Health insurance can protect you financially if you’re involved in an accident or get sick and need to go to the hospital. But if you don’t have health insurance through your employer, how can you get covered? Today, we’ll show you everything you need to know about individual New Hampshire health insurance.
Get Health Insurance in New Hampshire
Tip: compare 2-3 companies
The Best New Hampshire Health Insurance:
- Best Overall: Celtic Insurance
- Best Customer Service: Harvard Pilgrim Healthcare
- Best for Claims: Anthem BCBS
- Most Affordable: Humana
- Best for Health & Vision: Delta
What is Health Insurance?
Health insurance is a type of coverage that protects you from high medical care costs. When you have health insurance, your insurance provider pays a set percentage of your medical care bills. Without health insurance you could end up with a bill for hundreds of thousands of dollars if you’re involved in an accident or need to stay in the hospital.
Though it’s no longer a requirement that you have health insurance, it’s not a good idea to go for long without some type of coverage.
Though most Americans get their health insurance through their employer, it’s possible to buy insurance through the Affordable Care Act (ACA) Marketplace. You can access the Marketplace by making an account at Healthcare.gov. Once you enter a little information about yourself and your income, you can shop for plans on the Marketplace.
When you shop, you’ll probably notice a few industry-specific terms. Understanding health insurance lingo helps you better understand how much your plan will cost. Some terms you need to know include:
- Premium: The amount you pay to your insurance company every month to keep your coverage active. Your premium is due every month, even if you don’t use your benefits.
- Deductible: The dollar amount you must spend on your own medical care before your insurance starts covering your care costs.
- Coinsurance: The amount you pay for your health insurance after you meet your deductible, expressed mainly as a percentage. If you have a 10% coinsurance rate and you get a $100 doctor’s bill, for example, you’ll pay $10 and your insurance will cover the remaining $90.
- Out-of-pocket maximum: The highest dollar amount you’ll pay for your medical care in a single year. Once you hit your maximum, your insurance provider covers 100% of your care costs.
Average Cost of Health Insurance in New Hampshire
The average resident of New Hampshire pays about $496 each month for an individual health insurance plan. If you have a low income, you might qualify for a government subsidy that lowers your insurance costs. Create an account at Healthcare.gov to find out if you qualify.
Types of Health Coverage
When you compare plans, you’ll see a number of different plan types available. The differences among these plans usually have to do with which healthcare providers you can see. Some of the most common plan types you’ll run into include:
- Health maintenance organizations (HMOs): HMO plans only allow you to use your insurance benefits with healthcare providers who are inside the plan’s network of approved providers. With an HMO, you must choose a primary care provider, stay within your network and get a referral before you see a specialist. HMO plans are the most affordable type of long-term health insurance.
- Preferred provider organizations (PPOs): PPOs give you the most freedom to control how you use your insurance. PPOs allow you to see both in-network and out-of-network service providers. You also usually don’t need to choose a single primary care provider, nor do you need a referral to see a specialist. PPO plans are usually significantly more expensive than HMOs.
- Point-of-service (POS) plans: POS plans function as a combination of an HMO and a PPO. With a POS plan, you can see any doctor you like — but you pay less when you stay in network. You also usually need to get a referral to see a specialist.
What Does Health Insurance Cover?
The ACA established a list of 10 essential benefits that every insurance provider must offer on each of its ACA plans. These benefits include:
- Preventive care and wellness services: This includes things like annual checkups and chronic disease management treatments.
- Prescription drugs: Every insurance provider needs to offer some form of coverage for prescription drugs. Insurance companies aren’t required to cover specific medications. If you’re currently taking a certain medication, check and make sure that your plan covers it before you enroll.
- Emergency care: Services like emergency room treatments and surgeries after trauma are included. In a true emergency, you should always visit the closest emergency room. Legally, your health insurance provider cannot force you to contact them before you seek emergency care, nor can they charge you more for using an out-of-network emergency room. This rule applies no matter which type of insurance plan you have.
- Hospitalization: Your insurance company needs to cover surgeries and treatments you receive in a hospital setting.
- Ambulatory patient services: This includes treatments and services you receive without being admitted to a hospital.
- Mental health services and addiction treatment: Both inpatient and outpatient mental health and addiction treatment services are included. Your insurance company cannot put a specific limit on mental health benefits that don’t apply to other plan areas. For example, it’s against the law for your insurance provider to charge a higher coinsurance percentage for attending psychotherapy.
- Rehabilitative and habilitative services: This includes services like physical therapy and mobility assistive devices like wheelchairs and crutches.
