Whether you need need an individual or a family plan, here are some tips on finding the best affordable health insurance.
There are a lot of benefits to self-employment and being your own boss. But there are some hurdles. One of the biggest concerns for self-employed individuals is finding health insurance. Finding the best affordable health insurance for yourself and your family is, unfortunately, not as easy as it should be.
When you search for health insurance on your own, you need to be confident that you find a plan that best fits your needs and budget. Otherwise, you’re either spending money that you don’t need to or you won’t have the right coverage when you need it.
How to find the best affordable health insurance for your lifestyle
When you look for health insurance, pay special attention to a few separate components to help you get the best policy. These will impact how much you will pay, when you pay, and where you can go to receive care.
The “metal tiers”
The health insurance marketplace separates into four primary ‘metal tiers;’ bronze, silver, gold, and platinum. Each of the tiers indicates how the costs of care get split between you and the insurance company.
Plans in the bronze tier will have a high portion of healthcare costs falling on your shoulders. Moving up each tier, from silver to gold to platinum, will shift more of the expenses toward the insurance company. While more of the expenses are covered, this will also increase monthly premiums.
The network types are perhaps one of the more confusing components in finding the best affordable health insurance. Depending on the network type you choose, you will have different options of which healthcare providers you can go to for covered service. Depending on the network, going outside of it could mean taking on 100% of care costs, even if it is a generally covered service.
Network types include:
- Exclusive Provider Organization (EPO) – Your care will only be covered by these insurance plans if you use doctors, specialists, and hospitals in the plan’s network. Exceptions may apply for emergencies.
- Health Maintenance Organization (HMO) – This type of plan limits you to receiving care from providers who work for or contract with the HMO. HMOs are often limited to people who live or work within a specified service area.
- Preferred Provider Organization (PPO) – Under a PPO, you will pay less when using providers in the plan’s network. You may use doctors, hospitals, or specialists outside of your network without a referral, but it will cost more.
- Point of Service (POS) – In a POS, you will pay less when using doctors, providers, and hospitals that belong to the plan’s network. You may only see a specialist in this type of plan with a referral from your Primary Care Physician.
The best affordable health insurance: Premiums, deductibles, and out-of-pocket expenses
While cost is probably the category most people are concerned with, every part of the plan will influence premiums, deductibles, and out-of-pocket expenses. The list of expenses that you will have to cover include:
- Premium – Every month, regardless of whether you receive care or not, you will pay your insurance premium.
- Deductible – This is the amount you must agree to pay for covered services before your insurance company begins to pay for anything.
- Co-payment – Once you have paid your deductible in full, you will still pay co-payments every time you receive medical care.
Plans also come with an out-of-pocket maximum. This is the threshold for which you will pay for your cumulative services in a year. Anything above and beyond that, the insurance company will cover all expenses for covered services.
Remember to explore the options thoroughly when you’re searching for the best affordable health insurance. Healthcare.gov is the most well-known location to look for plans, but it is far from the only option. Other brokers include eHealth, GetInsured.com, and GoHealth. The list of insurance carriers on these broker sites ensures you can explore thoroughly enough to find something that matches your needs.
What are some problems you have experienced while looking for affordable health insurance?
Nancy Zambell, Chief Analyst of the Financial Freedom Federation, has spent more than 30 years helping investors navigate the minefields of the financial industry. Nancy's book, Make Money Buying & Selling Stocks is an introduction for new investors and a reminder for experienced investors on how to profit in the stock market.Learn More