Healthcare is a fundamental aspect of our lives, but it’s no secret that it can be financially burdensome. The rising costs of medical treatments, prescription medications, and health insurance premiums have left many individuals and families grappling with the dilemma of securing adequate healthcare without straining their finances.
The good news is that cost-efficient health insurance plans are available to help you address these challenges. In this guide, we’ll explore several options to help you navigate the world of health insurance and make informed decisions.
Short-term Health Insurance
Short-term health insurance is a temporary option that often costs less than more comprehensive plans. It’s particularly attractive to individuals seeking coverage for a limited period or looking for ways on how to get health insurance fast, such as those between jobs or waiting for employer-sponsored insurance to begin.
Short-term plans can vary in duration. In some states, you can purchase coverage for up to 364 days and renew it for 36 months. However, it’s important to note that the Biden administration has proposed rule changes that may cap short-term plans at initial terms of three months, with a total duration (including renewal) of four months.
Qualification for short-term health insurance largely depends on an insurer’s assessment of your risk. You may be eligible for this lower-cost option if you’re young, healthy, and not considered a high-risk candidate.
However, it’s essential to carefully read the policy details, understand post-claims underwriting, and know what the plan covers and doesn’t cover. You can purchase a short-term health insurance plan through several avenues:
- Directly from a health insurance company.
- Use your insurance agent if you have one.
- Find a health insurance agent or broker through the National Association of Health Underwriters website.
- Utilizing a non-governmental private online exchange, such as ehealthinsurance.com.
Medicaid
Medicaid is a government-based health insurance program that provides comprehensive coverage to low-income individuals and families. In most cases, Medicaid is free health insurance for those who qualify, with a few exceptions in some states that charge small premiums for higher-income individuals.
Medicaid eligibility criteria can vary from state to state. Generally, eligibility is based on low-income and asset requirements, with variations depending on factors like age, pregnancy, and disability.
Thanks to the Affordable Care Act’s expansion of Medicaid, coverage now extends to various populations in most states:
- Adults under 65 with household incomes up to 138% of the federal poverty level (FPL).
- Special eligibility criteria in certain states for non-pregnant adults.
- Pregnant individuals and children with higher income limits.
- Disabled individuals and those aged 65 and older with lower incomes and minimal assets.
- Coverage gaps exist in states that have not expanded Medicaid under the ACA.
Job-based Health Plan
Employers in the United States often offer health insurance as part of their employees’ benefits and compensation packages. While health coverage is common for full-time employees of large companies, it may be less prevalent for part-time workers and employees of small businesses.
Job-based health plans enhance an employee’s overall well-being and provide financial security in the face of unexpected medical expenses. By participating in a group health plan provided by your employer, you often benefit from lower premiums, as the cost is shared between you and your employer.
This cost-sharing arrangement significantly reduces the financial burden of obtaining comprehensive health coverage.
When considering a job-based health plan, you must carefully evaluate the available options. Employers often offer a selection of plans with varying levels of coverage and associated costs. Take the time to review the plan’s details, including deductibles, copayments, and network providers, to ensure it aligns with your healthcare needs and budget.
Affordable Care Act Subsidy
The Affordable Care Act (ACA), often called Obamacare, provides government subsidies to make health insurance affordable for those who purchase coverage through the health insurance exchange or marketplace.
The ACA offers premium tax credits to offset monthly premiums and cost-sharing reductions that reduce out-of-pocket expenses for medical care. Legal U.S. residents have the opportunity to enroll in a health plan and apply for a health insurance subsidy via either the federal government’s exchange or your state’s health insurance exchange.
Spouse’s Health Plan
You may be eligible for the same coverage if your spouse has job-based health insurance. Many employers offer health insurance to their employees’ spouses and children.
You have the option to enroll in this coverage during the initial enrollment period when your spouse initially secures the job. If you happen to miss this opportunity, you will have another chance each year during your employer’s annual open enrollment period. You can also join your spouse’s plan during a qualifying life event.
Conclusion
Consider your unique circumstances, income, and coverage needs when deciding. Whether it’s short-term health insurance, Medicaid, job-based plans, ACA subsidies, or coverage through a spouse, there’s a solution that can fit your budget and provide the necessary protection for your health and well-being.
