Health insurance is complicated and expensive but there are some ways to save money on health insurance.
Most people have some options to pick their health insurance either through work or through government healthcare exchanges. Even if your employer offers health insurance, you may still qualify for an ACA plan with a subsidy. There are various situations and income calculations that determine if you can opt for an ACA plan instead here. In some cases, an ACA plan may be cheaper and offer better coverage.
Employer Plans With Options
If you are lucky enough to have plan options through your employer there are a few things to consider when selecting a plan. First should be catastrophic coverage. What will the plan cover if you have a sudden unexpected and expensive health event? Even the healthiest people could end up in a horrible accident or have some unexpected health crisis.
If your insurance is going to leave you facing bankruptcy due to a lack of coverage you may want to consider a better plan. Look at the deductible, co-insurance, and maximum out-of-pocket costs. Co-insurance is typically a percentage. A 20% co-insurance sounds ok unless it is 20% of an astronomical medical bill. That is where your maximum out-of-pocket comes in. That will cap how much in total you are liable for.
For ongoing medical needs, look at what you typically need in a year. Have you needed regular office visits, lots of diagnostics or lab tests, or take expensive medication? Look at what your insurance will cover and how much you will have to pay out of pocket. Some plans have deductibles on lab work, diagnostics and medications. Do some math vs. past or expected expenses to see what you may end up paying out of pocket. This site provides cost estimates for various medical procedures in cities around the US.
Buying An ACA Plan
If you don’t have access to insurance or you think you may qualify to opt out of your employer-sponsored plan, ACA plans offer a variety of options many of which are free depending on your income. Others may cost as little as $20 a month.
Plans in most states have a variety of coverage levels, some with basic coverage and others with more coverage in specific areas. You can shop for plans on healthcare.gov. in addition, you can sign up through the exchange on that site, or you can contact the plan directly to ask questions or for assistance signing up.
In Network
For any insurance plan, who is in your network should be a major consideration. Some plans only cover doctors and facilities in a specific state or region while others have wider national coverage. Also, make sure any providers you already use or may want to use are in the network.
Pharmacy Coverage
Some plans slap a large deductible on prescription drug coverage, requiring you to spend a significant amount out of pocket each year before they will cover your medications. Others try to force members to use the plan’s contracted mail-order pharmacy. These contracted pharmacies vary widely in quality and customer service. If your only pharmacy coverage is through one of these contracted pharmacies and they can’t get your medications to you on time or create excessive red tape, it may be like you have no coverage at all.
Bonus Coverage
Some plans have limited vision and dental coverage included in the plan but bury it in the details of the policy documents. We found included coverage for eye exams, discounts on glasses and contacts, and dental coverage that covered routine cleanings and a percentage of most dental procedures included in some plans.
Certain dental problems such as tooth damage from an accident or a dental abscess may be covered under the regular portion of your health plan. Many employers offer separate dental or vision coverage that doesn’t really offer anything above what is buried in the health insurance policy. So always look to see if you already have coverage before buying dental or vision insurance.
What Isn’t Covered
Don’t forget to look for other services you may want or need and make sure they are covered by the plan. Most plans cover chiropractic visits, but some do not or only offer limited benefits. Reproductive health care is not offered in every plan. Some health plans offered by religious health care providers do not cover any sort of reproductive health care including birth control.
Even if you currently have insurance, it pays to review what is available every year. Plans change, coverage is removed here, added there and new plans are added so check what is available during open enrollment.