A Guide To Understanding Health Insurance

Health insurance provides you with the health care that you need during unforeseen emergencies. So your health plan will cover your medical expenses if you get sick or injured. It should also cover preventive care, which means visits to your doctor for a check-up and the necessary tests requested for the visit should be covered, too.

The Basics

One important principle to remember is that your health plans don’t always cover 100% of your medical expenses. It is actually set up to share the costs with you up to a certain degree. When you reach this particular out-of-pocket limit, your plan will have to pay 100% of your health care costs. Knowing your shared costs and the out-of-pocket limit is important.

Another important aspect of your policy is to make sure that they cover the 10 essential benefits. Aside from this, the plan is also required to meet particular affordability standards too. Please do note that rules can vary depending on where you live so you can be included in the government-run health insurance exchange. In the past, all American citizens were required to have qualifying health coverage, else they’ll have to pay a fee on their federal tax return. This was outlined in the Affordable Care Act back in 2018. In 2019 though, the individual mandate was suspended and the penalty was lifted for not having health plans. Which leads us to the next question, who should buy a policy then?

Who Should Buy Health Care Plans

Everyone is advised to secure a health insurance policy because medical expenses are simply too high to be covered out of the pocket. Oftentimes, this leads to compounding financial problems. Whether you’re single, married, or with children, you should all get a health plan but do consider the fine points in looking for one.

If you’re buying for a family, please do note that your policy may have a family deductible on top of the individual deductibles of each member. When a member pays off their individual deductible, their policy takes effect for them. However, when the family deductible is met then the whole insurance is in force for all family members regardless if other members have paid off.

If you’re still a student, you can be covered by your parent’s health plan until you reach 26 years old. So there’s no need to secure a plan just yet if your parents are still willing to include you in their plan. Do check your school’s offerings as they may be cheaper. This is most helpful if you’re studying out of state or your parent’s plans may not work in your current state.

Meanwhile, self-employed can use COBRA to continue your previous employer’s insurance health plan until you’re able to find a new one. Should it not be open enrollment, you should still be qualified for a special enrollment period to shop on the marketplace. Please take note that since your income is not fixed, make sure to select an affordable premium. For frequent travelers, you may also want to explore PPO or POS plans.

You should also be able to secure a policy even if you’re pregnant while applying for one. Two of the essential coverages are maternity care and childbirth-related services so you should be able to get health insurance even if you’re currently pregnant. See the Summary of Benefits and Coverage of your policy for more details.

Lastly, if you’re married with no children, you can opt to get individual health care plans or be a dependent on the other’s employer-provided health plan. If you’re ready, then you can also opt to get a family plan.

Which Type To Buy

In general, there are two types of health care plans: the public (Medicaid, Medicare, and CHIP) and the private. The private health plans can either be purchased personally or offered by employers. Most state and federal exchanges also offer both public and private health care plans.

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