Choosing the right health insurance deserves careful thought and consideration. Some people rely on their employers for health insurance. But what happens if you don’t have a job? Here are the steps you can take to find the best health insurance option for your needs.
Get The Best Health Insurance
Tip: compare 2-3 companies
Step 1: Think About What You Need and Your Budget
Not all health insurance companies and plans are the same. The provider and plan you choose can make all the difference. Consider a number of factors to find the best plan.
First, you need to determine who in your family needs health insurance. Once you’ve decided who you need to find coverage for, you’re ready to move onto the next steps.
Consider Your Budget
Your budget matters. A few terms can help you understand the costs associated with your plan:
- Deductible: Each health insurance plan has a deductible assigned to it. The deductible is the amount of money you must pay for your medical services out of pocket before the insurance company contributes toward your care.
- Coinsurance: After you’ve met your deductible, your plan may charge coinsurance payments for each medical service you receive. You will see a coinsurance amount listed in the plan details. If your plan uses coinsurance, it means that you will pay a certain percentage of your medical services after you’ve met your deductible.
- Copay: Your health insurance plan may use copays instead of coinsurance. Copays are a set dollar amount that you pay for your medical services. Your health insurance company will pay the remaining balance of any covered services.
- Premium: Premium payments are the amount you pay monthly to keep your health insurance plan active. Premiums often vary depending on the level of coverage the health insurance plan offers. For example, if you pay a low premium, your plan may come with a higher deductible.
- Out-of-pocket maximum: Your health insurance plan will also come with an out-of-pocket maximum. This is the maximum amount of money that you will need to pay for your covered medical services throughout the plan year. Any money you pay out-of-pocket — including coinsurance and copays — will count toward this. If you meet your out-of-pocket maximum within the plan year, your health insurance company will pay 100% of your covered medical services until your plan expires.
The amount you pay for your health insurance plan may also depend on other factors, including your:
- Previous employer
- Household income
- Eligibility for a government-backed health care plan
Here are some averages to give you an idea of the different costs of coverage:
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Think About Your Health, Prescriptions and More
It’s important to consider your specific needs when you choose a plan. Some of the questions you may want to ask yourself are:
- How often do you think you might need to visit the doctor?
- Do you have preexisting or chronic conditions that require ongoing treatment?
- Do you have any prescription drugs?
If you visit the doctor often or receive ongoing treatment for a condition, this is something you should take into consideration. You might find that a plan with a higher premium but a lower deductible will end up being more affordable for you in the long run.
Review past invoices from your doctors to get an estimate of how much your medical bills cost throughout the year. You should also be able to review prescription drug coverage for each plan you consider.
Step 2: Figure Out if You Qualify for a Government-Backed Health Care or Plan from Your Old Employer
In some cases, you may be eligible for unique health insurance options. Through these options, you may be able to find plans that are more affordable or more tailored to your needs.
Can You Still Get Insurance Through Your Old Job?
You may still be eligible for health insurance from your previous employer if you recently became unemployed. This type of coverage is also referred to as COBRA insurance. You may be eligible for this type of coverage for up to 18 months if:
- You were covered by the employer-sponsored plan before you lost your coverage.
- Your hours were reduced, thus making you ineligible for employer-sponsored coverage.
- You quit your job.
- You were fired for any reason other than gross misconduct.
Do You Qualify for Medicaid, Medicare or Another Government-Backed Plan?
You may also qualify for government-backed insurance plans, including Medicaid and Medicare.
Medicaid is a joint federal and state program that offers health coverage to individuals and families across the United States. The rules for eligibility vary from state to state. Some of the factors that may determine your eligibility are:
- Family status
- Household size
- Household income
If your state has expanded Medicaid coverage, you can qualify for Medicaid based on your income alone. In these states, you will qualify if your household income is below 133% of the federal poverty level.
Medicare is a federal health insurance program. It is offered in multiple parts, each of which handles a specific area of health insurance coverage. You may opt in to government-backed Original Medicare or a Medicare Advantage plan. Medicare Advantage plans are offered by private insurance companies instead of the federal government. The availability of these plans vary depending on where you live. You may also want to look into Medicare supplemental insurance.
You may qualify for Medicare if you:
- Are 65 or older.
- Have a disability.
- Need dialysis or a transplant due to end-stage renal disease.
The Children’s Health Insurance Program (CHIP) provides low-cost health coverage to children of families that make more than the income limit to qualify for Medicaid. In some states, this program may also cover pregnant women.
Step 3: If You Don’t Qualify, Check Out the Private Marketplace
Don’t qualify for health coverage from your previous employer or from a government program? It’s time to move into the private marketplace. The Marketplace will show you options from private health insurance companies. You can compare your coverage options and find out whether you qualify for tax credits within the Marketplace.
As you evaluate your options within the Marketplace, you will see the monthly premium listed with each plan — the cost of your plan. The plans you qualify for and their costs will vary depending on:
- Out-of-pocket costs, including plan deductibles
- Where you live
- Whether you are applying for individual or family plans
- Your age
- Your household income
How to Pick a Plan Type
There are a few different plans you might come across in the Marketplace.
- Exclusive provider organization (EPO): With this plan, your medical services will only be covered if you use a provider that is within the plan’s network.
- Health maintenance organization (HMO): These plans tend to focus on prevention and wellness care. It usually limits coverage to care from doctors who work within your plan’s network.
- Point of service (POS): You can expect to pay less if you use health care providers within the plan’s network. It also requires you to receive a referral from your primary care doctor if you wish to receive coverage for a specialist visit.
- Preferred provider organization (PPO): You can also expect to pay less for your medical bills if you receive medical treatment from a doctor within your PPO plan’s network. You may also use doctors outside of the network without a referral for an additional cost. These plans usually do not require a referral for specialist visit coverage.
You may also see additional coverage options, such as dental insurance and vision insurance.
Apply and Sign Up for a Plan
After all of this, you might be wondering how to actually get health insurance.
First, if you think you may qualify for COBRA, speak with your previous employer. Otherwise, you can follow the links below:
You will need to provide general personal information when you apply for health insurance. You may also be asked for documents. Some of the documents that may be required are:
- Proof of identity
- Your yearly income estimate
Find the Right Plan for You
Take the time to consider your needs. Once you know the type of coverage you need, you can check your eligibility and compare your options.
Remember, the health insurance plans that are available to you and your eligibility may vary depending on which state you live in. Be sure to use your ZIP code when you compare plans to ensure that the plan you’re considering is available in your area.
Frequently Asked Questions
1) Q: Is health insurance required?
The federal mandate that required health insurance has been lifted but some states have enacted state-level mandates that require residents to have health insurance. Even where not required, health insurance can protect your family against catastrophic healthcare costs and help make routine medical expenses more predictable. Get your most affordable quote through our top providers today.
2) Q: What does health insurance cover?
Most health insurance plans provide the 10 essential health benefits that were part of Obamacare requirements. Coverages include preventive and wellness services, prescription drug coverage, emergency services, ambulatory services, lab services, pediatric services, and more. Many plans cover a wider range of healthcare expenses but may cost more than basic plans or may have higher out-of-pocket costs for some services.Get a custom health insurance quote to cover you and your family today.
3) Q: How can I save money on health insurance?
For healthcare plans that comply with the Affordable Care Act, only a handful of rating factors affect your premium. These include age and location, at least one of which can’t be changed. Smokers will pay more in most cases and your choice of plan level can affect premiums as well. Choosing a high deductible health insurance plan can reduce the cost of premiums. These plans can be combined with a health savings account to take advantage of tax-free savings for healthcare expenses. Get the cheapest health insurance premium from top providers.