In the US, you have a variety of options for health insurance. You can get it through a state or federal marketplace, Medicaid, Medicare or through your employer.
One key to finding affordable health insurance is to understand what you can expect to pay for coverage. The deductible, copays and coinsurance will all determine how much you’ll have to pay out of your pocket.
Health insurance marketplaces
The health insurance marketplaces (also known as exchanges) help people shop for and enroll in affordable insurance. They are operated by the federal government and by some states, which choose to operate their own marketplaces.
The marketplaces establish and maintain online purchasing options; work directly with private health insurance companies; manage enrollment; and determine eligibility for tax credits. They also serve as the “no wrong door” eligibility process that the ACA envisions.
In addition, the Marketplaces provide information on plans for each state. They offer four “metal” levels of coverage that differ only in how your and your insurance company share the cost of your premiums.
The most effective way to promote enrollment in individual market plans is to provide subsidies that can lower the costs of premiums. This is especially important for low-income individuals. There is strong evidence that increases in state subsidies lead more people to purchase Marketplace coverage.
Medicaid
If you’re looking for affordable health insurance, there are several ways to find coverage. The federal government and states offer Medicaid, Medicare, health insurance marketplaces and other subsidies to help people purchase coverage.
If your income is below a certain amount, you may qualify for Medicaid in your state. Usually, you need to make 133% of the Federal Poverty Level (FPL) to qualify.
Depending on your state, you can also get low-cost care at federally qualified health centers, which provide services on a sliding scale. Learn about these health centers to find one that meets your needs.
Under the Affordable Care Act, most adults and children can be eligible for Medicaid based on their income alone. However, this option is limited in a number of states.
Medicare
Many people who are not covered by employer-sponsored insurance need to look into Medicare, a government program that provides health coverage for US citizens and permanent residents aged 65 and older. It also covers younger people with disabilities and those who have end-stage renal disease (ESRD) or permanent kidney failure that requires dialysis or a transplant.
Medicare Part A (hospital insurance) pays for inpatient hospital care, skilled nursing facility and hospice care. It also pays for a variety of medical services, including doctor visits, outpatient treatment, prescriptions and preventive screenings.
Premium prices are another important factor to consider when choosing a health insurance policy. The government website notes that premium prices can be affected by factors such as plan category, medical history and gender.
You can compare plans and prices on online marketplaces such as the federal and state insurance exchanges or through your local health department. They should offer a summary of benefits and a provider directory, which will help you compare plans.
Group health insurance
One of the most effective ways to find affordable health insurance in the us is through group health insurance. Often referred to as employer-sponsored coverage, group health plans offer an employee and their family members a lower cost option than individual health insurance policies because the risk to the insurer is spread across a larger pool of policyholders.
In addition to being less expensive than individual policies, group health insurance can also help you save money on out-of-pocket medical expenses. Additionally, you may be eligible for a small business health care tax credit to help cover some or all of the costs.
The type of group health plan you choose depends on your unique circumstances. You’ll need to determine what type of coverage is best for you, your family and your budget. Then, you can compare free quotes to find the best options for your needs.
