For most adults in the US, allocating enough resources to afford quality health insurance is one of the most important priorities when it comes to building a dependable monthly financial budget that satisfies your needs. For this reason, getting your health insurance in order can seem like an intimidating task. However, with the resources listed in this guide, you’ll have everything you need to know to get started on a path towards receiving good protection at an affordable rate.

This information will help you receive the medical coverage you need, and assist you in ensuring your future is well-protected and safe.

What exactly is health insurance, and why do I need it?

Health insurance is your first line of defense against any impending medical bills should anything ever happen to you or your loved ones. Even before COVID-19 struck, over 30 percent of American households were burdened with medical debt, Stanford University reports. The average total among these households was $2400 in debt. This financial burden can cause extreme strain on a family’s ability to make ends meet.

It’s also worth mentioning that having a secure health insurance plan can provide peace of mind and a sense of stability for those insured. By opting to go without a health insurance plan, you risk the possibility of suffering an accident or falling gravely ill without a strong support system to expedite your recovery.

Additionally, medical providers can also outright refuse to care for uninsured guests. It is essential for many of these clinics that they can guarantee their patients will actually be able to pay for any costs incurred during their stay. Only emergency services are bound by law to accept patients regardless of insurance status. Although health insurance is no longer legally required by federal law, these are the reasons why having a health insurance plan is strongly recommended by practically every medical professional in the US.

How much should I expect to pay for health insurance?

There are several factors that will determine how much health insurance will cost you personally, so it’s best to have a full understanding of what ultimately affects the total cost you can expect to pay. These factors include, but are not limited to:

  • Whether or not your insurance is provided by your employer
  • Your local state laws and governance regarding health insurance
  • Your income
  • The size of your employer’s business
  • The state you reside in
  • The county you reside in
  • Your age
  • Your history with tobacco, alcohol, and other substances
  • Preferred platinum packages

This wide range of variables will ultimately impact how much you’ll pay for health insurance in a big way. If you are self-employed or work for a small business, it can be quite difficult to get these covered. Working for a large company that can offer employee benefits and health insurance packages are two great ways to work around this.

Premiums for health insurance are one of the largest annual expenses for families today, as an Employer Health Benefits Survey done by the Kaiser Family Foundation found insurance was costing the average family over $21,000 in 2020. This is roughly equivalent to the price of a new car and further demonstrates how expensive medical coverage can be.

The survey also found that workers provided an estimated $5,588 to the yearly cost of their family coverage, indicating that employers covered 73% of the cost of health insurance. In 2020, the average premium for a single worker was $7,470. Workers paid $1,243, or 17%, of that total.

Kaiser calculated typical premiums by including health maintenance organizations (HMOs), PPOs, point-of-service plans (POS), and high-deductible health plans with savings options (HDHP/SOs). PPOs were discovered to be the most frequent plan type, covering 47 percent of all eligible employees. HDHP/SOs represented 31% of all insured workers.

Out Of Pocket CostsFamily PlansIndividual Plans
Per Month$5,588$1,243
Per Year$466$104

However, anything companies expend on health insurance benefits for their employees reduces the available pool of money for employee wages and salaries. As a result, employees are actually bearing a greater share of their premiums than these figures indicate. Indeed, one reason earnings may not have grown significantly over the last two decades is because healthcare expenses have increased so dramatically.

That being said, it’s worth pointing out that employees who receive health insurance benefits from their employers also benefit from the costs coming from pretax dollars. In this way, paying exclusively out of pocket for your benefits could still end up costing you significantly more money in the long run.

>>More: What Is A Health Insurance Premium | Life Insurance vs. Health Insurance: What’s The Difference | Can You Have Two Health Insurance Plans? | Can You Get Health Insurance Without A Job

Is health insurance mandatory?

In short, no. Since the 2019 federal decision to reverse the legal mandate to have health insurance, you are no longer legally obligated to have minimal coverage, and no exception is required to avoid the penalty.

Some states, however, continue to have their own criteria for health insurance coverage. Check your state’s legislation to learn what amount of insurance you’re necessary to carry and what fines, if any, exist for failing to meet these minimal levels.

Which provider should I choose for health insurance?

When picking which provider to go with, it’s crucial to examine which medical insurance companies in the United States have the greatest ratings in sectors like prevention, treatment, and customer happiness. These listed organizations find themselves among the best with a diverse product offering.

Best for Medicare Advantage: Aetna

Best for Nationwide Coverage: Blue Cross Blue Shield

  • Blue Cross Blue Shield provides health insurance to one out of every three Americans.

Best for Global Coverage: Cigna

Best for Umbrella Coverage: Humana

  • Humana is one of the only health insurance providers that cover expenses such as eyeglasses, contacts, dental exams, and crowns through their private policies. Humana also has a variety of plans for those living with chronic health conditions.

Best for HMOs: Kaiser Foundation Health Plan

Best for the Tech Savvy: United Healthcare

  • United Healthcare simplifies the process by allowing insured clients the opportunity to file claims, set up appointments, and find doctors online. It also offers Apple Watch integration with health trackers and other useful information.

You may input your postal code as well as other information on the businesses’ websites to get the best insurance for you as well as your family. You will be guided to plans available in your region that are suited for your situation, after which you may compare local clinician, hospital, and pharmaceutical options. You may also locate the optimal combination of premium, deductible, and other out-of-pocket payments for you.

What does health insurance cover?

Health insurance coverage varies greatly from one health insurer to the next, and even between different plans offered by the same provider. While your specific selections may vary, there are fundamental coverage criteria that must be met by any health insurance policy.

The Affordable Care Act requires all healthcare insurance to cover ten types of health services known as essential health benefits. Pregnancy and childbirth services, prescription medication coverage, mental health services, outpatient hospital care, preventative care, emergency services, and other benefits are available. Minors must also get dental coverage under the plans, but providing dental coverage for adults is optional and up to the discretion of the insurer.

Plans offered by insurance provided by insurers often differ depending on the state you reside in. If you are provided health insurance via your employer, you should verify with your employer’s plan to determine exactly what is covered.

Read More