How To Get Health Insurance | Finding a health insurance plan that fits your budget might be difficult. Here are some options for obtaining health insurance so you can ensure your family’s safety.
What Types of Coverage Exist?
Employer-sponsored health insurance, individual or private plans, Medicare, and Medicaid are the four main categories of health insurance. According to the Kaiser Family Foundation, a work-based health insurance plan covers more than half (56%) of employees in the private sector.
Since the Affordable Care Act (ACA) went into effect in 2014, private health insurance obtained independently of an employer has increased in popularity. Consumers can compare health plans offered in their area thanks to the health insurance marketplace the Affordable Care Act (ACA) developed.
In addition, the law established premium tax credits and money-saving subsidies to lower the cost of health insurance for those who purchase it through Healthcare.gov’s ACA marketplace.
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Insurance through an employer
Group health insurance that is sponsored by your workplace is a health plan that is selected and largely funded by your employer. Your dependents may also be offered these plans or they may be included (usually spouses and children).
The majority of the cost of your health insurance premiums is covered by your employer, who also determines the plan alternatives you can choose from. Employees frequently pay premiums as well, which are deducted from your salary before taxes and reduce your taxable income.
Individual health insurance
You can purchase individual health insurance for your family or for yourself. Individual health plans can be purchased from a health insurance provider directly or through the ACA marketplace. With the help of these plans, you can locate health insurance protection that offers the features and covers the medical professionals and facilities of your choice.
You can change jobs at any time without worrying about losing your insurance because the health plan is not offered by your employer. Each year, you have the opportunity to renew or modify your health insurance options.
For those over 65 and those under 65 with a disability, end-stage renal illness, or amyotrophic lateral sclerosis, Medicare is a federal program that offers health insurance (ALS).
Medicaid is a jointly administered federal and state program that offers health insurance to low-income Americans who qualify, as well as to expectant mothers, kids, persons with disabilities, and seniors.
Medicaid and Medicare may both be available to you. For more information and to submit an application, go to medicare.gov or medicaid.gov if you believe you qualify for one of these programs.
5 Ways to Get Health Insurance
1. The ACA health insurance marketplace
Individuals, families, and small companies can purchase insurance plans through Healthcare.gov’s health insurance marketplace. You can compare plans, enroll in a plan, learn more about health insurance, and calculate your potential savings from premium tax credits and subsidies through this online resource.
Even if your work offers insurance, you can still purchase a health plan through the marketplace; but, if you have access to employer-sponsored coverage, you might not be eligible for subsidies. You must enroll during open enrollment or a special enrollment period in order to purchase an insurance on the marketplace.
For the federal marketplace, open enrollment for 2023 coverage starts on November 1, 2022, and it lasts through January 15, 2023 in most states.
Enroll by Dec. 15, 2022 for coverage to begin on January 1, 2023.
There can be a small difference in the open enrollment times for some state exchanges. If you have a significant life change, like as moving, getting married, having a child, or losing your current health coverage, you may be eligible for a special enrollment period if you miss open enrollment.
Go to Healthcare.gov during open enrollment or after you are eligible for a special enrollment to start your search for insurance through the marketplace. Enter your ZIP code. It will point you either to the federal market or to your state’s exchange so you can start shopping.
2. A health insurance broker or agent
You may browse the extensive insurance alternatives and sign up for the finest health insurance plan for you with the aid of a health insurance broker or agent.
Working with agents or brokers doesn’t cost you anything because they are compensated on commission by the insurance companies. You can schedule in-person, phone, or email appointments to find a broker or agent using the Find Local Help tool provided by the federal government.
To be contacted by an agent or broker to discuss plan options, you may also give your phone number or email address. To offer health insurance, agents and brokers need to be licensed in their states.
3. Directly from a health insurance company
Directly contacting health insurance providers can help some consumers identify policies that better suit their unique requirements or financial situation.
These plans can be compliant with the ACA, or you might find a less expensive plan that doesn’t provide the same level of comprehensive coverage as those offered on the ACA marketplace.
