Which Health Insurance Plan is Right For Me?
The enrollment period for 2021 health plans is approaching quickly. In most states, you can enroll in a new insurance plan or change companies between November 1st and December 18th each year. Knowing what types of plans are available will help you get the most benefits at the right price.
Understanding Medical Insurance Options
The best way to make a health insurance comparison is to first look at the types of plans that are being offered. In most states, there are four levels of health insurance plans.
– Bronze Health Care Plans
Bronze health care plans have the lowest health insurance premiums out of all of the plans. However, these plans have high deductibles and high copayments. Many of these plans have minimal networks of providers, and some of these plans may not cover your medical care if you go outside of the network.
– Silver Health Care Plans
Silver health care plans generally have a little bit lower copays than bronze plans and will have a larger network of providers. Silver plans often offer additional benefits like credits for gym memberships or discounted wellness programs.
– Gold Health Care Plans
Gold plans have a higher premium for the coverage, but they generally have lower deductibles and lower copayments. This coverage has a much broader network of providers and will offer additional benefits such as credits for health memberships and discounted or free wellness programs.
– Platinum Health Care Plans
Platinum health care plans have the lowest yearly deductibles, the lowest copayments, and the highest amount of extra benefits. However, these are also generally the most expensive plans available.
Some states will allow certain individuals to purchase a catastrophic health insurance plan. These plans generally have high deductibles and are really only in place in the event of an emergency. Most states, however, discourage people from using these plans because it does not give you any real protections for common medical needs.
Other Factors That May Affect The Cost Of Health Insurance
Some of the other factors that may affect the cost of your health plan are if it is an individual plan or a family plan. Individual plans will be less costly because it is only covering one person. Family plan costs may differ based on the size of the family and the ages of the family members.
Health insurers cannot charge you higher rates for a preexisting condition. Part of the Affordable Care Act that regulates health insurance coverage prevents insurers from charging higher rates or declining coverage based on medical history.
If you are purchasing your health insurance coverage through the Health Insurance Marketplace, your premiums may also be affected by your income. The marketplace will provide discounts on your health coverage either through discounted premiums or tax credit at the end of the year based on your income.
To get accurate health insurance quotes, it will be important to have your financial information from the previous year available so that you can discover if you have any health care credits available to reduce your rates.
Laws Governing 2021 Health Plans
The Affordable Care Act of 2010 governs health insurance coverage. This law has regulated how the insurance companies can offer coverage and what types of coverage they must offer to qualify to provide insurance.
Under the Affordable Care Act, all insurers must provide the following as part of their insurance coverage:
- All policies must cover pre-existing conditions. Applicants cannot be denied coverage based on previous or current health conditions, age, sex, or other factors.
- All policies must provide some preventative care measures without additional costs to the policyholder. This generally includes yearly physicals and some forms of cancer screenings.
- All policies must cover mental health treatment
- All policies must cover addiction treatment
- All policies are prohibited from placing lifetime maximums on treatment or enacting yearly gaps in coverage.
These laws were put into place as a way of ensuring that more people were able to get affordable coverage. Additional regulations may be in place in your state that guarantees additional coverages as part of your health insurance plan.
Health Insurance Comparison
When you are ready to look for a new health insurance plan, you will want to make a comparison of available plans before committing to one plan for the next year. There are several things that you should look at in the plans before making your final decision. Some of the items you should compare between plans include:
- The level of coverage the plan provides compared to your needs. If you need a lot of medical care due to a medical condition, you will want to make sure that you have coverage that has lower deductibles and lower copayments because you will be going to the doctor more frequently.
- The network of service providers. Is your current healthcare provider a part of this network? Do you like the hospitals that are part of the network? Do you have options like going to urgent care instead of the emergency room? Are there surgical centers and diagnostic labs included in the plan? If these are important factors in your medical care, you will want to make sure that they are included.
- Out of network costs. Does the plan allow out of network treatment, and if so, what is your cost? Every plan will differ when it comes to out of network treatment.
- Does the plan include prescription drug coverage? What are the copayment costs for medications? Are multi month prescriptions available to save money?
- Does the plan have any special benefits such as discounts for gym memberships, free or discounted wellness products or services, tele-doctor services, or other services that you can benefit from while covered?
- Will the plan allow you to add on services if you want, such as optical or dental coverage?
You will also want to look over the following costs:
- What is your yearly deductible for individuals or family plans?
- How much is your copayment for regular office visits? Specialist visits?
- What is the copayment for hospital visits?
- What is your copayment for imaging, testing, and similar services?
- Do you have copayments for using clinics or walk-in centers?
Once you have found plans that meet your needs from the above list, you can move on to comparing any additional benefits and costs of those plans to determine which plan is right for you. Make sure that you compare extra benefits and add on options as well so that you can see the complete cost of coverage.
Medical Insurance Is Worth The Investment
A lot of people are concerned about the cost of having health insurance. Even with some of the discounts and assistance offered by the Affordable Care Act, many people are worried about the cost. However, not having coverage could place you and your family at financial risk.
Medical care can be expensive. An emergency operation, an extended stay in the hospital, or a diagnosis of a medical condition could cost you tens of thousands of dollars to treat. Some care may even take that number into the hundreds of thousands.
But even if you are not thinking about catastrophic events, treatments for regular conditions can be overwhelmingly costly as well. A broken leg, for instance, can cost over $7,500 to treat without insurance, and that does not include imaging costs or if any specialists were consulted. A trip to the emergency room could exceed $10,000 for just a few hours of care. With health insurance in place, this type of care will only cost you your copay and deductible.
Things like the recent COVID-19 outbreak are another reason to consider having insurance in place. No one can predict when things like this can happen, and having medical insurance protects you and your loved ones under these conditions.
Having medical coverage is also a great benefit. Having access to doctors for yearly physical and routine screenings allows you to keep your health at its best. It also allows you to find issues at their earliest stages so that they can be effectively managed or treated.
In the end, investing in a health insurance plan is investing directly in your own health and care.
Answering Your Questions
If you have questions about medical insurance options, or you would like health insurance quotes on available plans in your area, we are here to help. Our service is designed to help you find the right insurance plan to meet your needs.
We will answer all of your questions about family health insurance and individual health insurance plans. We can help you compare services and costs. We can even help you find plans that have your doctors or providers as part of their program so that you can continue your current care.
Finding the right health care coverage does not have to be difficult or confusing. If you are having trouble finding all the information that you need to make a good decision about your medical care coverage, we encourage you to contact us – we can help.
It is important to remember that the insurance plans available will change each year. New plans will become available, and changes to older plans may occur. It is very important to review your coverage each year so that you can take advantage of the open enrollment period and get the best possible health plan for your needs.
To review all of the health plans that are available in your area for 2021, you are encouraged to contact one of our service reps. We will be pleased to help you find the perfect health insurance for your medical needs and budget.