How to Get Health Insurance
It’s hardly possible to discuss healthcare without mentioning costs. Bills for medical care are often the leading cause of bankruptcy in the US. And for this reason, the majority of people often search for better healthcare services at lower costs. But it’s rarely possible to get quality healthcare at inexpensive value unless you have medical insurance. Therefore, whether you are a citizen or a green card holder, having medical coverage in the US will come in handy when you least expect.
So, where do you start to get your health insurance?
Before getting health insurance, there are certain factors you must first consider to ensure you make the right choice. The following below will cover a majority of the type of person and health plans that are for you.
Which group is for you?
If you are working in the US military service, then there is no need to worry about getting medical insurance coverage for your family. TRICARE will cover you and your family. It is medical coverage that is provided by the employer in the military service.
When you are at a ripe age of 65 and above, you are the right candidate for Medicare. Medicare is an active program from the federal government that serves to provide healthcare coverage when you are old. But before Medicare starts working, supplementary insurance will come in handy in taking care of your deductibles, coinsurance, and copayment.
Pregnancy, childbirth, and maternity care are among the essential benefits of a health plan that is qualified to be under ACA. You may not be aware, but once you have enrolled in your preferred healthcare plan, this service is covered even before your medical coverage begins.
Pregnancy also counts as an exceptional circumstance that qualifies for a period of special enrollment. You can switch your previous plan for a new or enroll a new plan if you don’t have medical coverage.
Additionally, if you are the right candidate for CHIP and Medicaid, and you are pregnant, you can apply for either of them. They also cover childbirth and Maternity care bills. CHIP registers through the marketplace or state agency.
Married with no kids
When you are married but no kids, you have the option of either enrolling for family plan coverage or individual plans. In this case, you can discuss with your spouse and choose an option that suits you both. It is also possible for either of you to rely on the employer’s health plan of the other in case it’s available.
If you are a veteran, you don’t need to apply for other forms of health care. Trough the Veteran Affairs department of the US, you can apply for medical insurance coverage. The health benefits of VA are not affected by the mandate of ACA health insurance; therefore, you are free from enrolling in one.
But if you are enrolled in healthcare coverage by an employer in the private sector, you can use both to cover your medical expenses.
If the income you are currently earning is low and not sufficient to cover your medical coverage, then consider Medicare. Check to confirm if you are eligible for the program first. Medicaid is an insurance healthcare plan that caters to qualified low-income families or individuals.
But if your income falls between the federal poverty ranges of 100% – 400%, then you have a chance of qualifying for a subsidy. The subsidy comes in handy in reducing the cost of your health insurance.
If you shift from being employed to self-employment, you have two options when it comes to your medical coverage. Its either you proceed with your employer coverage through the use of COBRA until you enroll in a new plan. Alternatively, you can shop for further medical coverage on the marketplace by using the period of special enrollment. Special enrollment is only available when the enrollment period closed. In this case, you will need Health Insurance Agent Coverage Map to guide you through on making the right choice. You have to remember that self-employment is not income assuring as being employed.
If you are 26 years below and you need to get health insurance coverage, you have several options at hand. First, you are eligible to rely on your parents’ healthcare coverage until you are above 26 years. You can decide to check with the healthcare plan of the University that can be more affordable. Student qualified insurance is very important, especially if the institution is out of the state that you are parents are residing.
You can either opt for family deductible or individual deductible plus family deductible for each family member. You can choose either of them depending on the expense you need to incur. Generally, different deductibles are lower as compared to the family deductible. But irrespective of what you choose, there is an essential factor that you have to consider. When a total deductible amount is met, coverage begins for every family member. The total amount spent is added to all members. On an individual plans deductible, the insurance coverage begins for the family member who’s deductibles are met.
Which Types of Health Insurance Coverages are Available?
In general, we have only two types of insurance coverage to select. They include public medical insurance and private medical insurance coverage. The two categories are modified into various subcategories to make the coverage more specific and convenient to the clients. Below are the major options you can select depending on your needs and financial capabilities.
3rd Party Health Insurance
With off-exchange private medical insurance, you can purchase the coverage directly from the insuring company, from a marketplace that’s privately run or from a broker who is the third party. Whichever the off-exchange coverage that you may opt for, it has to have the 10-essential benefits and must follow the Affordable Care Act mandate.
With off-exchange plans, subsidies do not apply. With off-exchange, both you and the insurer have flexibility when dealing with healthcare plans. For example, since the insurers are free from offering coverage at each tier, they are free to provide a single type of medical coverage. If you are shopping for insurance coverage but you are not eligible for a premium tax credit, the exchange offers you with the various options at affordable prices.
Government Marketplace (Obamacare)
Government Marketplace healthcare plans are those sold through government-run exchanges, such as healthcare.gov or state exchange. This option provides you with 10-essential benefits, additional services, and it follows the Affordable Care Act mandate. Also, if an insurer needs to participate in On-exchange, plans will be necessary at each metal tier.
