Choosing health insurance is complicated. The industry has its own vocabulary which isn't familiar to most people. Furthermore, plans have many different options, letting you choose how much you want to pay every month relative to what you pay out of pocket for your own care. Sorting between the different plans and the different places to buy insurance might be confusing, especially for young married couples. But there are a few basic rules that will help you get the right insurance at the right price.
If your employer offers insurance, it's often a better deal than buying your own on the open market. Not only is your employer able to access a greater variety of plans that offer more coverage than you might be able to get on your own, but you're also able to pay for your insurance with pre-tax money, meaning that it costs you less. If both of you work, compare the cost of having separate policies or of sharing a policy and choose the option that gives you the most coverage at the lowest price.
If you're under 26, you can be included on your parents' insurance policy. Unfortunately, you can't go on your parents' plan together, so you'll have to split your insurance. If your parents have other children that they're insuring and their insurer charges a flat per-family rate, you could even get free health insurance this way. Please note that this won't work if your parents are retired and on a retiree plan.
Whether you buy your own insurance in the open market or have a choice of plans from your insurer, consider using a federally-qualified, high-deductible health plan with a health savings account. Under these plans, your routine preventative care -- including physicals and well woman visits, vaccinations and many screening tests -- is usually covered at no cost. You pay out of pocket for anything else until you reach your deductible. After that, the insurance starts paying for you. You can save for your deductibles in a tax-free health savings account that rolls over from year to year. When you're young and healthy and aren't likely to need a lot of medical care, these policies can save you a lot of money. If you do hit your deductible, though, try to get as much care as possible in that year so that you're maximizing the benefit you get from your insurance.
Pre-Existing Conditions and Limitations
When you have a pre-existing condition or are subject to a limitation of coverage, your options may be more limited. In these situations, you might be able to purchase health coverage through a special high-risk pool. According to the WebMD website, 34 states have insurance policies available to those who can’t get insurance due to health problems, although most of them charge a higher premium than non-high-risk insurance. A list of states with high-risk pools is available from the National Association of State Comprehensive Health Insurance Plans. Otherwise, you will need to get coverage through a group carrier. You might even need to change jobs to get one with health insurance if coverage is really important to you.
On Jan. 1, 2014, additional provisions of the Patient Protection and Affordable Health Care Act, sometimes referred to as ObamaCare, are scheduled to go into effect. Starting on that date, you'll be able to buy insurance without having to worry about pre-existing conditions, so you can purchase whatever coverage you want at any time. This provision of the law makes high-risk pools obsolete, so if you're in one, you'll need a new insurance policy. Insurers also won't be able to exclude labor and delivery coverage, which can be helpful if you're thinking about starting a family. On the other hand, being uninsured won't be as attractive an option any more, since you will have to pay a penalty to the Internal Revenue Service if you don't carry health coverage from some source.
- Consumer Reports: Choosing health insurance
- KevinMD.com: HSA-Compatible High Deductible Health Plan Advantages
- CNN Money: Figuring out Health Insurance
- WebMD: Getting Insurance When You Have a Health Problem
- Nolo: What Obamacare Means to the Self-Employed
- WebMD: Health Care Reform and Preventive Care: FAQ
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