Are you an individual looking for the best health care options for yourself?
Have you been considering the health insurance market place for individuals, but aren’t sure where to start?
Do you need some guidance in choosing the best health insurance for your situation?
Choosing health insurance as an individual can be a little bit daunting – there is insurance lingo, limits, minimums, and maximums, and dozens of plan options.
But choosing comprehensive health insurance market place options for individuals is simple with the help in this guide.
You’ll get a primer on the health insurance market place, recommendations on some of the best plans for specific scenarios, and what terms you need to know to choose a plan that fits your budget.
Overview of the Health Insurance Market Place for Individuals
The first thing to know is that open enrollment for 2021 begins on November 1, 2020, and ends on December 15, 2020. You’ll need to fill out your application, and submit any documents as soon as possible after that, by the deadline to get coverage beginning January 1, 2021.
After open enrollment ends, you’ll only be able to apply for coverage through the health insurance market place if you qualify for a Special Enrollment Period. This can be anything from a job loss to the birth of a new child.
Once you apply and submit your documents, you’ll be able to choose plans from four different categories:
The higher the category (platinum), the higher the premium, and the more the insurance company pays for each covered claim.
Health Insurance Market Place Options for Individuals
Rather than choosing the least expensive option or choosing a plan that has maximum coverage limits, it’s important to think about your health care needs. Everyone’s situation is different, and the best plan for you may not be the best plan for your brother, sister, or best friend. Here are a few scenarios where it’s important to compare coverages carefully.
1. Best Health Insurance Coverage for Women
There are a few things women need to take into account when choosing their health insurance policy from the health insurance market place for individuals. The most important is whether or not they plan to conceive children during the plan year.
A Fiorella Insurance Agent can help you choose insurance that’s right for you.
For women planning to have children, a gold plan with higher premiums and a lower deductible and out-of-pocket limit may be more suitable to deal with the costs of additional tests, doctor visits, and hospital stays. Pro tip: You may be able to change coverage once your child is born, so keep that in mind.
2. Best Health Insurance Coverage for Entrepreneurs
Being an entrepreneur has its fair share of struggles. Most entrepreneurs wear multiple hats and pivot jobs throughout the day. Things to keep in mind for entrepreneurs are how often you may travel and whether or not your coverage extends to those areas.
If you’re a reasonably healthy entrepreneur who travels in the states frequently, you may not need as much coverage as a woman planning to have children. A silver plan with a mid-range deductible and relatively low premiums may be more appropriate to deal with infrequent visits to urgent care clinics.
3. Best Health Insurance Coverage for People with Chronic Health Conditions
Individuals with diabetes – or other chronic health conditions – may want to compare their coverage options more carefully. While doctor visits may be few and far between for some, prescription and insulin costs can add up over the course of a year.
Chronic health conditions can lead to dozens of doctor visits and expensive tests, not to mention the trial and error of prescriptions. A platinum plan – which offers the most coverage – would be the best choice to limit the out-of-pocket burden that those tests can place on an individual.
Health Insurance Market Place for Individuals: Terms to Know
Now that you have an idea of the different circumstances that impact an individual’s health insurance decision, read through these important terms to know to help you better select a health insurance policy.
These terms are common across plans and give some insight into how much you’ll pay for your health policy over the course of a year:
- Premiums: This is what you pay each month for your health insurance. Regardless of whether you go to a doctor or not, this is the minimum you’ll pay to have health insurance.
- Deductibles: This is what you pay before your insurance company starts to pay for services. You may have a separate deductible for your prescription plan, as well.
- Coinsurance/copayments: This is what you pay at the doctor, pharmacy, or clinic when you receive services. Typically, you pay copayments and coinsurance after you meet your deductible.
- Out-of-pocket maximum: This is what you pay out of your own pocket each plan year for health care expenses. After this, your insurance typically pays 100% of your claims.
Remember that you’ll owe money for services ranging from doctor visits to bloodwork to prescriptions, so calculate what you anticipate you’ll spend each year before choosing a health insurance plan.
How to Choose Health Insurance Market Place Options for Individuals
Don’t just choose the first plan that pops up and call it good – use these tips to help you choose the best health insurance market place options for individuals:
- Make a list of how often you expect to visit the doctor, what tests you typically need to have run, and what prescriptions you need to have filled every year to help analyze costs.
- Work with a health insurance market place agent or broker to help you choose the best plan for you and your financial situation.
- Compare coverage limits, deductibles, premiums, and other out-of-pocket costs carefully, so you know what you are paying for – too much insurance isn’t good, either.
With this guide, a few specific options, and these quick tips, you should have no trouble choosing from the health insurance market place for individuals.
If you need help understanding your policy, a Fiorella Insurance agent or broker can walk you through your coverage options and exclusions.
Are you looking for more help in choosing the best insurance for individuals? Contact Fiorella Insurance Agency today to get comprehensive advice on the best insurance plan for you.