For many people, health insurance conjures up debt and big bills.
Health insurance can be very expensive, but it doesn’t have to be.
There are a variety of ways to get affordable health insurance.
In this article, we’ll talk about some of those ways and how to choose an affordable health care plan that fits your needs.
Types of Health Insurance Plans
There are three types of healthcare insurance plans: private plans, government plans, and plans employer plans
Most Americans get their health insurance through an employer.
Typically there is either one plan your employer automatically connects you to, or you can choose between two or three different plans.
These plans come in three subsets: health maintenance organization (HMO), preferred provider organization (PPO), and high-deductible health plans (HDHPs).
HMOs offer the lowest premiums overall but require you to choose from a small network of providers. PPOs are similar to HMOs but have the highest premiums.
In turn, they provide more flexibility in choosing providers to see.
HDHPs have lower premiums than PPOs but higher than HMOs. Their deductible is higher than with either PPOs or HMOs.
Government plans are based on specific criteria.
For instance, Medicaid is a program that allows people with little or no money to receive health insurance.
Eligibility varies by state, but you typically have to be at or near the federal poverty level to receive Medicaid coverage.
The federal poverty level for 2022 is $13,590 for a single-person household and goes up by $4,720 for each additional family member.
The qualifying medication conditions can include stroke, kidney failure, uncontrolled chronic conditions, and severe injury and mobility problems.
Individual health insurance plans are plans you pay for yourself, without an employer offsetting any of the costs.
These plans are also not sponsored by the government, but you can receive a tax deduction for what you pay based on your income.
Plans can be compared on the Affordable Care Act (ACA) site, which offers four different tiers of health insurance plans: bronze, silver, gold, and platinum.
Bronze plans offer the lowest costs per month but the least coverage, platinum plans cost the most but offer the most coverage.
Choosing a Health Insurance Plan
Once you’ve decided what sort of plan you want to have, you need to choose a specific plan.
Several different things can have an effect on your choice, and some of those considerations are below.
If you have selected to go with your employer’s plan, there may not be a choice in the plan selected by that employer.
If you’re not choosing your employer’s health insurance plan, then there are usually various criteria you need to meet before being approved for health insurance.
This is most clear with government-based plans: you are only eligible for Medicaid if your income is below a certain level and for Medicare, if you are over 65, have kidney failure, or have certain other conditions.
If you want to select an individual plan, you can go to the ACA site and enter your income and various other questions about you and your family.
The site will then tell you which plans you are eligible for.
One advantage of employer-based health insurance plans is that your monthly premium will typically be lower.
Your employer will pay a percentage of it and you pay the remaining balance.
Medicaid usually does not charge a monthly premium, but there may be other costs associated with the Medicaid plan you have.
Part A Medicare plans do not charge a premium, but part B and part D have premiums that vary based on your plan and your income level.
Individual plans have monthly premiums that you must pay all of, and the costs for those vary.
Most health insurance plans have various deadlines.
If you take advantage of open enrollment to choose an individual ACA plan, you must select a plan between November 1 of the previous year through January 15 of the year you want to be covered in.
Some states have expanded enrollment periods and you may want to see if your state is one of them.
If you are enrolled in an employer-based plan and want to switch to an individual one, you can change that during a period of open enrollment.
Your employer-based insurance plan can also be changed during certain life events, like childbirth or getting married.
If you experience one of those events and want to change your coverage, you have between 30 and 60 days from that event to apply.
Once you have chosen a health insurance plan, there are several things most require you to do to get coverage.
Those are typically detailed in the papers you are given after your application is approved.
How to Get Affordable Health Insurance
Find a plan within your budget
Unless you’re eligible for Medicaid, you’ll have to pay a premium each month for your healthcare coverage.
If you’re covered through your employer, your employer will pay part of this premium.
If you aren’t covered through an employer, or their plan is not right for your needs, you can search through the health marketplace for ACA plans that you can afford the premium on.
Understand your needs
Plans that offer the most comprehensive coverage often come with the highest premiums.
If your current health is good, you may be able to save money by choosing a less comprehensive plan.
HDHPs and HMOs are more likely to have lower premium rates than PPOs, as are bronze and silver plans from the ACA marketplace.
Look into alternative options
If you do not have health insurance through an employer, are not eligible for Medicaid or Medicare, and have missed the deadline to apply for an individual or ACA health insurance plan, you may be able to get a short-term healthcare plan.
These plans have much lower monthly premiums than other types of plans, but don’t cover as much as other plans, and can exclude you because of certain pre-existing conditions.
How K Health Can Help
If you need to know more about affordable health insurance options, talk to a medical provider.
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Frequently Asked Questions
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Federal Poverty Level (FPL). (2022).
2021 Poverty Guidelines. (2021).
What are the deadlines for the ACA's open enrollment period? (2022).