Where Can a Person Find Affordable Health Insurance?

Health insurance can help you get care when you need it. It can also save you money in the long run by reducing your out-of-pocket costs for doctor visits and prescription drugs.

People can find affordable health insurance through Medicare, the Affordable Care Act Marketplace, employer coverage and short-term health plans. The best plan for you depends on your needs and budget.

Medicare

Medicare is the Federal health insurance program for people 65 and older, some people with disabilities and people with end-stage renal disease (ESRD). It also covers people who have limited income or resources.

There are several ways to get affordable health insurance. The best way is to enroll in a private insurance plan through the Health Insurance Marketplace.

Original Medicare includes Part A, which helps pay for inpatient hospital care. It also includes Part B, which pays for doctor visits and preventive healthcare services like most vaccinations.

Part B usually includes a deductible and coinsurance costs. There are also supplemental coverage options, such as Medicare Part D and Medigap.

In addition to covering your medical and prescription drug needs, a Medicare Advantage plan may also offer additional benefits such as gym memberships, dental, vision and hearing care, and transportation to your medical appointments. These bundled plans are sold by private insurers and have yearly contracts with Medicare.

Health Insurance Marketplace

The Health Insurance Marketplace is a place where individuals, families and small businesses can find affordable health insurance. These markets are regulated by the Affordable Care Act (ACA) and make it easier for people to shop for health insurance plans.

ACA-compliant plans sold through the Marketplace must meet certain requirements, including not using medical underwriting and not excluding people with preexisting conditions. They also must offer essential health benefits, such as maternity care and prescription drug coverage.

Premium tax credits can help reduce your costs, depending on your income and family size. If you qualify, you may also be eligible for cost-sharing reductions on your out-of-pocket medical costs, such as deductibles and copayments.

You can apply for coverage in the Health Insurance Marketplace online, by phone or with a paper application. You can also get help with your application from a trained assister.

Employer Coverage

Employer coverage is the most common way people get health insurance. Many employers offer employee-only and employee-plus-family insurance, which can help people with higher incomes save money on their premiums.

The Affordable Care Act requires that all businesses with 50 or more full-time employees or “full-time equivalents” provide affordable, minimum value health coverage to their workers. This coverage must also be offered to their dependents.

Most employer-sponsored plans are considered affordable if they cost less than 9.5% of an employee’s household income. But if the plan costs more than that, it’s considered unaffordable and may not be eligible for premium tax credits in the Marketplace.

The ACA requires that all employer-sponsored health plans meet a basic minimum value standard, which covers inpatient hospital and physician services at a reasonable price. These plans must pay at least 60% of the total cost of covered healthcare services.

Short-Term Coverage

Short-term coverage can provide affordable health insurance for individuals when they need temporary protection. These plans typically cover medical services such as doctor visits, hospital care and medical tests for a period of one month to a year.

Many people choose to enroll in a short-term plan as a bridge between an employer-provided or Medicare plan and another health policy. If you are a young adult changing jobs or losing your current employer-provided plan, for example, a short-term policy can fill the gap while you wait for your new long-term insurance to kick in.

The best place to find a short-term health plan is on an online marketplace, such as eHealth or Agile. These websites offer quotes from hundreds of insurers, making it easier to compare prices and coverage.

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About the Author: Raymond Donovan