A Quick Guide to Obtaining Healthcare Coverage

Do you have health insurance? It is undeniable that health insurance makes healthcare more accessible, including preventive services such as screenings and regular check-ups with your doctor.
 
Consider the fact that only a third of the uninsured U.S population scheduled a preventive visit with their doctor in 2018. On the other hand, 74% of adults with health insurance saw their doctor for a preventive visit during the same year.
 
If you don’t have insurance, or have a policy that doesn’t meet your needs, it’s important that you learn more about healthcare coverage to find a policy that matches your needs and your budget.
 
Ask yourself these important questions before purchasing a policy:
 

1. What is the Affordable Healthcare Act? The purpose of the Affordable Healthcare Act is to make health insurance more accessible by extending Medicaid coverage, creating a marketplace where you can shop for policies, and requiring insurance providers to offer coverage to clients in spite of pre-existing health conditions.
   
   

• However, this law also makes it mandatory to purchase healthcare. If you’re not insured, the government levies a fine with your income taxes. The amount of this fine is $95 or 1% of your income (depending on which is greater) and will go up next year. In 2019 this fine was cancelled, however the states of CA reinstated this fine for 2021.

 

1. Are you eligible for Medicaid or Medicare? You’re eligible for Medicare if you’re over the age of 65 and have been paying Medicare tax for at least 10 years. Medicaid coverage is available on a state level, which means requirements vary depending on where you live.
   
   

• The Affordable Care Act sets the minimum income that makes you eligible for Medicaid at 133% of the federal poverty level. It’s possible that your state offers coverage to individuals who earn more.
  
  
• Even if you’re eligible for Medicaid or Medicare, you can also purchase additional coverage if you feel that these programs do not entirely meet your needs.

 

1. What are your options if you don’t qualify for Medicaid or Medicare? You still have many options:

 

• You can purchase insurance on the Healthcare.gov website and possibly qualify for other subsidies.
  
  
• You might also receive coverage through your employer.
  
  
• If you’re under the age of 24, your parents can include you on their policy.
  
  
• In addition, you can also find alternative personal policies outside these realms.
  
  

1. What factors should you consider when choosing a policy? It’s important to select a health insurance policy that corresponds to your needs and budget. Consider these factors before purchasing coverage:
   
   

• Monthly premiums. This corresponds to the amount you will have to pay on a monthly basis to receive coverage.
  
  
• Deductible. This is your portion of your medical expenses – before your insurance even starts to cover your expenses. Most policies include a co-pay for doctor appointments and a larger deductible if you need surgery or another expensive form of treatment.
  
  
• Amount of coverage offered. What percentage of your medical expenses will the insurance company pay? Is there a maximum amount?
  
  
• Reputation of your health insurance provider. Choose a company with good reviews. Your insurance provider should value customer service and process claims quickly and efficiently.

 

1. Which factors influence your health insurance premiums? Your premiums are based on how likely you are to need coverage for medical expenses. These are the factors healthcare insurance providers look at:
   
   

• Your age. Purchasing healthcare coverage while you’re young and healthy will help you secure low premiums.
  
  
• Your location. The cost of living in your area can affect your premiums.
  
  
• Smoking. Using tobacco could result in your premiums being 50% higher than the premiums offered to a non-smoker.
  
  
• The type of plan you purchase. Premiums are higher for policies with lower out-of-pocket amounts.

 
There are many downsides to not having healthcare, including putting off screenings for a number of health conditions and not scheduling regular check-ups with your doctor. Should you become ill or injured, you would end up with huge medical bills.
 
A more important question to ask yourself might be, “Can I afford not to have health insurance?”