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- The options for health insurance include private insurance, Medicare, and Medicaid
- Private insurance can fall into three tiers which are bronze, silver, and gold
- Medicare and Medicaid are both government programs with eligibility requirements
Health insurance covers most doctor and hospital visits, prescription drugs, wellness care, medical devices, emergency care, and preventive care.
There are several ways to enroll in a health insurance plan. Many Americans get their health insurance at work through an employee benefits program. Others purchase coverage through the health insurance marketplace.
However, those aged 65 and older and other adults with disabilities have the option to find health insurance through government programs like Medicare and Medicaid.
Read on to learn more about your health insurance options, what it costs, and what is covered right here.
Find affordable health insurance in your area by typing your ZIP code in the free tool above.
What does health insurance cover?
What is covered by a health insurance plan depends on the plan and the insurance company. Some plans are designed to cover only catastrophic health needs, such as a major illness or injury. These plans may not have coverage for routine needs.
Other plans are very comprehensive and cover preventative care, routine care, injuries, illnesses, and even prescription drugs.
Regardless of the plan you have chosen, there are a few things that are never covered. Health insurance doesn't cover dental care, vision, or hearing, including eyeglasses and hearing aids. Anything that is considered a cosmetic procedure is also not covered.
How to Find Affordable Health Insurance Rates
By definition, health insurance is a contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium.
You can get insurance through work, through the health insurance marketplace, or through government programs like Medicare and Medicaid. Primary health insurance can be either a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO).
In addition, Point of Service (POS) plans may also be available.
Providers like Aetna, Humana, Cigna, Kaiser Permanente, and more all provide private health insurance plans. If you get your insurance through work, you will have to enroll with the company they choose. Depending on your employer, rates can be as low as $10 or $20 per month.
If you don't currently have access to health insurance through your job, the healthcare marketplace is a great place to begin.
Obamacare or the Affordable Care Act (ACA) was put in place to make affordable health insurance available to more people, expand Medicaid and innovate medical care delivery methods so that health care costs are lowered.
Persons aged 65 and older and those with disabilities are offered health insurance through Medicare. Whereas Medicaid provides health coverage to low-income adults, children, pregnant women, elderly adults, and people with disabilities.
Differences Between the Types of Health Insurance
The main differences between the sources of health insurance are related to eligibility. Plans from private insurance companies have many differences in terms of price and coverage.
Let's start by comparing the main sources of insurance.
Medicare vs. Medicaid: Medicare is a government health insurance program. Medicaid is a government health assistance program.
Private Insurance vs. Medicare and Medicaid: Private insurance is typically more expensive than Medicare and Medicaid. Criteria like age, pre-existing conditions, and income must be met for both Medicare, Medicaid, and private insurance to be utilized.
Workplace Insurance vs. Marketplace Health Insurance: Marketplace health insurance is private insurance that is open to the public, whereas workplace insurance is typically a group benefit offered through an employer.
Marketplace health insurance has a period of open enrollment that typically begins in November and ends in December. During this time period, you can enroll in a new plan or make changes to your current plan.
Once this window closes, you can only make changes if you have a qualifying life event, such as the birth of a child.
Health Insurance Plans on the Marketplace
Marketplace insurance plans are tiered. Each tier offers different coverage and benefits and a different price range.
Bronze Tier: A bronze-level plan is the cheapest health insurance plan available to individuals 30 years and older. This option offers the lowest premiums but with high deductibles and out-of-pocket costs.
Silver Tier: A silver tier plan is an affordable health insurance plan with comprehensive coverage. This option offers manageable rates with a mid-range deductible and fewer out-of-pocket costs.
Gold Tier: In contrast to the bronze plan, a gold tier plan has the highest rates, but the benefit is low or no deductibles and minimal out-of-pocket costs.
Catastrophic Tier: This tier is available for individuals 30 and younger. Under the catastrophic plan, you pay a minimal monthly rate and have coverage for a major health event, but not for most routine care.
The plan you choose depends on how much you want to pay each month versus the potential out-of-pocket expense if you are injured or become ill.
How to Find Cheap Health Insurance
Health insurance cost depends on availability and coverage.
Aetna, Cigna, Humana, and United Healthcare are popular private insurance options. Each health insurance provider is available in most states.
| Health Insurance Provider | HMO | PPO |
|---|---|---|
| Aetna | X | X |
| Cigna | X | X |
| Humana | X | X |
| United Healthcare | X | X |
When choosing a health insurance provider, you have to decide whether you'd like a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO).
An HMO plan is subject to a network of providers and programs. There is no out-of-network coverage, which makes the plan more affordable.
A PPO plan has both in-network and out-of-network coverage and generally costs more. It's important to find a plan that balances monthly costs with out-of-pocket costs for care.
No matter your needs, there are available options that can fit your needs. You have to choose which plan, premiums, and deductibles are best for your income.
Find health insurance in your area and compare rates by entering your ZIP code in the free tool below.
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