How to Find Affordable Health Insurance

Health insurance is a legal requirement and life essential for all Americans. Without the backup of health insurance, one serious illness or injury can devastate a family’s finances.

Even without catastrophic events, the ever-escalating costs of health care and medical practice policies can prevent individuals and families who lack insurance from accessing the right kinds and amounts of care. On top of that, families without insurance can face tax penalties each year they fail to get qualifying insurance, although the individual mandate fee is not required after 2018.

For financially strapped consumers, health insurance can feel like the worst kind of dilemma. The costs of medical expenses without insurance are extremely prohibitive, but consumers are not always sure they can afford to pay for a policy, either. Fortunately, there are plenty ways to find qualifying health insurance policies without breaking the bank.

The first step is knowing where to look for an affordable policy. There are five primary places consumers can expect to find health insurance plans, and these include employer-based health insurance plans, Medicaid and other government-managed options, ACA Healthcare Marketplace plans, open market plans and insurance plans offered by other agencies or organizations. By systematically examining each policy, consumers can get a good idea of their options quickly and take the shortest route to the most cost-effective plans available.

Employer-Based Insurance and Other Group Plans

Consumers who qualify for health insurance benefits through their employers’ group plans should start by looking at what their companies offer. The reason to start here, for anyone who can, is that employers’ group health insurance plans typically cost less than comparable plans sold individually on the open market. Employers may also pay a portion of employees’ health care premiums as part of their benefits packages, further reducing costs. Where applicable, consumers should remember to compare the plans available from their employers with the plans available from their spouses’ employers. They can then select the best of all options.

When exploring employer-based policies, potential buyers should consider what their needs and priorities are. In many cases, buyers can get lower premiums, deductibles and copays on plans if they are flexible on points that are important to the insurance company. For example, plans with smaller networks or that require jumping through a few additional hoops (e.g. getting primary care provider referrals before seeing specialists) often cost less than plans that promise more flexibility. Buyers who do not have particular preferences or who are satisfied with smaller networks can capitalize on opportunities to shave some of the cost off their premiums.

A surprising number of consumers may find that they qualify for health insurance plans sold or moderated by a variety of agencies, organizations or businesses. Veterans and their families are typically eligible for special plans and pricing through the Department of Veterans Affairs. They may also be able to find good deals on health insurance through national veterans’ organizations.

College students and graduate students often have the opportunity to purchase a form of group health insurance through their colleges and universities. Although these plans can be limited in what they cover, they are often inexpensive and meet all minimum legal and functional requirements.

Medicaid

Consumers who meet the age, income or disability requirements necessary to qualify for them may want to consider enrolling in government-issued health care programs. Although Medicaid and other government-managed care plans may not offer the range of options and flexibility that consumers ideally want, they can create a solid base on which to build. Supplemental insurance policies and flexible spending accounts (FSAs), for example, are potential add-ons for basic health care plans to expand consumers’ access to the care they want.

The ACA Marketplace

Federal and state-level Affordable Care Act Health Insurance Marketplaces are another place that consumers can look for affordable health insurance. ACA Marketplace plans are sold individually. This can put them at a cost disadvantage compared to group plans, such as those offered by employers.

ACA Marketplace plans, however, offer an array of discounts for qualifying buyers. Potential buyers of Native American, Native Alaskan or Native Hawaiian descent, for example, qualify for government-funded subsidies, discounts and other cost-reducing benefits on ACA Marketplace plans. These discounts are often not available through other sources but can result in competitive pricing.

The ACA Marketplace also allows certain qualifying consumers to purchase minimalist catastrophic plans. Catastrophic plans offer very little coverage but can usually be secured at a low price.

The General Market

Although the open insurance market has a reputation for being an expensive place to shop for coverage, it does not have to be. Insurance brokers and representatives are well versed in their fields and understand the ins-and-outs of the marketplace better than most consumers ever will. With a little patience, consumers can sometimes work with insurance professionals to find perfect matches. Insurance plans perfect for their needs that carry no excess costs and prevent them from paying out large sums in hidden costs later on.

Keeping Costs Down

Regardless of where consumers go looking for coverage, there are few things they can do to help themselves find the least expensive, most cost-effective plans.

  • Have clear priorities. Knowing what one will and will not compromise on when it comes to care can help employers and brokers match consumers to appropriate plans. It can save consumers time when selecting between plans, as well.
  • Be flexible. A willingness to compromise on features of insurance plans that are not priorities can go a long way toward helping consumers secure lower-cost coverage. For example, accepting a plan that pays for a long list of generic prescription medications but only a few brand-name ones might satisfactorily meet a family’s needs and cost much less than a plan that fully covers brand-name prescriptions.
  • Speak up about characteristics that might qualify for discounts. Consumers who are of Native American, Alaskan Native or Hawaiian Native descent may be eligible for certain discounts. Families in which some members are above or below a certain age, or families with individuals who have been diagnosed with disabilities, may also qualify for extra benefits or cost breaks. Being upfront about any and all family characteristics that might qualify a household for discounts can make a powerful difference.
  • Do the math. Consumers shopping for insurance should take the time to do some accounting of their standard medical care usage rates and types over the last year or two and any expected health care needs they anticipate in the next year. These numbers can prove critical to determining how much a given plan will actually cost a family. Those insights into the relatively benefits and drawbacks of co-pays, deductibles and premiums can save consumers significant amounts of money over time.

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