When you enroll in on-exchange, you are eligible for subsidies if you are qualified to receive them. Also, they are the only healthcare coverage that allows cost-sharing reduction and premium tax credits. Therefore, this is a great healthcare plan to enroll in if you are eligible for subsidies such as premium tax credits.
Short-term Health Coverage
When you need temporary healthcare coverage, then Short-term Health coverage is the best choice. Also note, the medical coverage from short-term insurance has limited benefits. This form of coverage does not qualify for health coverage.
It only comes in handy when you need to evade the tax penalty and fulfilling the ACA mandate. Nonetheless, it is helpful when you need short health insurance of about 1 or 2 months. It can be one of those scenarios where you have a new job, and you are still waiting for the medical coverage to kick in.
You may realize that many large medical insurers do offer short-term plans. However, be aware that the short-term plans come with limits that are absent from the regular healthcare care coverage. Hence only rely on them when you need short gap coverage.
Employer health insurance
Employer Health Insurance also known as group plans, is private healthcare coverage that is bought and managed by the employer. They also follow the primary mandates of health insurance coverage like any other private insurance plan. Employer Health Insurance includes the 10-essential benefits and also supports the Affordable Care mandates.
Thus if you are qualified for the employer healthcare coverage, there is no need to enroll in another plan. Contact the company’s human resources department and inquire for specific details about the coverage and what it entails.
By any chance, if you are above 65 years or trying to get health insurance for such a person, then Medicare is the way forward. It’s a government program that caters to medical covers of the elderly who are above 65 years of age. The enrollment into this program requires age eligibility only and does not involve income level.
Coverage contains four parts placed into two categories. Part A, B, and Part C and D. Small premiums or taxes are used to pay A & B while C & D are catered for by the client. This program is applicable through a state exchange or healthcare.gov.
Medicaid and CHIP (Children’s Health Insurance Program)
If you have financial strain due to low income and medical bills, then Medicaid will relieve a bit of finance stress from you. Medicaid is a medical insurance program of the state and federal government. The main program’s role is to assist families or individuals with low incomes.
Thus, you can only be eligible for this health coverage when you are earning low and your low liquid assets. To confirm your eligibility, complete registration through a state exchange or healthcare.gov.
CHIP, on the other hand, is also a medical insurance program of the state and federal government. But in this case, it covers specifically under-18 year children. The main focus of the program is to cater to children who are under 18 years if you belong to a family that cannot afford private medical insurance but has income too high to be eligible for Medicaid.
Similar to Medicaid, you can also confirm your eligibility for CHIP through a state exchange or Healthcare.gov. But if the information is still unclear, you can click here for a much better understanding and also assistance on the way forward.
How much should you pay?
When you are getting health insurance coverage, it is essential to note that certain factors will determine what you will pay. We’ve summed up the features into five major categories. For more information, click here.
Premium is likely monthly bills that you need to take care of by paying the insurance company. It’s what ensures you have access to the insurance coverage. Premium is not equal to what you will pay directly to health services. Therefore, if you choose a lower premium plan, you will most likely spend more from your pocket.
The amount of money you will incur from your pocket before the insurance coverage kicks in. Dealing with health covers that have low premiums tend to cause higher deductibles.
A copayment is a given fixed charge for specific prescriptions and services when you enroll for medical coverage. It is a means of cost splitting when you attain your deductible. In some cases, there is copayment even before you reach the maximum out-of-pocket limit.
Coinsurance, you split the cost with the insurance company. The amount spent isn’t fixed. Instead, it’s a percentage of what you are paying for the services being covered. For instance, if you have a coinsurance of 40%, then what you will pay as the cost of service included until you attain the maximum out-of-pocket limit is 40%.
Out-of-pocket maximum amount
Out of maximum pocket, the amount is the maximum amount of money you can pay out of your pocket in a year for a given service that is covered by your health insurance. Its primary role is to protect the client. Before, there was no limit, and this meant the clients could receive an unlimited amount of medical bills.
How to choose the Health Insurance
Learning the various types of healthcare insurance is essential, but that is just the tip of the iceberg. The real challenge comes in when you need to select the right health insurance coverage. Making the wrong selection of the coverage will not only hurt you financially, but it’s also risky health-wise.
The coverage is meant to protect your health as an individual and also your family if it’s group coverage. Therefore, you need to be particular about what you are enrolling in as your medical coverage. In this case, you need a professional agent, and not just any agent, you need the one with assurance in service delivery, both in quality and on time.
Due to this reason, our website of health insurance agents are at your disposal to ensure you get only the best. Our main objective is customer satisfaction through the provision of top-notch quality services. In this case, we have a lineup of best professional agents who are a call away from serving you. They are equipped with resources to ensure you receive only the best, and they also have years of experience to ensure you get the right coverage. Just click here, and let’s get in touch.