How To Get Affordable Health Insurance? A Helpful Guide To Health Insurance

Healthcare is becoming more and more expensive and unaffordable for the common person. To be able to afford the treatment of a disease, one needs to spend thousands of dollars. In this case, health insurance has become a necessity in life.

For the well-being of yourself or your family, it is important to get checked on a regular basis. Health should always be your priority. If you do not take care of your health, you will feel tired easily and have no energy to work on your requirements. Doctors always recommend people to get themselves checked more often so that if there is any detection of disease, the treatment can eradicate it in its pre-stage.

People buy health insurance to afford medical treatments. The health insurance companies exist to provide assistance in paying bills based on the plan you have selected. There are so many companies that sometimes it is hard to know how to get affordable health insurance.

The key to buying health insurance is to buy the one that is economical for you. Here is a complete guide on how to get affordable health insurance:

What is health insurance?

Health insurance is a type of insurance that facilitates an individual with medical benefits. The individual has to sign with the insurance company to utilize those benefits. There is a contract with agreed policies signed by the government, insurance company, and individual.

Health insurance has many benefits that can save a person from financial loss. Usually, people have to spend a lot of money on healthcare facilities. Health insurance offers these facilities based on monthly payments.

Health insurance includes surgery bill coverage, daily check-ups benefits, prescription drug discounts, dental and vision expenses. Each company has a certain percentage set in different plans that you can choose from based on your health needs. You must know how to get affordable health insurance from among these plans.

Health insurance can be bought by the individual personally, or a company can provide benefits to the employee. It is especially beneficial for those who suffer from a long-term illness because it covers the medical cost without any financial loss to the patient.

Some of the most important terms in health insurance that you must know as a newbie are as follows:

Premium: Premium is used in almost all insurance sectors. Premium means the monthly amount the insured person has to pay to benefit from the insurance plan. The pay is decided based on the plan you choose.
Deductibles: Deductibles are the percentage of the amount that the insured person has to pay before the insurance plan covers the cost of the medical bill. The less you will pay in your premium, the more deductible you get. The deductible can be of a certain percentage or dollar currency.
Copayment: Copayment is the fixed amount that the insured person has to pay after they have paid the deductible. The insurance company covers the remainder of the cost.
Coinsurance: Coinsurance is a certain percentage set by an insurance company that the insured person has to pay after they have fulfilled the deductible percentage to the service provider to receive benefits.
Out-of-pocket maximum: Out-of-pocket maximum is defined by the expense A young person’s health needs might not be as you have to pay with your pocket. After an insured person has spent all the percentage amount of deductibles, copayments, and coinsurance, then the insurance will cover the full expense for the year.

Why is health insurance important?

Health insurance is very essential in life. Many people might convince you that buying insurance is a waste of money but in truth, it is a smart way of living. If you are the type of person who keeps their funds organized by sticking to a budget, then health insurance is perfect for you and your family.

Health insurance prevents financial loss and maintains the monthly budget. Furthermore, in case of an emergency, you do not have to worry about finances because the insurance company takes care of it.

For the physical and mental well-being of yourself and your family, you should buy health insurance.

What does health insurance cover?

Health insurance is a big industry that every country offers to its citizens. There are dozens of health insurance companies in the U.S. that provide health benefits to American citizens. There is a public sector and a private sector; both work together or separately to facilitate people.

Health insurance covers all the necessities of healthcare in their plans. The most common services that every insurance company covers are

regular medical checkups
prescription drugs
preventive care and wellness services
medical devices and many more

There are other medical benefits provided by insurance companies based on the plans an individual chooses.

Some companies offer more than the benefits mentioned above, but that depends on each company. The key to gaining maximum coverage of services from an insurance company without any financial loss is to know how to get affordable health insurance.

How does health insurance work?

The procedure for health insurance is quite similar to every other insurance. An insurance company offers a wide range of plans that include benefits based on an individual’s medical needs.

