How to Get the Best Health Insurance

October 26, 2020

Health insurance provides assistance in covering the exorbitant costs of medical care. Without health insurance, a severe illness or a major injury can wipe someone out financially. Even affording basic medical services and prescriptions can be quite costly if done solely out of pocket.

As of January 1, 2019, health insurance is no longer mandatory at the federal level. Thus, people who do not hold a policy aren’t subject to a penalty anymore. However, purchasing health insurance provides peace of mind that receiving medical attention won’t be as great of a burden on your bank account.

Providers of Health Insurance

The United States does not have a universal healthcare system. It’s up to citizens to determine the medical insurance for which they are eligible and decide which plan best meets their need and budget.

Many Americans receive health insurance through their employer. This option oftentimes proves attractive since the company contributes money toward the cost of the monthly premium.

People age 65 or over and certain younger folks with disabilities may qualify for Medicare, a federal health insurance program. Another government program, Medicaid, is available to low-income individuals regardless of age.

Health Insurance Marketplace was created in 2014 by the Affordable Care Act in order to provide a variety of medical insurance options to Americans unable to obtain coverage through other sources. Some states have their own version of this insurance shopping and enrollment service. People also may seek out private insurance companies on their own to inquire about possibilities.

Comparing Health Insurance Plans

Health insurance plans definitely are not all the same! After figuring out what you and your family members may be eligible for, the next step is determining the specifics regarding cost and coverage.

When evaluating plans, consumers often focus primarily on the premium. This number states how much you’ll pay each month to belong to a certain health plan. While important, the figure only represents part of the overall financial picture. More attractive premiums frequently mean the following factors will be higher:

• Co-pay: The amount you’re responsible for contributing when seeking a service or filling a prescription.
• Deductible: The amount of money you must pay for the year before an insurance company will contribute to claims.
• Coinsurance: The percentage of medical costs for which you’re still responsible after paying your deductible.
• Out-of-pocket maximum: The limit of medical expenses paid with your own money for the year. Once reaching this cap, your insurance will start to cover 100 percent of your medical bills.

Plans also differ substantially in what services they will cover and who can provide them. As might be expected, greater choice tends to mean greater premiums. An often-affordable selection such as an HMO, for example, entails going to doctors and facilities that belong to your insurance company’s network. A PPO, on the other hand, allows the flexibility to utilize services outside of the network if desired but at a more expensive rate.

Other Health Insurance Considerations

For most types of health insurance, signing up is only allowed at certain points of the year. The Health Insurance Marketplace, for instance, enrolls from November 1-December 15. The choice of plan made stays in effect until the next enrollment period, so consumers need to think carefully about their decision.

As you compare plans, think about things that might be of great importance to you vs. coverage you’re unlikely to use. Some people may scrutinize the pregnancy benefits whereas others will not be concerned. Other individuals may double-check to ensure a preferred medication for their chronic condition is covered at an affordable rate. Someone who has had a long-term relationship with a certain doctor may want to ask what health network he’s on and select accordingly.

The bottom line is that there are a variety of health insurance options available. Examine plans carefully, especially in terms of coverage and total costs possibly incurred over the year. While nobody can predict their healthcare needs with complete certainty, making educated guesses will likely lead to selecting a plan with which you feel confident.