Taking the plunge into managing your own healthcare can feel like stepping into uncharted waters. For many, this is a rite of passage into adulthood, but that doesn't mean it has to be overwhelming. Whether you're recently off your parents' plan, starting a new job, or just trying to understand your options, these tips can help you navigate the world of healthcare without breaking the bank.
Learn all you can
For most Americans, health coverage isn’t exactly a popular topic at parties, nor is it commonly taught in high school and college. So, when you’re suddenly in a position where you need to choose healthcare, it’s usually the first time you’ve been faced with seriously considering the subject.
So, first things first: gobble up as much knowledge as possible. When you brush up on the basics, you’ll feel far more confident when browsing the marketplace or your employer’s elections portal.
To start, grab your cozy beverage of choice and dig into the following topics:
- Key terminology (like deductible, copay, and premiums)
- Where you need to go to obtain coverage
- What coverage is legally required and which is best for your personal situation
- How much you can expect to pay for each option
Start your journey with the glossary and topic library at healthcare.gov or this blog post, where we break down basic insurance terms.
Explore your options
The first step in managing your healthcare costs is finding the right insurance plan. Don’t just settle for the first option that comes your way. Instead, take the time to compare different plans. Here are a few things to consider:
-
Premiums: The monthly cost of the plan.
-
Deductibles: The amount you need to pay out-of-pocket before your insurance kicks in.
-
Co-pays: The fixed amount you pay for certain services, like doctor visits.
-
Network coverage: Make sure your preferred doctors and hospitals are included in the plan.
If your employer provides coverage, they will likely have a few options you can choose between and purchase via payroll deductions. In many cases, employers will contribute toward the cost of these premiums, making them more accessible for employees. However, it’s important to compare other factors, especially based on your personal medical needs.
Options for medical and dental insurance include the Health Insurance Marketplace, established by the Affordable Care Act (ACA) to provide coverage access. By creating a Marketplace profile and completing a questionnaire, you can see if you qualify for ACA subsidies to help with premiums. You can also compare and apply for plans online.
Another option is coverage through public services like Medicare and Medicaid. State and local governments might offer additional assistance, sometimes alongside or independent of federal plans. These often have strict requirements, so check with your local health department.
Be mindful of healthcare beyond major medical services
There is a lot of information out there and it is easy to get wrapped up solely in medical coverage. After all, that’s what the majority of healthcare programs focus on first and only general healthcare is required under the ACA. However, it’s important to consider access to affordable dental care, vision care, prescription drugs, mental health care and other specialties based on your needs.
Similar to healthcare, your employer may also offer separate coverage you can enroll in for coverage such as dental or vision. Some medical insurance programs also include additional optional plans (sometimes called “riders”) that you can add to basic medical insurance to help cover these things. Some plans include basic dental, vision and other services as part of the medical plan, but they are usually limited to preventive care.
Fill in the gaps with health insurance alternatives
The final tip is internalizing this: formal insurance programs are not the only way you can obtain affordable healthcare. In fact, there are a number of options available for health insurance alternatives that may make sense in your unique circumstances.
These include, but are not limited to:
- Dental discount programs
- Discount plans for vision care
- Prescription drug discount plans
- Negotiating with local doctors, dentists or other care providers for lower fees or payment plans
- Office-specific discount packages
- Health Savings Accounts (HSAs)
- Flexible Spending Accounts (FSAs)
- Low- and no-cost clinics
Remember, it’s okay to ask for help. These programs exist to ensure everyone has access to the healthcare they need.
The bottom line: Navigating healthcare on your own might seem daunting, but with a bit of knowledge and planning, you can take control of your health without breaking the bank. Remember, it's all about understanding your options, budgeting wisely, and making informed choices. Here's to a healthy and financially sound future!