Affordable Individual & Family Health Plans

Health Insurance is complicated—and the financial sages behind MoneyWizard are here to help! Shopping for your first plan, or just need a quick refresher of what’s available to you?

Read on to find information from our experts about your health and health-related insurance options for you and your family. After all, we’re the source for accurate information you can trust.

Factors to Consider when Choosing an Insurance Plan

Choosing a health insurance plan can feel like an overwhelming task. Here are a few things to keep in mind when choosing health coverage for you and your family. For specific information on plan components, see your plan’s summary of benefits and coverage, call your insurer or visit your insurer’s website. When choosing a plan, it’s a good idea to think about your total health care costs, not just the bill (the “premium”) you pay to your insurance company every month.

Premiums

Premiums are the amount you are on the hook to pay an insurance company for coverage, whether or not you use medical and pharmacy services. Premiums are usually paid monthly, and if you stop making payments, you are at risk of losing the coverage they provide. Keep in mind that these aren’t tthe only costs associated with coverage. You will also be responsible for paying things like deductibles and for cost sharing for most health care services and treatments. 

Other Costs

Beyond your monthly premium, you will be responsible for deductible, copays and out-of-pocket costs. Your deductible comprises how much you have to spend for covered health services before your insurance company pays anything. Copayments and coinsurance are payments you make each time you get a medical service after reaching your deductible. Lastly, your out-of-pocket maximum is the most you have to spend for covered services in a year. After you reach this amount, the insurance company pays 100% for covered services. Whether you are employed or not, MoneyWizard can help ensure you are covered! 

Individual vs Family Health Insurance Plans

In 2014, the Affordable Care Act (ACA), popularly known as “Obamacare”, created the Health Insurance Marketplace where individuals without the option of enrolling in an employer-sponsored health insurance plan can purchase an insurance cover. During the open enrollment period, you can shop around for individual and family health insurance plans that suit you. 

Buying Private Health Insurance

If your employer doesn’t offer you health insurance as part of an employee benefits program, you may be looking at purchasing your own health insurance through a private health insurance company. It covers only one person and can be obtained through an exchange or off-exchange. Traditionally, an individual health insurance plan was cheaper compared to group and family insurance. Before 2014, individual health plans were medically underwritten in most states which made pre-existing conditions like diabetes and cancer obstacles to getting insurance coverage.

Buying Family Health Insurance 

As opposed to an individual health insurance plan, a family health insurance plan covers you, your spouse, and children against any medical emergency. A family plan can also be obtained through an exchange or off-exchange, but for a higher cost as compared with individual coverage. Family size often affects the premiums payable.

However, there are certain exceptions for bigger families where a family with three or more children under the age of 21 is allowed to only pay for the three eldest children. Besides premiums, subscribers for family plans also pay double the deductibles paid by individual plan holders. For instance, if an individual subscriber pays $1,500 in deductibles, the family plan will cost $3,000 regardless of the number of people the plan covers. The same applies to the out-of-pocket maximum. 

Types of Individual Health Insurance Plans

Don’t have an employer-based health insurance option? Don’t worry! The Affordable Care Act of 2010 established the marketplace to ensure that as many Americans as possible are enrolled in health insurance. Many states offer their own marketplaces, while the federal government manages an exchange open to residents of other states.

The current marketplace offers different plans that can cushion you from a medical emergency. Each plan is designed differently to cater to the diverse needs of people. 

Individual health care plans come in four types: Bronze, Silver, Gold, and Platinum. The four divisions are based on premiums and out-of-pocket costs as discussed below.

Bronze 

While the Bronze plan allows you to pay for the lowest premiums, you’ll undoubtedly make up for the deficit by paying the highest costs when you seek medical care. It’s a good option—provided you want a low-cost way to protect yourself from worst-case medical scenarios, like serious sickness or injury. Your monthly premium will be low, but you’ll have to pay for most routine care yourself.

Silver 

The Silver plan allows you to pay moderate premiums and moderate costs when you need medical care. The deductible costs you pay before your coverage takes effect is lower than that of the Bronze plan. It is a suitable plan for individuals qualifying for “extra savings” and are willing to pay slightly higher premiums.

Gold 

The Gold plan allows you to pay high monthly premiums and lowers costs when you need health care. You’ll pay even lower deductibles compared with the Bronze plan. This plan is ideal for those who require a lot of medical care and are willing to pay higher premiums so that you won’t have to incur exorbitant costs when you need medical care.

Platinum 

The Platinum plan is a suitable choice for individuals that require a lot of medical care and are willing to splurge on the most expensive plan on the list. It’s a good choice if you usually use a lot of care and are willing to pay a high monthly premium, knowing nearly all other costs will be covered

Types of Family Health Insurance Plans

The choices or rather types of health insurance options available in the exchange for individual policyholders and families are the same and only differ in terms of cost. Families, as well, get the “four metal” categories of Bronze, Silver, Gold, and Platinum like individual subscribers.

The types of plans a family can get in the marketplace include: 

Exclusive Provider Organization (EPO). This is a managed plan that only covers the services of doctors, specialists, and hospitals listed in the plan with an exception of emergency cases.

Health Maintenance Organization (HMO). This plan restricts coverage to care of doctors working with the HMO only. This plan doesn’t cover out-of-network care unless it is an emergency.

Point of Service (POS). This plan allows you to pay less for using doctors, specialists, and hospitals within the plan’s network.

Preferred Provider Organization (PPO). This plan allows you to pay less for using providers in the plan’s network. You can always use providers outside the network, but for an additional cost. 

How to Choose the Right Individual Health Insurance Plan for You

Whether you are buying insurance from the federal marketplace or seeking coverage through your employer, the importance of carrying out due diligence before settling on a specific plan cannot be overstated. Here are a few considerations that you need to keep in mind to avoid ending up with a bogus plan. 

• For starters, ensure that you don’t miss out on the federal exchange open enrolment window.
• Always compare all the available options no matter how much you like your current plan. Be on the lookout for a better value throughout the open enrollment period.
• Always review estimated yearly costs as much as the monthly premiums to avoid suffering extra costs.
• Know how much medical care you really need! Understanding this question can save you from paying expensive premiums and not actually using that much cover, or paying less and then incurring more costs when you need care.
• Beware of deals that look too good to be true. Ensure that you are looking into an ACA plan to avoid missing out on ACA’s 10 essential benefits. 

If you have any further questions on choosing the ideal healthcare plan for yourself or your family, feel free to contact the financial sages at MoneyWizard!

Average Cost of Health Insurance for Families

The average cost of insurance for a family stands at $1,152 as of 2020. Note that this figure is only an approximate value and it can greatly vary among different policyholders depending on location, level of coverage, and size of the family among other factors. The cost of your health plan premiums is directly influenced by the number of people insured under the plan. 

As previously mentioned, a family with more than three children under the age of 21 will only pay premiums for the three oldest. A family of seven with all the children under the age of 21 is likely to pay for five individuals excluding the two youngest children, while a family of three will pay premiums for all the three members.