost faith-based health care plans, which share costs within a community rather than work with a traditional insurance company.
Whatever route you decide to take, make sure to check current legal requirements for health care. Laws for health care change and can impact both insurers and individuals seeking insurance.
Take The Next Step
Health care options in America are as individual as the people looking for them. Before you start researching specific plans, take some time to consider your personal needs, preferences, and opportunities.
Finding the right health care option requires some deep digging. Use this guide to get started on your research, and happy shopping!