“Is learning something you did, or something you do?”

- Nathan Baughman

Introduction:

Health insurance is known for being opaque with confusing terminology and language. It can be challenging to decipher the various plans and understand what kind of care you will receive. In my personal experience, I find more and more that people are completely unaware with what they have. Short of knowing their deductible or copays, bring up terms like HMO, PPO, in or out of network and eyes begin to glaze over. Today we will explore the three most common and comprehensive health insurance plans that people have. By understanding the differences between these options, you will be better equipped to choose the plan that best suits your needs.

With that said, here are 3 Health Plans You Can Trust 🤝

✅ 1. Employer-Based Group Coverage/COBRA

Employer-based group coverage is the most common form of health insurance for individuals. If you live in the United States, you likely get your insurance from an employer or from your spouse...who gets it from their employer. This type of coverage is provided by large companies or businesses, generally at a percentage of the cost.

One crucial factor to consider is how much is actually being covered by the employer. Some employers may cover 50% while others may cover 80% or more. It is also important to note whether or not the plan includes coverage for your spouse or dependents. Many times when offered insurance through an employer they cover a portion of costs for the employed, yet when adding a spouse or dependents the plans cross over into being less affordable or economical.

The advantage of employer-based group coverage is that it is often more affordable due to the employer's contribution with the largest caveat being the household size and total income. With larger families or middle to lower incomes, limitations may arise if the employer does not offer coverage for your spouse or dependents.

✅ 2. State-Based Marketplace Plans (Obamacare Exchange)

State-based marketplace plans, also known as Obamacare exchange plans, are based on your income and household size. These plans offer coverage that is subsidized based on your current income. The subsidies are designed to make the plans more affordable for individuals who earn lower incomes. However, if your income exceeds a certain threshold, you may not be eligible for subsidies and will have to pay the full price for the plan. State-based marketplace plans provide comprehensive coverage, with all the necessary benefits included. When choosing a state-based marketplace plan, it is essential to consider your income and whether you qualify for subsidies.

✅ 3. Direct to Carrier - Private Insurance

Direct to carrier private insurance is similar to life insurance, as you need to qualify for coverage based on a health history screening. Insurance providers ask about factors such as smoking, medication usage, and previous medical conditions. Your risk rating is then used to negotiate lower rates for your health insurance. Direct to carrier private insurance is competitive with employer-based group coverage and state-based marketplace plans. It serves as an excellent alternative if you are priced out of a subsidy. The advantage of this type of insurance is that it tailors the rates and benefits to your specific risk profile.

Conclusion

Understanding the different types of health insurance plans is crucial when selecting the right coverage for your needs. Employer-based group coverage, state-based marketplace plans, and direct to carrier private insurance each have their own advantages and disadvantages. It is important to consider factors such as coverage percentage, eligibility for subsidies, and risk profile when choosing a plan. Seeking professional assistance can help you navigate the complexities and find the most affordable plan that offers the benefits you need. With this guide, you now have a better understanding of health insurance plans and can make an informed decision regarding your coverage.

Note: The information and suggestions provided in this blog post are for informational purposes only and should not be considered as professional advice UNTIL you have spoken with a licensed agent FIRST. Please consult with one of our, or any trusted, licensed insurance professional or broker to discuss your individual circumstances and insurance needs to best understand what you qualify for and limitations in your plan.

THREE HEALTH PLANS YOU CAN TRUST