Buying health insurance on your own can be an intimidating process – from technical terminology to extensive coverage documents, it can almost feel like it was designed to stress you out.
How to Buy Health Insurance on Your Own
The first thing to know about buying health insurance on your own is that you’ll likely want to use the health care market place to see if you qualify for any additional savings. The health care market place application is the only way to see if you qualify for premium tax credits.
Unless you’ve had a recent qualifying event opening a Special Enrollment Period, you will be eligible to apply for a health care market place plan when open enrollment begins. Open enrollment for 20212 is from November 1, 2022, to January 15, 2023.
A Fiorella Insurance Agent can help you choose insurance that’s right for you.
During open enrollment, you can fill out your application, submit any appropriate documents to verify income, citizenship, or dependent status. You can compare medical care plans and coverage options before choosing the best plan for your family.
Before we dive into how to save money when buying health insurance, let’s first make sure you understand the Affordable Care Act (ACA).
What Is the Affordable Care Act?
The Affordable Care Act (ACA, or PPACA) provides individuals and families greater access to affordable health insurance options including medical, dental, vision, and other types of health insurance that may not otherwise be available. It is formally signed into law as the Patient Protection and Affordable Care Act on March 23rd, 2010 by President Obama in a White House Ceremony.
Many Insurance Companies – One Healthcare Marketplace
The healthcare marketplace is managed by the federal government and provides extensive information from each health insurance company that has made an ACA compliant health insurance plan available on the marketplace. It is designed to allow you to select from among 4 levels of health insurance, each of which provides different levels of coverage as well as various deductibles. For example, silver health insurance plans have average premiums but lower deductibles than the bronze level. There is a health plan available for every budget. Each has different coverage options. Coverage options may include medical care, like preventive care visits, doctor visits, virtual visits and more. There are also family plans available.
Short-Term plans offer limited coverage at affordable prices. Easy to enroll and can start in just a few days. They are not fully compliant with the mandates of the ACA, but do provide valuable interim health plans with limited health coverage that are a valuable solution to many individuals.
Available to Small Businesses and Individuals
Offering health insurance to your employees is great benefit for employees of small businesses. Your small business may qualify for a tax credit that could cover some of the costs of employee premiums. Individual Contribution Health Reimbursement Accounts (ICHRA) provide flexibility for your employees and are a great way for your employees to save on health coverage. One of the productivity enhancing aspects of such plans is the inclusion of preventive care visits. Individuals can, of course, buy health insurance on their own through the ACA (Obamacare). Learn about small business tax credits to help companies with the equivalent of fewer than 25 full-time employees provide insurance coverage to their workers. Health Insurance Plans helps you and your employees pay for medical services and sometimes prescription drugs.
The Cost to Buy Health Insurance on Your Own
When buying health insurance on your own, there are some monetary terms you need to know that will help you compare costs accurately.
One of the most important things you need to know about the cost of buying health insurance on your own is how much your deductible is. Your deductible is what you pay for health care services before your insurance begins paying claims.
Certain things are covered before meeting your deductible, like annuals, physicals, and preventive services. You may have a separate deductible for your prescription coverage, so check that when comparing health insurance plans.
Costs for preventive services, are covered regardless of the deductible when provided by a doctor in your plan’s network.
Your premiums, which are made directly to the insurance company and not the health insurance market place, are what you pay each month for your health insurance policy. Like with auto insurance, premiums are in addition to other costs like deductibles and copayments.
Monthly premiums in Florida for an individual can start at around \$320 for a bronze plan – this is the lowest level of coverage and will have higher deductibles and copayments than some of the more expensive plans. The plans top out at around $940 per month.
3. Copayments or Coinsurance
After you’ve met your deductible, you’ll have either a copayment or coinsurance due at the time you receive health care services. What are copays? Copayments are fixed amounts (such as $10 or $20) due at the time of service that you pay out of pocket for visits to in-network healthcare providers, where coinsurance is a percentage of the amount due at the time of service. Amounts can vary depending on the provider (primary care or a specialist) you see or the services you receive (such as medications, labs, and diagnostic tests)
As with deductibles, typically you’ll have lower copayments when you have higher monthly premiums, and you’ll have higher copayments or coinsurance when you have lower monthly premiums. If you visit the doctor frequently, this is an important cost consideration.
How to Save Money on Health Care
Here are some tips on secret ways to save money on your medical expenses:
- Preventive Care: It’s almost cliché at this point, but the best way to save money on health care is to stay healthy through prevention. Get all of your annuals and physicals, typically covered with no additional copayments, so your doctor can spot any potential health issues before they become a problem.
- Wellness Programs: Like preventive care, wellness programs are designed to keep you in the best shape possible to avoid having serious health complications. Many health insurance companies offer incentives – like points-based rewards systems – for people to subscribe to their proprietary wellness programs.
- Prescription Drug Cards: Even if you have a prescription drug plan with your health insurance, you may look into alternative prescription drug cards. Some prescription drug cards can be used with your insurance, giving you a slight discount on your out-of-pocket costs. Most, though, can only be used as a standalone. They may, however, save you more money than your insurance.
- Premium Tax Credits: Applying for health insurance on your own through the health care market place is the only way to find out if you qualify for premium tax credits. Premium tax credits can be applied to your monthly premium payments to help offset those costs. This helps save you money while potentially giving you better coverage options.
Don’t forget to take advantage of any prescription drug coupons that are offered by your doctor’s office or pharmacy. These savings can add up over time and significantly reduce how much it costs to buy health insurance on your own.
Health Insurance Market Place: Buying Insurance on Your Own
It doesn’t have to be intimidating to buy health insurance on your own. Compare copayments or coinsurance, deductibles, and premiums carefully so you know what your expected costs will be. Overestimate your expected medical expenses. Remember these tips for buying insurance on your own:
- Apply to the health insurance market place before January 15, 2022, so you can qualify for coverage beginning January 1, 2022.
- Submit all documents requested to see if you qualify for premium tax credits that can offset your monthly premium costs.
If you feel like buying insurance on your own is a bit too complicated or overwhelming, work with an insurance agency or broker – they can help you find the best plan for your budget.
A Fiorella Insurance broker or agent can help you figure out what information you’ll need, what documents to submit if you need to, and decide which plan is best for you and your family.
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