How Much Health Insurance Market Place Coverage Do I Actually Need?

It can be difficult to figure out how much coverage you need, though. Do you pay higher premiums for more coverage, or do you go with less coverage for the lower premiums?

Healthcare is expensive and having the right health insurance market place coverage is the best way to ensure you don’t overpay.

It can be difficult to figure out how much coverage you need, though. Do you pay higher premiums for more coverage, or do you go with less coverage for the lower premiums?

Fortunately, there’s help. You can figure out how much coverage you need by asking yourself a few simple questions.

How to Figure Out How Much Health Insurance Market Place Coverage You Need

Health Insurance Market Place coverage
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The health insurance market place coverage options vary based on how much coverage you want, not what quality of coverage you receive.

There are four categories of health insurance plans through the marketplace:

  • Bronze: This is the lowest category of coverage and bronze plans will cover 60% of your eligible costs.
  • Silver: If you need a step up in coverage, silver plans cover 70% of your eligible medical expenses.
  • Gold: For people who need a bit more coverage, gold plans pay for 80% of your covered medical costs.
  • Platinum: The highest level of coverage available, platinum plans pay for 90% of your covered medical expenses.

When you apply for coverage through the marketplace, you’ll have several options available for each plan category. These plans may have different premiums, deductibles, and copays. They may also cover different doctors and hospitals. This is just one part of figuring out how much health insurance market place coverage you need.

5 Questions to Ask About Health Insurance Market Place Coverage

Before you select an insurance plan, ask yourself a few questions about your medical history and future. This will help you figure out if you need coverage.

1. Do You Have Health Insurance Through Your Work?

The good news is that a lot of small businesses are now able to offer health insurance because of the marketplace. This means more people are eligible for health insurance through their employers. You may not need a lot of coverage through the marketplace if your employer offers health insurance that meets the minimum essential coverage.

The marketplace is a good choice if you have children and your employer doesn’t cover dependents. You may even qualify for low-cost health insurance for your family.

2. Do You Have Any Chronic Health Conditions?

Chronic health conditions cost a lot of money. Between all your doctor visits, lab tests, and prescriptions, it can feel like you’re never done paying for your healthcare. If you or anyone in your family has a chronic health condition, you may want to consider an insurance plan with more coverage. Gold and platinum plans may save you money in the long run.

One thing you need to consider, especially if you’re already receiving care for a chronic condition, is making sure your plan is accepted by your health professionals.

3. Do You Have Any Family History of Illness?

A lot of family illnesses – like heart conditions, high cholesterol, or cancer – develop later in life. As you age, you may want to have a health insurance plan with more coverage. Heart conditions, for example, can lead to an expensive stay at the hospital. Cancer, on the other hand, may require lengthy outpatient visits and expensive trial medications.

Put together your family medical history to figure out when you need to start considering higher coverage limits.

4. Do You Plan to Have a Baby?

Planning a family is a wonderful experience, but it can be shocking to find out how much it costs to deliver a baby. If your family is hoping to expand soon, you’ll want to look for health insurance market place coverage that offers higher coverage limits. A gold or platinum plan will give you plenty of coverage for any extra doctor visits.

You may also want to think about what you’re going to do about insurance once you have your baby. You may qualify to change plans at that point through a special enrollment period.

5. Do You Need Dental Insurance?

The marketplace also allows you to choose a dental insurance plan. If you don’t have dental coverage, you can select a plan through the marketplace when you choose your health insurance plan. You won’t be able to choose a dental plan as a standalone service, but you can add it to your health insurance plan at a marginal cost.

If you have children that may need orthodontic services in the future, it may be a good idea to purchase a dental insurance plan that covers them.

Tips for Choosing the Best Health Insurance Market Place Coverage

The process of choosing the right health insurance market place coverage can be overwhelming. There are dozens of plans and each one is different from the next. You don’t have to sort through every single plan to find the right one for you, though.

Use these tips to make the insurance process a little bit easier:

  • Fill out your application accurately: This is important because your application determines if you qualify for any premium tax credits. Those credits can save you money each month.
  • Compare your coverage options: The marketplace has a tool you can use to compare insurance plans. Use this tool to see differences in the plan categories or within the same category.
  • Use the healthcare calculator: Another useful tool is the healthcare calculator. When you’re selecting a plan, you can calculate how much it will cost if you choose that plan.

If you compare your coverage options and use the calculator to figure out how much your healthcare will cost, you should be able to choose the right coverage option.

How an Agent Can Help You Choose the Right Health Insurance Market Place Coverage Option

You don’t have to put all your time and energy into choosing the right health insurance market place coverage option. You can get help from an insurance agent or broker. An agent can help you fill out your application, compare plans and coverage costs, and choose the right plan for your family.

Need help choosing the right health insurance market place coverage option? Contact Fiorella Insurance Agency today to get started on your application.

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