Health insurance is the single most important type of insurance you'll ever buy. That's because if you don't have health insurance and something goes wrong, it's not just your money at risk, it's your life.
Health insurance is intended to pay for the costs of medical care. Many people get health insurance through employers who subsidize premiums, meaning the employer pays the bulk of your premium, and you chip in a little with each paycheck.If you don't have employer-sponsored health insurance, you'll need to buy health insurance on the individual market. Thanks to the Affordable Care Act, you may be able to buy subsidized insurance on a state or federal exchange and get tax credits that help you afford the cost of monthly premiums. The specific coverage you get when you buy health insurance depends which policy you select. Your options include:
Low-deductible health plans: Low deductible health insurance plans are plans that keep your out-of-pocket costs for care low. You will pay higher premiums for these plans, since they provide more coverage. Your costs are more predictable since you'll know what your premiums are up front and you never have to worry about paying thousands of dollars if you end up needing medical services. Â High-deductible health plans: High-deductible health plans (HDHPs) have low premiums, meaning you pay less up front each month just to be covered. But the trade-off is that you're responsible for covering routine basic care, because your deductible -- or the amount you pay with your own money before insurance kicks in to pay the rest-- is typically several thousand dollars. With many high-deductible health plans, you can open a Health Savings Account (HSA) and contribute pre-tax funds to it that can be used to pay for medical costs as you incur them.
Catastrophic health plans: Catastrophic health plans are the cheapest in terms of premiums, but provide virtually no coverage for care unless you incur many thousands of dollars in medical costs. The deductibles are even higher than that of a typical high-deductible plan. Â Health maintenance organizations (HMOs): With an HMO network, you are restricted to receiving care from a specific network of participating doctors. These doctors are referred to as being in-network and they have agreed to accept rates for care set by your insurance company. You will need a referral from a primary care physician to see a specialist. Most HMOs define "specialist" to include anyone other than your primary care physician. This could include obstetricians, dermatologists, psychologists, chiropractors, and more. Â
Preferred provider organizations (PPOs): With PPOs, you don't have to get a referral to see a specialist. And while care will be cheaper if you pick a doctor who is in network, you'll have better coverage for out-of-network care than with an HMO. Exclusive provider organizations (EPOs): EPOs don't require that you get a referral to see a specialist, but will pay nothing for out-of-network care except in emergencies.Point-of-service plan: A point-of-service plan pays for in-network and out-of-network care, although you'll pay more if you see a doctor out-of-network. A primary care doctor will need to make referrals to specialists when needed.
Try to match your policy to your care needs out of what's available and offered to you. If you're someone who doesn't incur a lot of health expenses, a high-deductible health policy may be the most affordable solution. But if you see the doctor often for any number of reasons, get a policy with higher premiums but more comprehensive coverage and a lower deductible, so you don't go broke paying for all your services. Every health insurance plan is required to cover certain basic services before your deductible is met, like preventative care. The law also mandates insurance companies cannot charge more for a health insurance policy if the person has a pre-existing condition. The price of health insurance is based upon your age, geographic area, and whether you're a smoker. Insurers are prohibited by Obamacare from considering your gender, race, or past medical history. Â
Without exception, absolutely everyone needs health insurance because even a minor medical issue can become extremely expensive. Major medical issues can come with astronomical costs, as a single hospital stay or surgical procedure could cost many thousands of dollars. You can sign up for health insurance only at certain times of the year during "open enrollment", Â which is a designated period when anyone can buy coverage, unless you have a qualifying event, such as losing coverage because of a divorce or job change. Visit Healthcare.gov to find out when open enrollment is on the Obamacare exchanges, or check with your employer to see when you can sign up if your employer provides insurance as a job benefit.
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