What kind of health insurance do you have? While some people are lucky enough to be on the state-sponsored plan, many of us have to go out and buy our own insurance policy to make sure we don’t get stuck with thousands of dollars in medical bills when we get sick or injured.
This can be a difficult and stressful task, especially if you’re not familiar with all the different types of plans available.
Read on to learn about health insurance in your state and how to pick the best one for your situation.
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Medicare, which is a federal program that’s open to everyone aged 65 and over (and some people with disabilities) provides coverage for inpatient hospital stays, skilled nursing facilities and hospice care.
Original Medicare covers 80 percent of your approved Part A costs (inpatient hospital stays) and Part B, which covers doctor visits, outpatient care and other services such as lab tests.
You can purchase Medigap plans to fill in some of Medicare’s coverage gaps; these are sold by private companies but are standardized based on rules set by federal law.
Medigap plans cost extra but offer added protection: They cover copayments for example so you only pay for whatever’s left after Medicare has paid its share.
Know your options
If you’re going to buy health insurance, your first order of business is to figure out which plan best suits your needs.
You may want to investigate a high-deductible plan if you want lower premiums but are willing to pay more when you need medical care.
If paying lower premiums and just having regular checkups sounds like a better deal, then a low-deductible plan might be for you.
There are many other factors that go into deciding on an option, but knowing how each works will help guide your decision so you can make one that’s right for you.
You can start with a high deductible
A high deductible lets you contribute more to your HSA up front.
So if you invest wisely and spend carefully, there’s a decent chance you’ll come out ahead at tax time, when you can use your HSA funds to cover your medical expenses (including any left over).
But if that money goes unspent, it stays in your account to help lower premiums year after year.
However, you don’t get an income tax deduction for contributing to an HSA unless it’s through a workplace plan like those offered by employers and many self-employed individuals.
Employer contributions aren’t taxed either—but they’re also limited. You can put in $3,400 as an individual or $6,750 as a family in 2016.
Are you covered if you lose your job?
A recent Gallup poll found that only 66% of Americans are covered by some form of health insurance, which can lead to high costs for those who are uninsured.
Luckily, finding out if you’re insured is a pretty simple process: just visit your state’s health care exchange website and enter your name and social security number.
If you’re covered, you’ll be directed to apply for coverage.
If not, there may be tax penalties for non-compliance.
In addition to covering you on paper, your plan should protect you from financial strain in case of an accident or illness; even so, it’s important to know exactly how much care costs before using any service!
What’s the difference between HMO and PPO?
Health Maintenance Organizations (HMOs) are usually cheaper than preferred provider organizations (PPOs), but they often require you to use only doctors, hospitals and other providers that belong to your plan’s network.
With a PPO, you can see any provider—but you’ll pay more for it. And if your HMO or PPO plan comes with a high deductible, then it may be worth considering cost-sharing.
The deductible is like an upper limit for how much of your expenses you’ll pay for in a given year, so if your total healthcare costs are below that amount then good news: You don’t have to spend anything! It’s best to run some numbers before choosing a high-deductible health plan.
Flexible Spending Account (FSA) vs. Health Savings Account (HSA)?
If you currently purchase your own insurance, as opposed to having it provided through an employer or government program, then you know how confusing shopping for a new policy can be.
Luckily, HealthCare.gov is here to help. When you visit HealthCare.gov, you’ll be able to compare plans and prices on a side-by-side basis.
You can even check whether or not a plan covers doctors and providers near where you live or work.
CHIP covers more than healthcare costs
When deciding which kind of healthcare insurance plan to buy, you should weigh costs and benefits.
It is important to choose a plan that fits your needs and is affordable for you.
Individual plans offer many features, but they often cost more than group plans offered by employers.
However, individual plans may offer more flexibility in terms of coverage if you are older or are not eligible for a group plan at work.
Depending on where you live, your state may make it easier to switch between individual and group plans during open enrollment periods.
This can help reduce your costs each year by allowing you to drop an expensive individual plan and enroll in a less-expensive employer-sponsored plan when your employer allows it.
What about life insurance?
Finding an individual plan that fits you and your budget can be tricky.
You need to consider what level of coverage you want and how much it will cost.
Generally, it’s cheaper to opt for a high deductible because premium costs go down as deductibles go up.
It also helps to buy plans with lower out-of-pocket maximums, so even if you’re hit with unexpected medical bills, your expenses are limited.
And some plans might cost less than others based on where you live or whether you qualify for a subsidy from your employer.
When in doubt, contact an agent who specializes in health care or talk to your human resources representative at work about the type of coverage available through them.
Is mental health covered?
The Affordable Care Act makes mental and behavioral health services essential healthcare benefits.
But with so many plans available on today’s market, it can be hard to know exactly what those coverages look like.
The good news is that most policies include some form of mental healthcare coverage.
In fact, your ACA plan must include coverage for at least one full hour of behavioral health therapy per day, seven days a week.
Additionally, if you already have a plan in place through an employer or private insurer, you may be eligible for some additional coverage through Mental Health Parity and Addiction Equity Act (MHPAEA).
Check with your insurer or contact a licensed therapist in your area to learn more about MHPAEA requirements.
Best individual health insurance
Try getting a list of health care providers in your area to see which one is covered by your plan.
Your insurer may also be able to tell you if you’re going to need extra coverage, especially if it seems like you’ll use a lot of services while you’re receiving care.
You should also talk with your doctor or nurse practitioner about whether they accept your plan and can give advice on which options will work best for your family.
Just know that some doctors are trying to collect less from insurers so that their prices can stay low for patients.
As always, ask questions as you go along and make sure that you understand everything about your plan so that you don’t miss any treatments or medications.