Amidst all economic shifts in the past two to three years, people have health insurance on top of their minds. Are you also looking for a plan with basic coverage at affordable rates? Read this article to know about the affordable insurance plans for you and your family.
There have been a lot of changes in the past decade when it comes to health insurance plans, especially after hitting covid-19. You will find the sheer volume of information online, which can be overwhelming and, in some cases misleading as well. However, with brief and understandable information on well-reputed blogs or government sites, or insurance companies’ sites, you will get affordable health insurance.
You might catch yourself in surprise about how expensive the cost of health insurance is in the United States now. However, the cost is not the only challenge for navigating health insurance; the complex system also perplexes them. Health care can be confusing and expensive, but having affordable health insurance coverage can help you avoid unfortunate medical expenses in emergencies or unexpected accidents. It can also lower the cost of your prescriptions, surgeries, and routine doctor visits and provide peace of mind.
A health insurance plan covers your health expenditures for preventive health screenings, illnesses and injuries, procedures, prescriptions, and more. Often, you can enroll in a plan through your employer, but there are individual health insurance plans available that you can select and pay for yourself.
When selecting a health insurance plan, people often search, “Where can I find affordable health insurance?” Hence, it is vital to understand all your available options before deciding. Here’s a breakdown of information to grasp when determining the best and low-cost health insurance plan for you.
Where to get free or affordable health insurance?
You can potentially get health insurance through several different sources in the US. Insurance can be provided by the government or by your job or university. You can also buy it from a private health insurance company. Before exploring your options, you should know that health insurance is never really free and is rarely low-cost. If your health insurance is free or low-cost, it means that either:
- Someone else, such as any government organization, pays part or total of the plan’s monthly premiums for you. This is called subsidization. Usually, subsidies come from your job or the government. Having a subsidy means that you will not have to pay the total cost of the insurance yourself. If you qualify for subsidies, it is a great way to get health coverage that fits your budget.
- Reduced plan’s benefits. The coverage you are buying does not cover very much in this case. In other words, it is not comprehensive health insurance. Less comprehensive coverage can look appealing at first glance, but it might not be enough to help you if you have a significant medical claim.
Let’s present you with an overview of several options to get affordable health insurance. Through this, you will also learn about eligibility criteria, how to apply and what to expect from each plan.
Medicaid is a social welfare program that provides government-based health insurance to low-income people. The insurance covers many services, which means that it’s comprehensive. In most cases, Medicaid is free health insurance for people who qualify. However, a few states charge small premiums for people on the higher end of the Medicaid-eligible income scale. In addition to no premiums, there is no or minimal cost-sharing, for example, deductibles or copayments.
Who qualifies for medicaid?
Medicaid works differently in each state. As it is specifically for people with low-income, you must check the guidelines to check your eligibility. The below-mentioned guidelines depend upon various factors such as your age, whether you have any disability or not, or are you pregnant.
As a result of the ACA’s expansion of medicaid, here is an overview of who is covered in most states:
- Adults under 65 if their household income is no more than 138% of the federal poverty level (FPL).
- Pregnant people and children even if they have household incomes above the federal poverty level (FPL).
- People of age 65 and older with lower incomes and few assets.
- Some states have stricter eligibility criteria for adults under the age of 65. To qualify for medicaid in those states, you must meet low-income guidelines and be a member of a medically vulnerable group, such as pregnant people, the parents/caretakers of a minor child, the elderly, disabled people, and children.
As of 2022, eleven states do not consider you eligible for Medicaid merely based on a low income.
Can immigrants qualify for medicaid?
Medicaid is often available to immigrants who have been legally residing in the U.S. for five years or more if they meet the eligibility requirements. Medicaid is not usually open to undocumented immigrants, but there can be exceptions like short-term limited medicaid coverage in an emergency or emergency coverage for pregnant people.
