Health Insurance: Get It While You Can
Many of our readers are approaching the lovely age of 26 when we have to go out in the world and find our own health insurance. Megan just turned 26 last month and decided to do a little research into the wonderful world of health insurance.
So honestly, I still don’t feel like I really understand how insurance works despite doing a lot of research. I’m going to share some of the things I’ve learned and some tips for finding healthcare once you can no longer stay on your parents’ plan. If you have any additional tips or personal experiences, comment below or email us if you’d like to write a contributor post about your experience!
Note: the Affordable Care Act is still the law of the land for now. I will try to update when/if healthcare requirements change.
Do I even need health insurance?
Yes. Anything could happen. Any of us could get in a car accident or have a totally random injury happen. These things can happen no matter how healthy you are. You’ll want insurance for that otherwise you’ll be in major debt. And also, as of now, you are still legally required to have health insurance or you’ll have to pay a fine.
But it’s all so confusing….
Oh my gosh, I KNOW. Trust me, Google is your friend. Once you start finding plans, really read through them. The policies are often long, boring reads, but READ THEM! It is important to know exactly what your plan covers and what it doesn’t. Don’t be afraid to ask your parents or other more adulty adults for their advice and knowledge.
How do I know which plan to get?
There’s lots of options here. First, if you’re in grad school, most schools have student insurance that you can purchase. The plans are usually pretty good and have low copays. (pssst…copays are the amount you pay at the time of service, usually for office visits and prescriptions.) Many schools require grad students to have health insurance. There are often stipulations that your plan, if not the school plan, has to have equal or better coverage than the school health insurance plan.
For those of you not in grad school, you’ll either have to get insurance through HealthCare.gov or private insurance companies, if you’re not receiving benefits from a full-time job. If you do have a full-time job, your employer is required to offer you insurance. However, they can wait up to 90 days from your hire date to offer it to you. Whichever route you decide to take, the plans and coverage are pretty similar.
Types of Plans
There are two main types of plans: Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). An HMO covers care by doctors who work for the HMO or have a contract with the HMO. This type of plan typically does not cover out-of-network providers except in the case of an emergency. A PPO has contracts with hospitals and doctors to create a network of providers. These “preferred providers” have more coverage under the plan, but you can still see out-of-network providers, usually for a higher copay. There are other types of plans, but these are the two main ones. HealthCare.gov does a good job of explaining the different types of plans.
Get What You Need
You’ll need to consider your own healthcare needs when choosing a plan. If you mostly just get an annual exam, a physical every year or two, and want access to birth control, you can find an inexpensive plan that will cover this. If you have a disease or condition that requires ongoing care, you’ll need to find a plan that covers everything you need. No matter what your health situation is, carefully examine the monthly premiums, copays, and deductible (this is the amount you have to pay before the insurance will contribute their portion). You need to make sure that you can afford whatever plan you choose. If you find a great plan but aren’t able to keep up with the payments, it will lapse due to non-payment and you’ll no longer have coverage.
If you are healthy and don’t use your health insurance much, consider a plan with a low monthly premium and a higher deductible. Your monthly cost will be much lower, and you’ll be covered in an emergency. The only downside is that with the big deductible, you’ll end up paying out of pocket for trips to the doctor if you get injured or sick. However, under the Affordable Care Act, many preventative care services are required to be covered 100% by your health insurance provider. This means that contraception and well-woman visits (which include pap smears and breast exams) are free to you. Your insurance is required to cover every type of contraceptive, but not necessarily every specific brand. So make sure you and your doctor choose an option that is covered by your plan.
There are literally so many things to think about when it comes to health insurance, and this just barely scratches the surface. Cosmopolitan has some great information in this article. And remember that Google is your friend. Read through each policy and plan slowly and don’t be afraid to look things up or ask questions as you read through them.