When buying a health plan outside of the marketplace, the chance to qualify for premium tax credits or other subsidies offered by the marketplace is lost.
4. Membership organizations and association health plans
A group health insurance plan may still be available to people who do not currently have employer-sponsored health insurance, are self-employed, are looking for work, or own small start-up businesses.
Membership in a professional, trade, or membership group is required for these health plans. You can find out if the companies you work with provide association health insurance.
Freelancers, small enterprises, and independent contractors can pool their resources to get group health insurance at a discount through association health plans. Be aware of “health services discount” plans offered by some membership groups as opposed to real health insurance.
Although some plans don’t have extensive coverage, they can save you money on medicines. Customers who purchase outside of the market should be wary of health care-sharing ministries, where members of a common faith donate funds to a health care cost pool distributed by a ministry to pay for certain health-related expenses. This is not health insurance and doesn’t cover pre-existing conditions or guarantee reimbursements.
When Should You Sign Up for Health Insurance?
It is preferable to enroll in health insurance before you actually need it.
Every year, on November 1 through January 15, private health insurance open enrollment takes conducted through the federal marketplace (and many state markets).
Special enrollment periods
If you experience a qualifying life event, you might be eligible to sign up for health insurance during a period known as a special enrollment period.
Events that warrant special enrollment include:
- Losing your health coverage
- Getting married or divorced
- Having or adopting a child
- Moving to a new state
- Aging out of a parent’s health insurance plan
Special enrollment periods typically last 60 days after your qualifying event, so begin applying for special enrollment as soon as possible to avoid missing the window.
Short-term health insurance plans
A short-term health insurance plan can be an option for you if you don’t qualify for a special enrollment period or need to get health insurance outside of the open enrollment period.
These plans frequently fail to provide the minimum necessary coverage mandated by the ACA or to cover pre-existing diseases. These plans, which have a maximum duration of 364 days and two renewal options per policy, are not offered in every state.
How Much Does Health Insurance Cost?
A Forbes Advisor analysis of unsubsidized ACA marketplace premiums found that the average monthly cost of health insurance on the ACA marketplace is:
- $365 for individual coverage for a 21-year-old person
- $386 for a 27-year-old
- $412 for a 30-year-old
- $469 for a 40-year-old
- $655 for a 50-year-old
- $994 for a 60-year-old
Age, the kind of benefit design, the metal tier, and the number of individuals covered by the plan all affect how much an ACA plan will really cost. Your health status or pre-existing diseases cannot be taken into account when determining the cost of health insurance.
Common Health Insurance Scams
Robocalls and phishing emails that promote “comprehensive” health plans that adhere to “Obamacare” standards are frequent forms of health insurance fraud. The logos of well-known insurance companies or groups like AARP can be seen on some emails.
During open enrollment, callers pretend to be insurance industry representatives and offer discounted rates or induce you to join an organization or union in order to obtain coverage. Government representatives won’t ever call you to try to sell you insurance, and they won’t try to coerce you into buying anything.
How to Get Health Insurance FAQs
How do I get health insurance if I am retired?
Medicare is a government health insurance program that is available to those who are 65 years of age or older and provides complete coverage.
You have two options for health insurance: Original Medicare, which is provided by the government, and Medicare Advantage, which is provided by private health insurance providers under a contract with the government. Medicare Part D offers prescription drug coverage if you have Original Medicare.
How do I get health insurance if I have a disability?
If you are disabled, you might be eligible for Medicaid or Medicare coverage. These government initiatives provide total health coverage. The ACA marketplace is another way you can obtain insurance.
You might qualify for an ACA-subsidized plan that offers premium tax credits and cost-sharing reductions to lower out-of-pocket expenses, depending on your household’s income.
How do I get health insurance if I am self-employed?
Self-employed people have a number of options for health insurance coverage if they don’t have access to a spouse’s or parent’s health insurance plan.
Health insurance for independent contractors can be purchased via an insurance provider or through the marketplace established by the Affordable Care Act. If you are qualified, you may also be able to receive coverage through Medicaid or Medicare.