You must know medicaid eligibility criteria are different for each state. For example, California has chosen to extend Medicaid eligibility to undocumented children and young adults who otherwise meet the income criteria for eligibility.
Who pays for medicaid?
Medicaid is paid through federal and state taxes. Each state administers its medicaid procedures, and that’s why the eligibility criteria and coverage rules vary from one state to another. If you receive medicaid, your friends, neighbors, and fellow citizens pay for your health care with their tax dollars. With medicaid, you will likely receive treatment at the same hospitals and from the same doctors as people with private health insurance.
Even though Medicaid is government health insurance, most of the care provided to people who receive it comes from private businesses and healthcare providers. Most states contract with private insurance companies to administer coverage. On your ID card, you might find the name and logo of a well-known insurance provider.
Affordable care act subsidy
The Affordable Care Act (ACA) provides government subsidies to make health insurance affordable for people who buy their health insurance through the exchange/marketplace. This coverage is also commonly known as Obamacare. The law includes premium tax credits (premium subsidies) that offset some or all of the monthly premiums. There are also cost-sharing reductions (CSR) that reduce the out-of-pocket costs that some enrollees have to pay when they need medical care.
How subsidies work
If you are eligible for a premium tax credit, you can have it paid to your insurer each month on your behalf, which means you will not have to claim it all at once on your tax return at the end of the year. The government pays part of your monthly insurance premium, and you pay the rest.
You can only use subsidies if you purchase Obamacare health insurance sold on the ACA’s health insurance exchanges – also known as the marketplace. You can not use the subsidies to pay for health insurance through your job or a health insurance plan purchased outside the marketplace.
Usually, there is an income cap of 400% of the poverty level to qualify for the premium tax credit. However, the ‘American Rescue Plan’ changed the rules during the pandemic. For 2021 and 2022, there is no income limit on premium subsidy eligibility. The said changes imply that for two years, the subsidies will allow you to pay no more than 8.5 % of your household income in premiums for a standard plan if you purchase the health plan.
Who qualifies for subsidies?
Depending on where you live and how old you are, you may qualify for a premium subsidy in 2022, even if your income is well above 400% of the poverty level. However, if the cost of the benchmark plan would already be no more than 8.5% of your income without a subsidy, you would not be eligible for a subsidy.
Obamacare subsidies are not available to undocumented immigrants. However, most legally-residing immigrants can apply. With ‘American Rescue Plan,’ the centers for medicare and medicaid services (CMS) reports that:
- Eighty percent of marketplace enrollees have access to at least one plan that costs $10 or less in monthly premiums after the tax credits are applied.
- More than half of enrollees have access to a silver plan that costs $10 or less in monthly premiums.
If you search online and ask your acquaintance, “where can i find affordable health insurance?” Subsidies have made self-purchased health insurance much more affordable, but few people purchase their coverage. Most people get health insurance from their employer or the government (Medicare, Medicaid, CHIP).
If your income is between 100% and 250% of the federal poverty level, you may get more help from the government to pay your deductible, copays, and coinsurance when you use your health insurance. This is known as a cost-sharing reduction subsidy.
Cost-sharing reductions, often called CSR or cost-sharing subsidies, are an affordable care act (ACA) provision designed to make healthcare more affordable. Cost-sharing reductions improve the health plans available to eligible enrollees, making the coverage more robust and keeping out-of-pocket costs lower than they would otherwise be. The purpose is to prevent people from being underinsured due to unrealistically higher out-of-pocket expenses to their income.
How to apply?
If you are a legal U.S. resident, you can apply for a health insurance subsidy and enroll in a health plan on the health insurance exchange run by your state or federal government. You can find your state’s health insurance exchange using the HealthCare.gov tool.
Short-term health insurance
Short-term health insurance often costs less than more comprehensive plans. It is an attractive option to people looking for temporary coverage. In some states, plans are sold in terms of up to 364 days of coverage. Other plans can be renewed for up to a total of 36 months. There are also states that place more restrictive limits on plan durations. Some states do not allow short-term plans to be sold at all. Even in states that do not limit short-term plans beyond the federal minimum requirements, insurers can choose to offer plans that are non-renewable or that have shorter durations.
