The health care system in the U.S. has long been a source of reform efforts, due to high costs of care and to the fact that many Americans have gone without insurance. In 2010 the Affordable Care Act (also called the ACA, or "Obamacare") was passed to correct some of the main issues. The major goal of the ACA was to improved access and affordability of health insurance for many Americans.
The ACA is still in effect today, and there's a good chance that there's a health plan option out there for you, even if you have little money or you've lost your job. Learn about the many options out there, and which is best for you.
Look Into Your Family Members' Plans
If you have a partner or spouse, find out about their health plan before starting from scratch to secure your own. Their plan may cover you, or it may be very simple to join or get added on. Many insurers and plan sponsors have changed their rules to treat domestic partners just as they treat legal spouses, as well.
Students and younger people might also want to check to see if they can be added to their parents' current policy, or if their school offers a student insurance plan.
Under the ACA, most health plans are required to cover the policy holder's children, up to the age of 26.
Consolidated Omnibus Budget Reconciliation Act (COBRA)
If you've been laid off or are no longer working, but you were previously insured on a group health insurance plan with your former employer, you might be eligible to continue your health insurance through COBRA. Some young adults are also able to stay on their parent's health plan as well, thanks to COBRA.
This option can be a major help for people who happen to be under medical care, or undergoing treatment at the time they lose their job. COBRA allows them to find coverage quickly so they can carry on with the treatments, without a pause in care. The health plans offered through COBRA can be costly, so you may want to check out the other options first, to find one that best suits your needs and that you can afford.
Your state's workers' compensation program might be able to offer you some health care solutions if you're being treated for an injury that occurred while you were working. Though it's not a health care plan in the normal sense, it is a way to save money on health care costs, and worth looking into if this is your situation.
A lot changed with the ACA, including Medicaid requirements. Medicaid is the health care program sponsored at the federal level, and run by each state. As a whole, the number of people who are eligible to receive Medicaid has increased greatly since the onset of the ACA, yet statistics show that many people aren't taking advantage of the changes. The newer guidelines allow many people with incomes above the poverty line to qualify.
Medicaid expansion took place in each state, so rules and details may differ based on where you live. You can contact your state insurance commissioner, or check the Medicaid website to find out how your state takes part in the program and how you can apply.
Medicare is the health plan run by the Social Security Administration (SSA). You can qualify for Medicare if you receive Social Security disability benefits, or if you're age 65 or older.
Health Insurance Marketplace
In addition to expanding existing health plans, the ACA also created a Health Insurance Marketplace, or "exchange," where people can shop for health plans that best suit their needs and budget. The types and features of these plans vary. Some may offer perks for choosing doctors and care providers within a network, some offer lower rates for people with lower income, or with households of a certain size.
Plans found on the exchange cover treatment for pre-existing medical conditions. No health plan can in the exchange can reject you, charge you more, or refuse to pay for the care you need for a condition you have before you sign up.
High Deductible Health Plans
A high deductible health plan (HDHP) is one way to maintain a low-cost health plan. Since the deductible is high, this means you may have to pay a lot out of pocket before the plan helps with funds, but it can be a good safety net in case you end up needing emergency treatment or for any treatment that would result in a very high bill.
One way to offset the high costs you may need to pay to meet your deductible under an HDHP is to pair it with a health savings account (HSA). Using this account for smaller health issues can save you money in the long run.
Short-Term Health Insurance Coverage
Short-term health insurance can be a good choice if you need coverage quickly to avoid gaps in insurance while you search for another option.
Group Insurance from Organization Memberships
Many organizations provide health insurance group plans. If you belong to any kind of membership organization, it's worth asking if they have a health insurance plan. Some common sources include alumni groups, professional organizations, business bureaus, or independent worker associations.
Many of these groups help provide reduced health insurance premiums or other health care perks for their members. If you belong to one of these groups, it's worth looking into what they offer as an alternative to employer-sponsored group health insurance.
Group Health Expenses Sharing Plan
A group health expenses sharing plan consists of a group of people who pool their money into one fund to pay each other's health care costs. It works a bit like their own insurance company. Members' pooled funds are invested and for the most part are reserved to pay for major medical costs. These plans are not often used for more basic health costs like standard checkups or small procedures.
Group health expense sharing plans aren't insurance plans, so they're not regulated in the same way as insurance. Be sure to look into the details and rules of any of these plans before you join one.
Health Care Sharing Ministries (HCSMs)
A health care sharing ministry (HCSM) works on the same premise as the group health expense sharing plan. A group of people who share similar beliefs create a pooled fund to share the cost of health care. An HCSM is a non-profit entity, so again, it's not health insurance and it's not regulated in the same way. Rather, it provides an alternative to standard insurance.
These plans will often include rules that align with the beliefs of the group. This means they may not cover certain treatments or drugs that they object to on moral grounds.
Health Insurance Discount Cards
Health insurance discount cards provide low-cost health care in exchange for a membership fee. These cards provide discounts on many medical services, but it's not insurance in the normal sense. They don't offer any reimbursement for treatments you receive. They can only lower your costs when you use the services of the members who participate in the plan.
The Bottom Line
No matter which health plan you choose, make sure you have a sense of the full scope of the type of care and treatments it covers, as well as what costs you might need to pay out of pocket. If you're shopping on the health insurance exchange, these details may be clearly laid out, but other sources can be full of complex terms and details. The premium, or amount you pay each month, should not be your only factor. Make sure you understand the all the terms of the health plan you choose, so you don't end up spending more money than you have to due to higher out-of-pocket costs, lifetime maximums, or through coinsurance and deductibles.