5 Steps to Getting Medical Insurance You Can Afford


How Can I get The Best Deal in Health Insurance?

We cover 5 steps to take to get the best medical insurance you can afford so you can get the best deal on health insurance available to you.

Finding health insurance that truly is affordable is difficult for those who make too much for subsidies and not enough to pay for both insurance and healthcare. If you follow these steps, you will be giving yourself the best chance to succeed.

Step 1 – Start Looking Early

You need to begin looking as early as you can and not wait for the last minute.

Open enrollment under Trump is shorter than ever.

Not only is this less time than you had line the past, but the amount of money spent on public information was cut by 90% in 2017! The funds used to help people navigate through the insurance programs has been cut significantly as was tech support for the Healthcare.gov site, which has a history of software problems. On top of all this, the site will be down for 12 hours almost every Sunday for maintenance.

Shopping for health plans can be a lot more time intensive than one might expect. Thus, the bottom line here is to take your time comparing plans. To do that, you need to apply early so you have time to compare plans before you enroll.

See our page on What to do When the Healthcare.Gov Marketplace is Down if you are trying to work while the site is down.

TIP: The marketplace should be your first stop, but it isn’t your only option (another reason to start looking for coverage before the deadline). Even if you do want a marketplace plan, be aware that qualified private brokers and agents can sit down with you and help you choose a marketplace plan. Marketplace assisters can also help you choose a marketplace plan (although their budgets were cut this year, so it could be difficult to connect with one). It can really help to get one-on-one attention, plans sold this way don’t cost more (although sometimes a private broker or agent can end up offering a limited plan choice). Just make sure, no matter how you shop, you get a marketplace plan if you want assistance (as only marketplace plans qualify for assistance).

Step 2 – Get Your Information Together and Apply for Coverage

To get covered in the marketplace, or from a broker or agent outside of the marketplace, you’ll first need some information.

Thus, one should get their information together even before open enrollment.

You will need to provide some basic information such as the state you live in to use Healthcare.gov as well as needing the following information to enroll:

  • A list of the people in your household who need coverage. This includes their addresses, birth dates, social security numbers, and document numbers for legal immigrants.
  • Income information and employer information for each person for pay stubs, W-2 forms or similar sources.
  • Policy numbers of your current plan or plans and plan ID.
  • information on employer-based plans you are eligible for. Your employer should provide this.

The place to begin applying is the Healthcare.gov website. You can find a step by step guide to using Healthcare.gov on our page How to use Healthcare.gov.

Once you have enrolled in Healthcare.gov, you can apply for health insurance online. You can also apply by phone, with in-person help, or with a paper application in the marketplace or you can follow the directions give by a specific broker or agent.

For the marketplace:

  • The Healthcare.gov website will be available during open enrollment, but will be down for maintenance for 12 hours most Sundays. Please don’t wait. The process of enrolling and signing up for a plan will take time.
  • You can find local help by going to the website and entering your zip code, calling 1-800-318-2596, or by visiting the website.
  • Call 1-800-318-2596 (TTY: 1-855-889-4325) 24 hours a day, 7 days a week.
  • A paper application will be available by November 1st from the application page of Healthcare.gov. If you apply by phone or use a paper application, you should get your eligibility results in about two weeks. You must then create a online account or use a Marketplace call center to enroll.

Step 4 – Compare Plans

Comparing plans is essentially the hardest part of getting the right health plan.

This is the step where you have to compare networks, pick the right metal tier, decide if you want cheap premiums or low out-of-pocket costs, compare benefits, and more.

Choosing the best plan can be confusing and is bound to involve some guesswork unless you can see your future.

It can be helpful to read our guide on How to Compare Health Plans. If you don’t want to make a decision without expert advice, use an agent. Agents can be found on our site, by asking people you trust for recommendations, or by doing a local search and making sure to ask “are you qualified broker who can help me sign up for a HealthCare.Gov marketplace plan?”

TIP: When in doubt, choose a marketplace silver plan. These are the only plans that qualify for out-of-pocket assistance (which you can qualify for mid-year if you lose income or gain income)… or at least that was the going advice before Trump said he would cut out-of-pocket assistance. If that ends up being true, then a bronze plan with an HSA is the most cost effective way to go for most families, hands down. That said, every family has different needs. We can’t say it all here, so do see the link above for our guide on comparing plans.

Step 5 – Enroll, and Don’t Forget to Pay your Premium

Signing up for a marketplace account is one step, actually enrolling in a plan and paying your premium is another.

When you know what plan you want, enroll in that plan and then make sure to pay your first month’s premium.

Remember that you need to pay for your January insurance before it will take effect. If you pay December 15th, your insurance will start January 1st, 2018.

TIP: Consider putting your plan on auto-pay so you don’t have to remember to send a payment to your insurer every month.

Why Should I get Health Insurance?

Even if you are young and healthy, accidents can happen. You may be able to afford to go to a clinic or buy some medicine out-of-pocket, but you probably can’t pay for hospital care. A hospital stay in this country can easily run over $100,000. Who has that kind of money? The U.S.A. spends over $8,000 a year per person on medical care, and that includes spending for people who don’t need any care. Chances are that you will need some of that.

Although it’s true that a hospital will treat you in an life-threatening emergency, they will also charge you for it. Also, they don’t have to provide care that could keep a medical condition from becoming a life threatening emergency. To find out how the system works, see Does Everyone Get Medical Care in an Emergency?

Author: Linda DeSolla Price

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Very Informative.

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Our current insurance carrier (Molina) will not be on the exchanges next year. That being said, I looked at the other plan prices from last year and the cheapest one I could find was a bronze plan ($13K deductible) for about $100/month less than what we are paying for a silver plan, so I can only imagine that the prices for this year will be even higher.

I am beginning to question why I would want to pay ~$4K per year in premiums with a $13K deductible rather than going to a community health center and paying cash for the few times I do go to the doctor and then having some kind of catastrophic plan to cover hospital and such if I get really sick. The cost of the silver plans with the remaining insurance providers are way out of our price range.

I really think health insurance is a massive ponzi scheme :/

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It would be helpful if we had a national catastrophic plan. Like a single payer or public option system for at least catastrophic coverage.

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I agree Yvonne, ever since Obama stuck his nose into the healthcare system we are all getting screwed!!! Thanks for the change dumbass!

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Unlike before Obama when premiums were rising faster than inflation and 50 million didn’t have coverage? Is that what are you comparing it to? Or are you comparing it to Europe where they have limited costs and everyone is covered? Compared to that we are screwed, but compared to before the law, its a mixed bag.

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