Life is often unpredictable. No matter how hard we work to take care of ourselves and our loved ones, our circumstances can change in an instant. While most of us understand the need for health insurance to protect our health and financial security, why does it have to be so confusing? The number of options and all the variations between plans can leave us overwhelmed.
Here we cover some health insurance basics to get you started. Peace of mind, medical care when you need it, and financial protection are all excellent reasons to weigh your options against your current situation.
Why health insurance is important
Taking care of our health can be costly, especially when a problem arises. While no one plans to get sick or injured in an accident, most people will need medical attention at some point. Health insurance helps you provide financial protection when you need it.
Health insurance can help:
- Contribute to a longer and healthier life
- Provide financial assistance with medical bills and avoid large debts
- Support wellness services such as regular preventive screenings, checkups and vaccinations
- Save money using in-network doctors and services
- Get the affordable care you need close to home
- Giving you access to health information and other benefits to support a healthy lifestyle
How health insurance works
Although complex, health insurance works in much the same way as home or car insurance. You (or your employer) choose a plan and agree to pay a monthly premium. In return, the insurer agrees to pay a portion of your covered medical expenses.
What health insurance covers — and how much — varies depending on the plan you choose. The best health insurance plan for you may be different than what works for someone else.
When considering which plan is right for you, consider:
- Where to get care
- What is covered
- How much is it
In addition to the monthly premium, questions about other out-of-pocket costs should be understood before choosing a plan:
Is there a deductible?
A deductible is a fixed amount that you must pay each year before the insurance company pays for covered services.
Is there co-insurance?
Co-insurance is the percentage you are responsible for once you meet your deductible. You have to pay a percentage, and so does your insurance.
Is there a copay?
A copay is a fixed amount that you are expected to pay at the time of service. If a policy requires copays, the amount usually varies depending on the type of service.
What is the maximum deductible?
The out-of-pocket maximum is the most you have to pay for covered expenses during your plan’s term, usually a year.
Read more with a consumer guide to understand health care pricing.
Five things to consider when weighing your insurance options:
- Your health and how often you need care. How often do you have to go to the doctor? Do you have chronic conditions that require ongoing management?
- Bonuses vs. benefits: how much money are you willing to spend to get what you need?
- Your current doctor and healthcare services. Are they consistent with the policy you are considering? If not, are you willing to switch doctors or look at a different plan?
- What else is in the plan? Are there convenient health care options, self-care and virtual services, healthy lifestyle programs, or fitness deals with discounted rates?
- Are there additional coverage options you may need to consider, such as prescription, vision, or dental coverage?
Figuring out which plan is best for you and your family can be a challenge. U.S professionals in the field of financial advisory are trained in financial consulting specifically for medical services. They can help you navigate your current insurance policy what plans and networks are accepted by Nebraska Medicine and help you figure out which marketplace plan is best for your situation.
“If you have any questions or need clarification about a bill, claim, or insurance coverage, don’t hesitate to contact us,” said Kim Stueve, supervisor of patient financial services at Nebraska Medicine. “We’re here to answer your questions and help you understand the process.”
How to get affordable health insurance
There are several ways to purchase health insurance:
- Based on the employer: through your job or your partner’s job if the requirements are met
- Health insurance marketplace during the open enrollment period (usually November to mid-January)
- Public coverage through Medicaid or Medicare
- Individual health insurance taken out directly or through an insurance intermediary
- Health insurance program for children
- If you are under age 26, you may be able to continue coverage under your parents’ insurance plan
“If you need financial help or don’t think you can afford health insurance, contact us,” says Stueve. “Our financial advisors are here to answer your questions and help you navigate your options.”
Telephone call 402.559.3140 or 888.662.8662 to make a personal appointment or virtual appointment.