Jobs in America are considered as the best way to receive health insurance coverage, as a significant number of people in the country obtain health insurance through their employers. However, at the time of the pandemic, there is a good number of people who have either lost their jobs and health coverage or have financially become unstable to have health insurance. whatever might be the situation, people should always try to have proper coverage depending upon their healthcare needs.
People should check their Need and Budget
While out for health insurance shopping people need to understand that not all health insurance plans available in the market as well as the health insurance companies offering plans are the same. Every health insurance company and the plans offered by them differ in many aspects. First of all, people need to determine who all are the members of the family requiring health insurance. After knowing the members who all require health insurance people can move to the next step of finding the coverage.
The biggest factor that drives people’s decision of buying health insurance is the price of health insurance. The amount which people pay for their health insurance plan depends on some other factors too like their household income, previous employer, health, age, and eligibility for a government-backed health plan. People should be aware of the following terms that will help them to understand the costs associated with the plan.
Premium – Premium is the monthly amount that people pay to the insurance carrier to keep their health insurance plan active. The monthly premium amount for a plan depends on the level of coverage the plan offers to the members.
Deductible – Every health insurance plan comes with a deductible attached to it. It is the amount that policyholders pay for their medical services out-of-pocket before the insurance company starts contributing toward the policyholder’s care.
Copay – Copay is a specific dollar amount that policyholders pay for their medical services and the remaining amount of the covered medicals services are paid by the insurance company.
Coinsurance – Policyholders after meeting their deductible amount may need to pay the coinsurance amount listed in their plan details. If a health plan comes with a coinsurance then policyholders pay a certain percentage of their medical services after meeting their deductible.
Out-of-pocket Maximum – Health insurance plans also come with an out-of-pocket maximum, which is the maximum amount which policyholders need to pay for their covered medical services throughout the plan year. Any amount the policyholders pay out of pockets such as copays and coinsurance count toward this. If the policyholders meet their out-of-pocket maximum within the plan year, then their insurance company will pay 100% of the covered medical services until the expiry of the plan.
Besides health insurance costs, people also need to consider their specific needs while choosing a plan. People need to think about aspects like how often they need to visit the doctor, If they have any preexisting or chronic conditions that require ongoing treatment, or if they are taking any prescription drugs. If people often visit the doctor or are receiving ongoing treatment for a condition, then such people should select a health plan with a higher premium but a lower deductible, as this will turn out to be more affordable in the long run.
Check Eligibility for Government-Backed Health Plan from Old Employer
In some special circumstances, people may be eligible for unique health insurance options, and through these options, people may find more affordable plans that are tailored as per their needs. People will be surprised to know that they may be eligible for health insurance from their previous employer, in case if they recently lost their jobs. This coverage is known as COBRA health insurance, and people may be eligible for this coverage for 18 months if they were covered under an employer-sponsored plan before they lost their coverage, if their working hours were reduced thus making them ineligible for employer-sponsored coverage, if they leave their jobs, or if they were fired for any reason other than gross misconduct.
Government-backed Health Plan
People should also check their eligibility for government-backed health plans like Medicaid, the Children’s Health Insurance Program, and Medicare. Medicare is a federal health insurance program and people may either opt for a government-backed original Medicare or a Medicare Advantage Plan offered by private insurance companies. People qualify for Original Medicare if they are 65 or older, have a disability, or need dialysis or a transplant due to end-stage renal disease.
People may qualify for Medicaid plans based on their disability, family status, household size, and household income. People living in a state that has expanded Medicaid coverage can qualify for this program based on their income alone. People of these states will qualify for Medicaid if their household income is below 133% of the federal poverty level.
The Children’s Health Insurance Program (CHIP) is also a government-sponsored health plan offering low-cost health coverage to children of families who don’t qualify for Medicaid based on their income. In some states, this government program also provides health coverage to pregnant women.
People who do not qualify for COBRA coverage or for a government-backed health plan can start their health plan search in a private health insurance marketplace. People will find all health plan options from private health insurance companies. People can compare among all the plans available and also check their eligibility if they qualify for tax credits within the marketplace.
While shopping in the private health insurance marketplace, people will come across different health plans like HMO plans, PPO plans, POS plans, and EPO plans. After carefully evaluating health plans on different vital factors, people should select a plan that best serves their health care needs at a price that is easy on their pockets.