It is important to know how to get affordable health insurance to ensure that you have the best plan that covers your needs. Health insurance can be hard to familiarize with because there are too many options and complications that a beginner might not understand clearly. You must be well-informed about the plans and coverages to choose the best health insurance for yourself.

Types of Health insurance

Health insurance types offered by companies are based on the medical benefits that are required for any individual. Medical professionals and experts sit together to design the best plans that are affordable and give maximum benefits.

As there are dozens of plans, each varying from one another, you should know the basic types of health insurance plans that every insurance company offers. By knowing about types of health insurance plans, you will know how to get affordable health insurance.

There are mainly four types of health insurance plans that you need to know:

Health maintenance organizations plans

HMO plans or Health Maintenance Organizations are a type of health insurance plan provided by insurance companies in America. This plan gives benefits to the insured person by providing services within the network unless there is an emergency.

Every insurance company has signed contracts with various hospitals to build an in-network organization where insured people can go to receive insurance benefits. HMO plan requires an individual or family to get treatment within the network of organizations given by the company to receive plan benefits.

HMO plan also requires an insured person to have a primary doctor for medical treatment. If the person needs treatment from a specialist, then they must get a referral from a primary doctor. The insurance plan will cover the cost only if the primary doctor provides a referral letter to the individual.

Furthermore, all HMO plans have annual limits, deductibles, and copayments that need to be followed by the individual. The out-of-pocket cost of the HMO plan is lower compared to other plans.

Preferred provider organizations plans

Preferred Provider Organization or PPO plans are one of the health insurance plans that cover the cost of medical treatment if the insured person goes to a large in-network organization of hospitals and medical professionals, except during an emergency. You can go to an out-network hospital too, but you will have to pay more out-of-pocket costs.

The difference between an HMO plan and a PPO plan is that a PPO plan does not require any primary doctor or referrals. You can go to any specialist, and the insurance company will cover the cost based on deductibles and annual limits.

The in-network organization consists of every health professional for which a person might need treatment.

Exclusive provider organizations plans

Exclusive provider organizations plans are a type of health insurance that has a large in-network of hospitals, compared to HMO plans. You might need to get a referral from the primary doctor to see a specialist, but it depends on the plan or insurance company with whom you have signed.

EPOs plans have a higher premium compared to HMO because they offer more facilities to the insured person.

Point-of-service plans

Point of Service or POS plans are slightly different from the three health insurance plans mentioned above insurance plans. This plan is a hybrid of PPO and HMO plans but gives more options for out-of-network medical services.

POS requires an insured person to have a primary doctor. You can only see a specialist if your primary doctor writes a referral letter to the insurance company; only then will the plan cover the cost. Furthermore, unlike PPO, you can have most of your expenses of the out-of-network hospital be covered by insurance if the doctor gives a referral. Otherwise, you have to get treatment within the network.

High-deductible health plans

High-deductible health or HDHP plans are offered to individuals with the facility to pay lower premiums for high deductibles. Most people open a Health Savings Account with HDHP so that they get tax-free deductibles. HDHP benefits people greatly by offering maximum advantages.

An HDHP plan can be PPO, HMO, POS, or EPO, based on the health requirement of the individual. This plan is usually offered to those who have serious health conditions and cannot afford the cost of treatment. By using HSA, they can get medical benefits through HDHP.

How much does health insurance cost?

Health insurance costs are affected by various factors. Every insurance company offers different benefits, so the rates vary a lot. However, you must know the factors that can affect the cost of an insurance plan to know how to get affordable health insurance.

The factors affecting health insurance include:

Age

Age is a big factor for insurance plans. Some health plans are designed for old-aged people, while some are designed for young people. The insurance companies ask for your age because they need to decide on the cost and the type of insurance plan that is best for you.

Health condition

The health needs of a young person might not be as serious as an old or middle-aged person. Health conditions are analyzed very deeply to know what insurance plan can fit an affordable individual.

If a person suffers from a long-term illness, they will have to pay more for an insurance plan than a person with mild disease.

