How To Buy Health Insurance in the US
If your employer doesn’t provide medical coverage or you want additional coverage, you can decide to take out your own policy from providers such as Blue Cross, Cigna, or Aetna. There are several steps to buying health insurance:
- Compare policies. Since the passing of the Affordable Care Act (ACA), one of the easiest ways to get medical coverage in the US is by visiting healthcare.gov, which will point you to your state’s centralized health insurance marketplace - an online hub for buying policies. As long as you legally reside in the US, you can purchase a policy through this marketplace. Most marketplaces will even offer access to brokers who can help you choose a policy for free. Of course, you can also contact companies directly or work with a private broker.
However you choose to shop, it’s important to compare your options. Policies vary wildly in cost and coverage, so be sure to compare:
- Monthly premiums: the amount you must pay each month regardless of whether you use your insurance.
- Deductible: the amount you must spend in a year on medical expenses before using your insurance.
- Co-payments: fixed amounts you must pay for medical visits or prescriptions.
- Co-insurance: the percentage of medical procedures you are responsible for paying yourself.
- Coverage details: including what the policy considers qualified expenses and waiting periods before certain procedures can be accessed.
- Network Type: a Health Maintenance Organization (HMO) will require you to use only its own facilities and doctors but will minimize the amount of paperwork you must do and will often come with a lower cost. A Preferred Provider Organization (PPO) will give you greater flexibility in where you seek treatment, but you may have to fill out claim forms and wait for reimbursement, and plans are often more expensive.
As you can imagine, the coverage level, deductible, copayments, and coinsurance levels all factor into the cost of the premium. The lower your deductible, co-payments, and co-insurance, the higher the premium, and vice versa. In addition to policy details, the cost of your premium will also be based on your personal details, such as age, location, tobacco use, and weight. Because of this, advertised costs will only be estimates; the actual cost of the premium will be revealed after you send in your application.
- Submit an application. The applications will ask you similar questions you answered when getting the initial estimate but in much greater detail. After submitting your application, you will receive policy offers based on your eligibility and the type of coverage you are seeking. If you want to buy a policy through your state’s ACA marketplace, be aware that there are specific windows of time each year when you are allowed to enroll.
- Enroll & Make Your First Payment. Once you confirm the policy you want, you will likely submit additional documentation to enroll officially. After making your first payment, it usually takes a few weeks for your enrollment application to be processed. Be sure to ask when your coverage will officially begin.