Is a short-term plan right for me?
Although short-term health insurance can be a low-cost option, it is not suitable for everyone. You will need to understand what the plans will cover and how long you will have that coverage. For example, a short-term health insurance policy can cap benefits. This helps to limit the insurer’s potential losses if you get seriously ill while having coverage. If you get very sick and need a lot of medical care, that will be expensive for the insurer.
Short-term plans also do not cover essential health benefits like maternity care and mental health care. Many plans also do not offer outpatient prescription drug coverage. If you have a medical condition, you should know that almost all short-term plans do not cover pre-existing conditions.
If an insurer thinks you are a risk to cover, they can turn you down. On the other hand, if you’re young, healthy, and are not seen as a risk, you might be able to get short-term health insurance. While it is a lower-cost option, you need to read all the fine print, understand how post-claims underwriting works, and know what the plan does and does not cover.
How to buy a short-term plan
There are a few ways to buy a short-term health insurance plan:
- Buy a policy directly from a health insurance company.
- Use your insurance agent if you have one.
- Find a health insurance agent or broker through a ‘National Association of Health Underwriters’ website.
- Use a non-governmental private online exchange such as ehealthinsurance.com.
Job-based health plan
Many employers in the U.S. subsidize health insurance for their employees and their employees’ families as part of the employee’s benefits and compensation package. Health coverage is a common benefit for full-time employees of large companies, but it is less common for part-time employees and small businesses.
Your employer may offer only one health plan when you get a job with health insurance benefits. They may also provide several options you can choose from. You have a limited time to sign up for the health insurance your employer offers. If you do not sign up before the deadline, you will have to wait until the next annual open enrollment period.
Who pays for coverage?
When you have employer-sponsored health insurance, your employer usually pays part of the monthly premiums, and you pay your amount of the monthly premiums. Your employer will pay most of the cost in most cases, though it varies. Your share of the premiums gets taken out of your paycheck automatically. That means you do not have to remember to pay the bill each month.
Your employer usually doesn’t help you pay cost-sharing expenses like deductibles, copays, and coinsurance with job-based health insurance. However, some employers offer savings plans like flexible spending accounts, health savings accounts, or health reimbursement arrangements.
Low-cost health insurance for adults
If you are an adult, you may need to find your health insurance plan for the first time. However, there are great options for those in their teens and 20s that provide comprehensive coverage at an affordable price. When shopping for health insurance as an adult, you should consider your specific situation about your age, income, and stage of life.
As an adult, if you are looking for health insurance plans, we recommend you explore every option to find low-cost health insurance for yourself. Here are some low-cost options for adults that you may want to consider as an adult.
Employer-sponsored health insurance
One of the best free or low-cost health insurance options for young adults would be acquiring coverage through an employer’s health plan that is fully paid for. However, this is not as common as it used to be since health care costs are rising, and employers require their employees to pay a portion of the premium. However, employer-sponsored plans can still be a cheap option, as most employers will pay a more significant amount of the premiums for your health care.
It is also one of the low-cost health insurance plans for adults. You have to meet the criteria for the medicaid program and check if it has been extended by law in your state or not. As an adult, enrolling in the medicaid program would make sense if you are currently unemployed or work at a company that does not offer health insurance benefits.
Health insurance marketplace plans
Adults can purchase low-cost health insurance plans through the marketplace if they are not eligible for medicaid in your state. On the state exchanges, there are typically five different plan tiers that are offered: Catastrophic, Bronze, Silver, Gold, and Platinum. The best plan tier will depend on your income and your health.
If you are a single young adult looking for an individual plan, then the best health insurance could be a lower-tier plan like catastrophic or bronze. These policies can work well for most young adults who need basic health coverage.
