Without insurance, severe illnesses and accidents can lead to financial ruin, and even run-of-the-mill events like getting the flu or a broken leg can result in hefty bills.
According to the United States Census Bureau, fifty-six percent of Americans are covered by healthcare plans provided by their employers, but if you can’t get coverage through your job, you’ll need to find an alternative.
Getting the health insurance you need can seem like an intimidating prospect and one you can’t afford, but it doesn’t have to be. Follow these simple steps to protect your health and that of your family with minimal confusion and hassle.
Determine What You Do Need and What You Don’t
The first step in getting the right coverage is to assess your specific individual needs.
While it sounds obvious, different policies are crafted for people in various income brackets and may or may not cover preexisting conditions. It’s important to ensure you’re only paying for coverage you need rather than waste away money on a plan that doesn’t fit.
Are you single or married? Do you have children? Your priorities and options depend on your current circumstances, to a significant degree.
For example, if your spouse has insurance through his or her employer, you'll likely choose a different plan than you would if you needed to cover others as well.
Do you exercise? Eat right? Or do you have unhealthy habits? Do you participate in risky sports, or work in a dangerous occupation?
Your choices can have a significant impact on the type of insurance coverage you should carry, so an honest and comprehensive assessment of your lifestyle is essential.
Do you often get sick, or need to see a doctor regularly for chronic or recurring illness? Or are you generally healthy, requiring only a yearly checkup and an occasional visit for minor ailments like the flu?
If you see a doctor frequently, you'll want to choose a plan with low deductibles and co-pays, but if you rarely get sick, a higher deductible might be worth the lower premiums.
Next, you'll want to carefully consider the different types of health care insurance, government assistance, and optional policies that are available.
In the U.S., traditional health insurance policies are usually expensive, and deductibles and coverage limitations vary widely. These plans offer a great deal of flexibility, in that you can visit any doctor, hospital, or clinic you prefer. However, you’ll pay more out of pocket, and you’ll likely have a high deductible.
Preferred Provider Organizations (PPOs) and Healthcare Maintenance Organizations (HMOs) are policies that work with groups of healthcare providers called a “network.” Visits to doctors and facilities that are part of the network are covered, but you'll pay out of pocket for visits to specialists or others who are not. This option offers lower premiums and copays, and a few different levels for deductibles.
If you rarely need to see a doctor, it might make sense to opt for a high deductible plan. They’re lower cost, but you’ll pay more out of pocket on the rare occasion when you do need care, so be sure to save some money for those costs, should they arise.
Healthcare Ministries aren’t insurance plans – instead, each member of the ministry agree to pay a portion of every other members’ medical bills, in addition to a monthly membership fee. Such an arrangement may represent a lower cost alternative to traditional insurance, but be sure you fully understand the terms, coverage limitations, and other requirements for membership.
Unlike other healthcare plans, ministries aren't subject to regulations.
Healthcare Exchanges were enacted by the Federal Government in 2013, as part of the Patient Protection and Affordable Care Act. Also known as marketplaces, they're offered in every state and help individuals find and enroll in lower-cost health insurance plans.
For those over 65, Medicare offers limited coverage; however, since it only covers a portion of most healthcare costs, people will need supplemental private insurance to avoid high out-of-pocket payments, deductibles, and co-pays.
Similarly, Medicaid and CHIP are available to assist those with low incomes, disabilities, and children who are part of low-income households. However, it can be challenging to qualify, and since each state manages its own Medicare program, eligibility requirements and coverage limitations may vary widely.
Alternative Options and Supplementary Care
Depending on the type of health care coverage you choose, it might make sense to opt for one or more supplementary plans to protect your finances and ensure your peace of mind.
Long- and short-term disability insurance plans will pay your living expenses if you’re unable to work for a while.
Critical illness insurance can provide extra security if you or a family member receives a diagnosis that indicates serious disease.
Dental and vision insurance pay for routine exams, glasses and contacts, and most types of preventative and restorative care.
Hospital insurance will cover expenses related to a hospital stay that isn't covered by your primary healthcare plan.
Accident coverage handles bills that you’d otherwise have to pay when the unexpected happens, such as the cost of emergency medical services, transport via an ambulance, and x-rays or other tests not covered by your health insurance.
Travel insurance offers additional protection when you’re on the road. Plans vary widely, but in general, these policies will reimburse you if you're forced to cancel tickets and reservations, and they'll cover medical emergencies and care you receive while visiting a foreign country. Travel insurance is often a smart choice for those who spend significant time abroad and therefore outside of their primary health plan network.
Protecting your well-being and that of your loved ones is a tremendous undertaking. It takes time, focus, and patience to assess your health care needs and understand the various plans and options that are available to you.
It’s an effort you can’t afford to put off, so ask questions, do your research, and make sure you’ll have coverage when you need it.