- Laboratory services: This includes lab tests and bloodwork.
- Pregnancy, maternity and newborn care: Your insurance must cover treatments for health complications during, before and after your pregnancy.
- Pediatric services: Your insurance provider must cover all the above services for any children enrolled on your plan. Children must also have dental and vision benefits on your plan.
If you’re a woman, you’ll also receive birth control benefits if you have an ACA plan. Your plan must cover physical birth control methods (like diaphragm and IUD) as well as hormonal methods. Your insurance must also include coverage for emergency contraceptives like Plan B (sometimes called the “morning after pill”). If you get your insurance through a religious employer, you may not have access to all of these benefits.
What Does Health Insurance Not Cover?
No matter if you have the more extensive or the most affordable health insurance plan on the market, you won’t have coverage for everything. Here are a few areas where you’ll likely see exclusions.
- Male birth control: The ACA dictates that insurance providers only need to cover female birth control methods. Male birth control methods (including condoms and vasectomies) are rarely covered.
- Experimental treatments: Experimental treatments or treatments not approved by the FDA typically aren’t covered by health insurance plans. This exclusion often extends to chiropractic care and acupuncture.
- Adult dental and vision services: The ACA only mandates that these services be provided to children. You’ll need to buy a separate dental and vision plan if you want coverage for adults on your plan.
- Weight-loss programs and bariatric surgery: There is no federal mandate that requires insurance providers to cover weight loss surgery, even when deemed medically necessary.
- Abortion services: There is no mandate that requires ACA plans in New Hampshire to cover abortions. Though your insurance provider may choose to extend coverage to abortions, most plans don’t include coverage for these services. Emergency contraceptives are not the same thing as a medicinal abortion.
Best Health Insurance Providers in NH
Now that you understand how the health insurance marketplace works, let’s take a look at a few of the best health insurance providers offering plans in New Hampshire.
1. Celtic Insurance Company
Celtic Insurance is an insurance provider offering both individual and family plans on the ACA Marketplace. Individuals or families who buy a plan through Celtic gain access to Ambetter’s directory of doctors and specialists.
Ambetter’s partnership with Celtic allows for a wider range of plans, including specialized plans for self-employed individuals. Most of its plans include HMO coverage, which can be especially beneficial if you’re looking for the most affordable coverage available.
2. Harvard Pilgrim Healthcare
Harvard Pilgrim is a nonprofit health insurance provider offering both individual and family plans on the New Hampshire insurance marketplace. Many of its plans include $0 copays for annual flu shots and physicals, and many options also include up to $300 reimbursements for annual gym or fitness memberships.
If you want coverage for acupuncture or chiropractic care, definitely consider a plan from Harvard Pilgrim. Many of its plans include these often-excluded treatments.
3. Anthem Blue Cross Blue Shield
Anthem Blue Cross Blue Shield offers a wide range of coverage choices in New Hampshire. Though it has a variety of HMO and PPO plans available on the ACA Marketplace, it also offers Medicare supplemental plans for older men and women and those on disability.
You can find individual and family plans that cover up to 80% of your costs after your deductible. Blue Cross Blue Shield also offers plans for men and women under the age of 26 and dental plans for anyone to add onto their ACA-compliant plans.
Unfortunately, Humana doesn’t currently offer ACA-compliant plans in New Hampshire. However, if you want to add dental coverage to your individual or family health insurance plan, Humana might be a great choice for you.
Humana offers some of the most affordable dental insurance on the market, with options beginning at just $19 per month in most parts of the state. Its dental insurance coverage includes low deductibles — individuals pay $50 per year, while families pay $150.
If you’re looking for a cheap way to add dental insurance to your ACA plan, Humana could be the right choice for you.
5. Delta Dental
Delta Dental is a nonprofit organization that offers dental insurance plans in New Hampshire. Its partner company, DeltaVision, also offers affordable vision insurance options as well. Delta Dental plans are available in most parts of New Hampshire from $30 per month, while vision options are available from $20 per month.
If you need to add both vision and dental insurance to your plan, a comprehensive policy from Delta might be the best option for you.
Protecting Your Health in New Hampshire
With so many different terms to memorize and steps to follow, you might still be a bit confused on how to get health insurance if you need an individual plan. Begin by heading over to Healthcare.gov and creating a Marketplace account. Once you’re signed in, you’ll see specific plan options you’ll have access to, as well as any subsidies that you qualify for. This site will give you a better understanding of what you’ll pay for insurance and how you can enroll.