Health insurance marketplace
If you are looking for an affordable health insurance plan, you might want to explore all available options. And the health insurance marketplace is a great option to do that. The health insurance marketplace is a service that helps people shop for and enroll in the plan that fits best to your budget. Through the federal health insurance marketplace, you can browse various plans available under ACA (Affordable Care Act).
It also enables small business owners to purchase health insurance for employees through its small business health options program(SHOP) marketplace. You provide income and household information when you apply for individual and family coverage through the Health Insurance Marketplace. You will find out if you qualify for:
- Premium tax credits and other savings that make insurance more affordable
- Coverage through the Medicaid and Children’s Health Insurance Program (CHIP) in your state
Who is eligible for the marketplace?
To be eligible to use the health insurance marketplace, you:
- Must live in the United States
- Must be a U.S. citizen or national (or be lawfully present)
- Cannot be in prison
No matter what state you live in, you can use the marketplace. Some states operate their marketplace. Whereas in most states, the marketplace is run by the federal government.
How do I apply for a health insurance marketplace?
Generally, you have to enroll during the open enrollment period. Though, you might qualify for a special enrollment period if you have gone through a significant life event like losing other coverage, getting married, or having a baby. During the open enrollment period, you can apply for a marketplace plan online, by phone, with a paper application, or with the help of a trained assistant in your community.
Individual health insurance
Individual health policy is a coverage that the insured person purchases on their own to maintain their health and take care of medical care whenever required. A medical insurance premium is required to be paid before claiming your coverage. Individual health insurance costs vary depending on your state. On average, you can expect to pay between $225 and $327 per month for a single person.
Whereas if you are looking for the cheapest individual health insurance coverage, that will depend on your household income as you may qualify for a subsidized plan. Without subsidies, you can find plans for as low as $139 per month for a single person.
You can get individual health insurance and compare prices from all carriers in one place with a marketplace. Marketplaces will provide support to help you find the right plan that suits your needs at no extra cost to you. Simply enter some basic information (age, zip code, gender, etc.) and compare quotes from carriers in your state to get coverage.
Types of individual insurance plans
There are several independent health insurance plans you should be aware of.
Health maintenance organization (HMO) plans are more affordable for consumers, and you may be able to receive preventive services without meeting your deductible. But plans with lower costs have drawbacks as well. HMO binds you to choose in-network providers for services to be covered. These doctors, specialists, and facilities sign a contract with your provider to serve you at a reduced rate. Moreover, you will not have the luxury of seeing specialists without a referral from your primary care physician. Therefore, if you decide to venture outside the network, you may have to pay 100% of the costs.
Preferred provider organization (PPO) plans allow you to use both in-network and out-of-network providers. While the latter will cause you to incur increased out-of-pocket costs, a percentage of the services may be covered under your plan. Unlike HMO plans, you do not have to choose a PCP provider, but you may be required to meet a deductible before coverage kicks in.
Exclusive provider organization (EPO) plans only offer in-network benefits. This means you can only use selected providers and hospitals to be eligible for coverage. If you receive care outside the network, you will be responsible for 100% of the costs incurred for services.
The point of service (POS) plan merges the best of HMO and PPO plans. Similar to a PPO plan, it is necessary to choose a PCP. However, it might cover your preventive healthcare services without meeting your deductible. It will also enable you to see out-of-network providers if need be. However, a significant drawback is assessing a bill for 100% of the costs. It will also be your responsibility to seek reimbursement from the insurance provider for the covered percentage of services. If you have already met your deductible, you will still be responsible for submitting your claims from processing.
Best individual health insurance
The best individual health insurance company for you will depend on your health situation and budget. The price tag must not fool you. Some health insurers offer cheap coverage but less-than-stellar customer service or a limited provider network. Some insurance companies provide the best individual health insurance, including exceptional customer service, smooth claims processing, great provider choices, flexible care options, and affordable premiums.
