Purchasing health insurance requires choosing which insurance plan works best for you, whether you are choosing from your workplace options or from the marketplace. Before you make your decision, think about what is important to you:
- Which doctors and/or hospitals are accessible with each insurance plan?
- Which prescriptions are covered?
- Where can you receive services?
Do comparison shop for costs too.
One large, reoccurring cost is the premium for health insurance. Typically, you will pay this monthly, whether or not you use any health services that month. Health insurance is very important for those unexpected, large medical bills that can come with illness or accidents. Some people also have regular health expenses; be sure the health insurance plan helps with these costs that can add up over time.
Another potentially large cost associated with insurance is the deductible. The deductible is the amount you must pay for health care costs before your insurance company starts to pay. For example, if your deductible is $2,000, then you pay the first $2,000 of health care costs that year, and then your health insurance pays most of the costs after that. (Some preventive health services may be covered before your deductible amount is reached – be sure to use these free services!)
When shopping for insurance, know that plans with lower monthly premiums generally have higher deductibles. Plans with higher monthly premiums usually have lower deductibles. It’s a trade-off. If you choose a plan with a higher deductible, how will you pay these health care costs if they happen?
Think “out-of-pocket” costs when comparison shopping. Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren't covered. These add up! Money set aside in a regular savings account, flexible savings account or health savings account can help. Learn more about these options in the recorded Get Savvy webinar, Health Insurance Dissected.
Be wary of short-term health insurance plans that may not cover essential health benefits. Review the pre-enroll checklist as you make your choice.
Why it matters.
It’s tempting to avoid paying for health insurance. However, medical costs can be so high that it’s very difficult to pay for health care without health insurance. Kaiser Family Foundation survey (2022) found that in the past five years, more than half of U.S. adults report they’ve gone into debt because of medical or dental bills. People report not being able to receive medical services they need due to this debt.
Check if you qualify for financial help.
If you need help paying for health insurance, check to see if you qualify for financial help through the HealthCare.gov website. Even if your employer provides health insurance options, you may still qualify. Nearly half (48%) of all consumers who selected a HealthCare.gov plan during the 2023 open enrollment period received cost-sharing reductions.
In Illinois, you can comparison shop for health insurance plans at GetCoveredIllinois.gov. The open enrollment period begins November 1st. However, qualifying life events mean that you may qualify now! There are four basic types of qualifying life events:
- Loss of health coverage (including turning 26 years old and losing coverage through a parent’s plan),
- changes in household situation, like getting married or divorced,
- changes in residence, moving including a student moving away or to school, and
- several other events such as a change in your income.
The website, “How to pick a health insurance plan,” has excellent information.
Kathy Sweedler provides personal finance online education with Illinois Extension. Kathy’s emphasis is to encourage people to be confident in their financial decisions, and to help them explore new ways of thinking about and managing money. When Kathy is not engaged in Extension work, she is often traveling and piecing together family genealogy. Genealogy is a puzzle, not that different from managing money!
Sign up for Illinois Extension’s Personal Finance E-Newsletter sent quarterly to receive updates about blog posts and events.