Size of a family

If a person is buying health insurance for their family, then the size of the family can affect the cost of a health insurance plan.

If you are a family of 4, then the health insurance cost will be more for you compared to a family of 3.

There are other small factors defined by insurance companies that can affect the cost of an insurance plan, like gender, location, etc.

Health Insurance Marketplace

According to the Affordable Care Act, government agencies and insurance companies work together to provide maximum benefit to U.S. citizens. There are insurance companies in each state that are administered under the law to benefit people. It is also known as ACA health insurance plans.

Health Insurance Marketplace is a platform that facilitates people in finding the right health insurance plan depending on the state or city they live in. Every health insurance plan that fits the budget and requirement of the individual is available on the Marketplace.

You can know how to get affordable health insurance through the Marketplace easily. It is easy to browse through for comparing prices and studying the medical benefits of each insurance plan.

Uses of Health Insurance Marketplace include:

Comparing health insurance plans offered by various insurance companies for an affordable cost
To know the coverage percentage of the plan and the estimated premium for it
Answers to all questions regarding health insurance
Eligibility criteria for health insurance programs provided by the government
Apply for a perfect plan based on your needs.

Eligibility for Health Insurance Marketplace

Health Insurance Marketplace is available to all legal U.S. citizens belonging to all states. The Marketplace was basically created under the Obamacare program to facilitate Americans in healthcare. The law has gone through many modifications, and so has the Marketplace.

The eligibility criteria for Health Insurance Marketplace is to be a U.S citizen and live in the U.S. If you are not enrolled in Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP), then you can apply through the Marketplace.

Individual health insurance

Health insurance is necessary for every individual to live a healthy life. People usually forget about taking care of their health or going for health checkups; health insurance gives them the opportunity to keep track of their body condition with time.

Young people usually don’t care about their health, which can cause problems later in life. Therefore, regardless of age, every individual is permitted to have health insurance. Many countries have made it compulsory for adults to buy health insurance as a law.

Buying individual health insurance can be tricky; you should know how to get affordable health insurance. You can easily find an insurance plan from the Marketplace.

Cost for individual health insurance

The cost of individual health insurance can vary based on the plan they choose. Every person has different medical needs, and the factors mentioned earlier also affect the cost of individual health insurance.

The national cost of health insurance for an average individual is $456 per month. The cost can vary if they buy from a private insurance company.

Family health insurance

Providing health insurance for a family is very important. Every member of the family has different needs, so the health insurance plan is designed in a way that fulfills all requirements that are common in families.

Insurance companies use data collected from their members to understand the medical needs in a family to design the plan. Furthermore, medical professionals are also involved in this process.

Whether you choose an HMO plan or a PPO plan, every plan has family health insurance. You can know how to get affordable health insurance if you go through the Marketplace.

Cost of family health insurance

The cost of a family health insurance plan is more compared to an individual’s. According to recent statistics from 2020, the average cost is around $1,152.

However, this cost can increase or decrease based on family members and medical needs. You can compare the cost through the Marketplace.

Health Savings Account

Health Savings Account (HSA) is provided by the federal government to American citizens for health insurance costs. The ACA facilitates its citizens with HSA. The savings account prevents financial loss and helps in saving up money for healthcare costs. This account is pre-tax money, so you save yourself from paying extra expenses. Furthermore, you can then know how to get affordable health insurance.

Every individual can open their health savings account and link it with their debit card. The funds transferred in this account can only be used to pay for deductibles, coinsurance, or copayments for health insurance. This makes health insurance plans affordable.

HSA features health plans that deductibles with high percentages or amounts. The federal government decides the high deductibles every year. The account enables you to separate your health expenses. Therefore, we recommend opening an HSA account for financial savings.

Best affordable health insurance plans

Choosing a health insurance plan from Marketplace can be quite hard because you need to buy the one that is perfect for you and fits your budget. Health insurance plans are offered by different private and public insurance companies.

To know how to get affordable health insurance, you need to consider a few things.

