Getting Health Insurance
If you are looking for health insurance, the first thing to do is to figure out what coverage you are eligible for. Find out if you can gain coverage through your employer or if you can be placed on your spouse’s or parent’s plan (until you turn 26 years old). About 55 percent of Americans have an employer-sponsored plan while another 10 percent buy health insurance on their own, according to the U.S. Department of Health and Human Services (HHS).
Figure out if your income, age or other factor, such as a disability, makes you eligible for a state or federal health plan. For example, the federal Medicaid program is designated for those with low incomes, families and children, and pregnant women, while Medicare covers people over 65 and certain people under 65 with a disability. As part of the Patient Protection and Affordable Care Act, starting October 1, 2013, people can fill out an application on the Health Insurance Marketplace to determine what public programs they qualify for or to find an affordable private health plan. (See these websites for more information on government health insurance and your options.)
Before deciding on health insurance, it’s a good idea to do some research to find the best coverage at the best price for your health needs. These websites can help:
- Healthcare.gov, a site managed by the U.S. Department of Health & Human Services, helps you find insurance, learn about preventing illness, compare hospitals in your area, and learn more about health care reform provisions.
- The government Agency on Health Care Research and Quality (AHRQ) has created a guide to health insurance plans and answers to common questions.
- Consumer Reports Health.org provides advice on how to choose an insurance plan.
- Consumer Reports also offers basic information about new health reform provisions and their impact on health insurance.
- AARP offers information on buying individual health insurance.
- Healthinsurance.org offers individual health insurance information including benefits, pricing and eligibility by state. Healthinsurance.org is not an insurance agency but functions like a health insurance exchange connecting people to different plans. Visit their site or call 866-573-8466 (toll free quotes)
How Much Does Health Insurance Cost?
The cost of health insurance typically varies from state to state and from region to region as the population by age, race, and sex, the numbers of uninsured and providers, local health care costs, insurance companies and taxes vary.
When evaluating health insurance, you should look at how much you will be paying; both for premiums—money paid on a regular basis for health insurance—and for deductibles and co-insurance, which are the amounts insurance companies require you to pay for a health service before they cover a portion or the rest of the amount and the percentage you pay for a service after your deductible is met, respectively. (See Health Insurance: Glossary of Common Terms.)
Don’t just select the plan that has the lowest deductible without looking at what’s covered under the plan. What’s appropriate for a healthy twenty year old may not cover enough for a person over 50 with a chronic disease. Also, check to see whether prescription drugs are covered as well as mental health services, and look at coverage differences for inpatient hospital care versus outpatient office visits.
Resources reviewed June 2013
|Getting Health Insurance|
Advice for finding the right health insurance to fit your needs and budget, as well as information about health insurance reform.
|Health Insurance: Glossary of Common Terms|
Don’t know a deductible from a premium? Here’s a helpful guide to health insurance terms.
|What Are Medicare and Medicaid?|
Learn more about the U.S. government’s health insurance programs
|How Much Will Your Health Care Cost?|
It can be hard to figure out how much your health care will cost ahead of time. Here are some tips for preparing for the cost of your procedures and websites that can provide estimates for common procedures.
|Paying for Prescription Medications|
Prescription drugs can be expensive. Here’s how to get help paying for them and finding lower cost options.
|Handling an Insurance Dispute|
If you’re faced with an unexpected charge or your health insurance denies you coverage for a procedure or treatment, here are some steps you can take.
Massachusetts Residents Healthier After Health Care Reform