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If you’re in the market for individual or family health insurance, you probably have a concrete idea of what you need. However, your search for insurance may not always yield results that are as cost-friendly altogether, so you need alternatives to compare.
We often look at alternative insurance as a way to save a few bucks, but you shouldn’t assume that they’ll provide conventional medical coverage or apply to you outright. Before you sort through the available health insurance alternatives, our quick guide will prime you up with the inside scoop.
Benefits of Insurance Alternatives
Health insurance plan alternatives offer the kind of flexible, affordable coverage you need for the dynamic times of change in your life. Other benefits of insurance alternatives include:
- Fast coverage, sometimes as soon as the day following your application.
- Access to a vast network of health care professionals.
- Get generally lower premiums than with ACA plans.
- Drop coverage without a penalty
Risks of Insurance Alternatives
As earlier mentioned, you shouldn’t assume that your insurance alternatives will provide the medical coverage traditional plans avail. Alternative plans aren’t necessarily state-regulated, and they must not conform with the Affordable Care Act (ACA) guidelines. Unlike traditional plans, alternative plans:
- May not cover all illnesses, including chronic and pre-existing conditions.
- May have longer waiting periods to enroll, disburse less for each medical service and limit their total annual payments.
- Don’t let you get federal assistance — such as cost-sharing reductions and tax credits — to lower your out-of-pocket costs and premiums.
Sure, health insurance alternatives differ from the major medical plans, but can be smart choices and worth the time. Shopping smart can help you find the right alternative health plan. Start by researching the coverage options and common exclusions for the alternative. You may also consult your doctor or insurance broker to ensure a plan will meet your needs.
Here are our recommendations for the best insurance alternatives you’ll want to explore.
Primary Care Memberships
You probably spend $200 per month on a fancy cable TV package, the golf course, or a gym membership; why not spend the same for what you’d consider exceptional primary care? Otherwise known as concierge care plans, primary care memberships are alternatives that let you access primary care services directly from a physician without an insurance provider as a middleman. In return, you’ll pay a flat monthly or annual fee.
The membership fee you pay lets you access a wide range of primary care and medical administrative services, including exams, consultations, care coordination and some laboratory services without incurring any extra costs at the time of service.
The direct primary care framework eliminates the need for the traditional system of 3rd party insurance coverage for primary healthcare services. The result is unrestricted access to physicians of your choice, little to no wait time and appointments, often for fees as low as $70 per month.
With zero out-of-pocket costs at the time of service, you’re less likely to skip obtaining care due to costs. Combined with the increased time physicians spend with a patient, primary care memberships could help thoroughly address your primary care needs as soon as they arise.
And since your doctor no longer has to worry about your insurer covering telehealth services, most primary care memberships avail care through phone calls, video chats or email — which is more convenient than endless in-person consultations.
On the flipside, your primary care membership won’t cover medical services that extend beyond primary care, including surgery, specialty care, emergency care and inpatient care. Since these things can quickly get out of your reach, primary care programs often recommend that you carry a major medical health plan.
Designed for both families and individuals, short-term health insurance provides an affordable safety net while you’re switching between life events and don’t carry a comprehensive health plan. Short-term insurance is a great option if you missed Open Enrollment, are transitioning between jobs or coming off your parent’s coverage.
Coverage from short-term insurance varies depending on your plan and the insurance carrier you buy from. Term lengths also vary by state — you can apply for 1 up to 12 months of coverage. You can’t extend coverage but can apply for another short-term plan altogether.
Short-term plans are not mandated to comply with the Affordable Care Act guidelines, including providing the minimum essential coverage. You can expect some level of coverage for doctor visits, preventive care, emergency care, prescriptions and urgent care. These plans use simple underwriting to assess your eligibility for coverage and carry blanket exclusions on pre-existing conditions.
Short-term plans generally carry lower premiums than ACA health plans, coverage takes effect almost immediately and you can drop coverage without a penalty if a more long-term solution comes along.
Sure, you can save money through a short-term plan, but it shouldn’t be at the expense of a rush decision. Be sure you know what you’re buying, and that it’s a great choice for your situation.
Ask for Discounts
Sometimes, getting affordable alternative coverage is as simple as asking for it. You’ll want to go this route if you find yourself cash-strapped. Insurance carriers often negotiate discounted rates with healthcare providers, but they may not avail these rates until you ask. For instance, you may shave some costs off your insurance plan if you’re willing to pay your full premium upfront.
Many doctor’s offices will also offer discounted rates if you don’t already carry insurance. Some insurance providers will also extend coverage discounts if you’re involved in a wellness, health management plan or gym membership.
Health Savings Accounts (HSA)
A health savings account (HSA) is like a financial savings account, except you put money pre-tax and it later goes toward paying for qualified health care expenses. You can lower your overall health care costs by using the money in your HSA to pay for copayments, coinsurance and deductibles. Other HSA-qualified medical expenses include:
- Preventive care
- Doctor visits
- Medical equipment
- Most dental care
- Most vision care
- Lab tests
- Physical therapy
- Hospital services
- Prescription drugs
You must enroll in a high-deductible health plan (HDHP) to qualify for an HSA. Once you set up your HSA, you can start contributing to it, just as you’d do with any other personal bank account. You’re in full control of the account, but your employer may add some money. Health savings accounts have no use-it-or-lose-it policy — your funds roll over through the years and you don’t lose your money regardless of whether you retire or leave your job.
High-Deductible Health Plans
When it’s time to enroll into a health insurance plan, a high deductible health plan may be a great alternative to manage your health care expenses. HDHPs are health plans that typically carry a lower monthly premium at the expense of a deductible higher than what traditional plans offer. In this case, you’ll pay for more of your health care service before your insurance plan covers the expenses.
The tax law mandates that HDHPs set a minimum deductible and maximum on all out-of-pocket costs. For the calendar year 2021, the HDHP amounts are as follows:
- Individual HDHP: A $1,400 minimum deductible and $7,000 maximum out-of-pocket costs.
- Family HDHP: A $2,800 minimum deductible and $14,000 maximum out-of-pocket costs
Pair a HDHP with a health savings account to pay the deductible amount plus other medical expenses with the money in your tax-free account.
Be sure to consider your anticipated health needs when weighing between a high-deductible health plan and a traditional plan. You’ll reap the benefits of lower monthly premiums from a HDHP if you don’t have many health care needs.
The Next Steps Toward Saving Money
Traditional health insurance plans may provide comprehensive coverage, but their premiums may not fit your budget. One of our recommended recommendations may provide the protection you need without breaking the bank. Just be sure to understand what it does — and doesn’t — cover. For the right situation, alternative health plans can provide fast, flexible and temporary coverage that fits your needs.
Frequently Asked Questions
Can I choose not to use my insurance?
Insurance is supposed to cover your medical costs when you’re sick or need to see a doctor. However, you can choose not to use insurance if you can meet all medical expenses and services out-of-pocket.
Can hospitals turn away patients without insurance?
Public hospitals cannot refuse care if you don’t carry insurance. However, private-owned hospitals can turn you away in a non-emergency. As a result, a public hospital is the best option if you don’t have health insurance or a means to pay for medical care.