Premium and annual cost

The annual cost of each insurance plan varies. This is based on the annual limit set by the different insurance plans; you need to be sure that you can reach it or fall near it, to benefit from the coverage.

Premium determines the coverage percentage for each plan. So, the more premium you pay, the more your coverage percentage increases.

To buy the best affordable insurance plans, you need to see your income that can afford the monthly premium and the annual cost based on medical needs.

Coverage and metal categories

The Health Insurance Marketplace has metal tiers–bronze, silver, gold, platinum, that have different coverage levels. Each coverage contains a deductible limit, out-of-pocket maximum, and copayment details.

Bronze

Bronze is the cheapest and most basic coverage metal category offered by insurance companies. In this category, the insurance plan covers the cost of accident injuries of the insured person. Furthermore, the deductible is high, so most of the cost is out of your pocket.

The monthly premium is the least expensive, so anyone with minimum wage can buy this affordable plan. The insurance plan can cover 60% of the medical expense; the remaining 40% is paid by you.

Silver

The silver metal category is slightly higher than the bronze standard. In this category, the insurance plan covers 70% of the cost for medical expenses like preventive care, prescription drugs, etc. The remaining 30% comes from your pocket.

This coverage level is quite cheap and affordable for any individual who has a low wage.

Gold

The gold category is higher than silver and bronze. It is an affordable premium with coverage of 80%; the 20% bill is paid by you. The gold category gives many benefits, and it is easier to get expensive medical treatments.

If you have a good salary, this category is perfect for you.

Platinum

The platinum metal category is the luxury coverage for people who need extra medical attention and can afford a high premium. The deductibles are the lowest, so you only pay 10% out of your pocket for the medical expenses.

This plan is ideal for those who need constant medical checkups or have to afford expensive prescription drugs. The insurance covers the most cost for a premium that you pay on a monthly basis. The annual limit is also convenient for the insured person.

Each coverage metal category is designed to facilitate the insured person in medical treatments. Health insurance makes it easier to afford surgeries, preventive care, and other expenses. You just know how to get affordable health insurance for the least financial loss and maximum benefits.

How to apply for health insurance?

Now that you know how to get affordable health insurance, you can apply for a health insurance plan that suits you best. Each state has different insurance companies that are administered under the federal government. So, to know the one that is available in your state, you have to search through the health insurance Marketplace.

There are many options to apply for health insurance. Insurance companies give the facility to apply from home, through an agent, or on a phone call.

The official documents needed to complete the health insurance application include:

– Age

– Citizenship

– Income history

– Military service

– Social Security Number

– Date and place of birth

Apply online

Busy life often prevents us from doing basic or official work physically. Insurance agencies give the facility to apply online in the comfort of your home or office. Some companies require you to apply online and wait for their operators to call you, while some require you to upload soft copies in the application and select a program through the website after approval.

You can find out more details about applying online by visiting the healthcare.gov Marketplace. It comprises all insurance companies with plans that are available for your state and how you can apply for them.

Agents

Insurance agents exist in every state. They are experts in selecting the best plans based on your income and health condition. Although they will ask for a certain commission, it saves time and worries for buying the best health insurance plan.

Agents are officially assigned by insurance companies, and some also work privately. You can choose either and apply for health insurance easily.

Phone call

Some of the insurance companies provide the facility to apply through phone as well. You can find the official phone numbers online through the website.

The call operators tell you how to get affordable health insurance and help you apply. Just make sure that you have your official documents on hand because they ask for details to tell you about the best health insurance plans that you can buy from the Health Insurance Marketplace.

Conclusion

Health insurance should always be a priority for every individual or family. The data from insurance companies show that mostly old people buy insurance to facilitate medical treatments. However, it is important for young and middle-aged people to buy insurance as well.

Health insurance is a smart way of saving up and valuing your health. Instead of spending money on useless things, invest in your health to live a carefree life.

This article on how to get affordable health insurance is a helpful guide to buying health insurance for yourself. Apply for health insurance today!