To help you shop for the best deal, we looked through premium costs, customer service, provider networks, and the financial strength of the top individual health insurance companies.
J.D. Power Customer Satisfaction Study ranked Cigna as the top health insurance provider in the US. It offers individual plans for every budget. It also has a vast provider’s network, so you will receive phenomenal service in all ten states they serve. It will provide you access to its health and wellness knowledge center to help you find the information you are looking for. You can also call Cigna’s customer service hotline 24/7 to get answers to your questions.
Your health should be your top priority. Aetna helps you prioritize your health through its most affordable suite of health and wellness programs. With over 70 programs to choose from, Aetna health connections have the tools to help you lead a healthy lifestyle. Aetna also offers an online program, ‘Simple Steps to a Healthier Life,’ which screens you for potential risk factors and creates tailored individual health insurance plans based on the findings. There are also personal health and wellness coaching, mindfulness programs, and more.
UnitedHealthcare is one of the best providers for individual health insurance plans. It held the top spot in the industry on Fortune’s “World’s Most Admired Companies” list for nine consecutive years. If you are a subscriber of UnitedHealthcare, you can take advantage of virtual visits without incurring any added costs. You can schedule appointments through your primary care provider and see a medical professional via your smartphone, tablet, or computer. Despite this, doctors are standing by 24/7 to assist you with your healthcare needs so that you can receive care any time of the day or night.
Blue cross blue shield
Blue cross blue shield is a top provider of individual health insurance plans in the US. It has been providing health insurance services since 1929 and insures 1 in 3 Americans. In 2019, J.D. Power honored several commercial plans from a blue cross blue shield for provider choice and customer satisfaction. It also ranked highly for benefits and coverage.
Beyond the high-quality benefits it provides to policyholders, its massive provider network helps it stand out among the competition. You will find providers for a range of medical services in every state around the nation.
You do not have to spend a fortune to receive quality medical care. Kaiser Permanente offers individual health insurance plans for all budgets. If you are a subscriber, you can enjoy low premiums, reasonable deductibles, and a vast provider network at a fraction of the cost you would pay with other providers.
Kaiser Permanente stands firm on the belief that every individual should have adequate access to healthcare. It offers subsidized health care coverage through its charitable health coverage programs to serve low-income individuals. Those who struggle to find affordable health insurance or do not have access to affordable healthcare through their employers may also qualify.
Free health insurance
You must know that there is no actual free health insurance; if you receive free or subsidized health insurance, know that citizens made funding for that. The taxes of citizens support all government operations, including healthcare expenditures. However, medicaid and the children’s health insurance program (CHIP) provide free or low-cost health coverage to millions of Americans, including low-income people, families and children, pregnant women, the elderly, and people with disabilities.
Even if you do not qualify for medicaid based on income, you should apply. You may be eligible for your state’s program, especially if you have children, are pregnant, or have a disability. You can apply for medicaid any time of year as medicaid and CHIP do not have open enrollment periods.
Health insurance in the US is not cheap, and its cost keeps rising with each passing year. However, there are some options available through the government-created marketplace. Health insurance helps pay for medical expenses, but it is not free. That’s why it is vital to know where to find affordable health insurance. The first cost of health insurance is the premium.
For 2022, if you are the only person in your household and make less than $51,520 per year and do not have health insurance through your employer, you may qualify for federal subsidies, like the premium tax credit to help you pay the monthly premium. The income limit for subsidies is based on federal poverty guidelines and varies based on your state and household size.
The Affordable Care Act has categorized all Obamacare health insurance plans into four metal tiers for the ease of US citizens: Bronze, Silver, Gold, and Platinum. Every plan across all tiers covers the essential health benefits; the cost-sharing between you and the insurance company differs. Lower-tier plans have lower premiums but a high deductible. Higher-tier plans generally have a lower deductible but higher monthly premiums. Hence, if you wonder, “where can i find affordable health insurance?” you have several options to choose from.