Everyone knows that they need health insurance, but people are often unclear exactly how to go about finding or enrolling in a policy.
They are even more unsure about what to look for in a policy or how to know if policies offered to them are a good fit for their needs. By breaking the process down into smaller steps, consumers can reduce the complexity and enormity of the task into manageable, bite-sized steps. The first step is to look at their needs and personal priorities. This includes reviewing past and current health care usage, anticipating what new need they might have in the upcoming year and deciding what is most important to them when it comes to quality of care.
With those core factors nailed down, consumers are ready to look at some of the main sources of health insurance. These include employers, federal and state marketplaces and special programs like COBRA.
Before consumers can begin the process of enrolling in a plan, they need to choose a health insurance plan. There are many criteria consumers can use to help them make that decision. One of the lesser known but most important rules of thumb is to start with the providers they already have. Patients who have established relationships with primary care or specialty providers they like and trust can use those relationships as a starting point. Plans with which those providers are affiliated can be an ideal choice. When that is not possible, plans that allow those relationships to continue through out-of-network care allowances can be desirable.
The size, diversity and quality of plans’ networks are other important factors to consider. Some types of plans will feature smaller networks than others, but consumers should feel confident that a plan’s network would meet their needs by offering sufficient providers within a reasonable distance of where they primarily live and work.
Objective and subjective quality and satisfaction ratings may also come into play. Are in-network providers openly advertising compliance with accepted best practices? Are they winning local or regional awards for competence or patient satisfaction? These characteristics may be a little harder to quantify in financial terms, but they can have a huge impact on consumers’ long-term contentment with their plans.
Health insurance protects consumers and their families from being financially decimated by unexpected medical costs. For consumers on a tight budget, however, health insurance plans with high premiums or deductibles can feel equally stressful and out of reach. Luckily, with some thought and a little legwork, buyers can find affordable health insurance policies that fit within their budgets.
Consumers have the following five main places to turn to when seeking affordable health insurance plans:
Employers regularly offer group health insurance plans as part of their employee benefits packages. These employer-based health insurance plans can provide employees with desirable medical coverage at competitive rates. Employers may further entice employees to stay with them by paying part of their insurance plan premiums each month. This creates a strong incentive for employees to stay in their current employment, as employer-based plans cannot be rolled over from one employment situation to another.
Employer-based health plans are not available to everyone. When they are available, however, they frequently offer some of the best pricing and benefits options on the market. They are often easier to select and sign up for than plans found through other methods as well.
The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) grants employees the ability to stay enrolled in their health insurance plans for months or even years after they would normally have lost access to them. COBRA applies to most consumers who have lost or quit their jobs or who were receiving health insurance coverage through a spouse they have recently lost to death or divorce.
Under, COBRA individuals receiving insurance through qualifying employers may continue their enrollment in their pre-existing plans for up to three years after they would normally have been disqualified for coverage. COBRA enrollees must pay the full cost for their health insurance and may be charged an additional administrative fee.
COBRA can be extremely expensive, but it also provides an invaluable opportunity for individuals and families with chronic conditions and other special health needs to keep their coverage. It can serve as a powerfully protective stopgap measure until workers can transition to new employer-based coverage or families can make other adequate arrangements.
Traveling to and living in foreign countries can pose unique challenges when it comes to selecting and maintaining health insurance abroad. Few health insurance plans, if any, offer global coverage. Although many plans theoretically cover the cost of emergency care no matter where it is needed or received, the logistics of the billing, claims and reimbursement processes are often less than smooth, and long delays and piles of paperwork are common.
Proper preparation in advance, as well as care selecting the best possible health insurance plan, can make a tremendous difference. In some cases, this is as easy as travelers calling and consulting with their insurance companies prior to the trip. Special riders can also help.
Some American citizens planning to live or travel abroad will benefit most from purchasing travelers’ insurance. Short or long-term travelers’ insurance plans can protect not only travelers’ health but their belongings and finances as well. Travelers’ insurance is available for single trips, in multiple trip batches or for set periods of time, such as one year. Costs will vary widely depending on factors like enrollees’ ages and destinations.
Some populations, such as students, veterans and retirees, may qualify for special insurance deals or plans through organizations with whom they are affiliated. In addition to researching these opportunities, travelers must also bear in mind other concerns. For instance, individuals planning to rely on travelers’ insurance for their health care needs may still be legally required to carry a qualifying health care plan or face tax penalties under the Affordable Care Act’s Individual Mandate. A little time spent in research ahead of time can help travelers and expatriates make the most of their time abroad.