I Need Health Insurance!
So You Just Turned 26.
When you were young, all you wanted was to be a “grown up.” Being an adult sounded so liberating—it meant doing what you wanted to do and being who you wanted to be. As the years go by, 16 turned to 18 and 18 turned to 21, and then the next thing you knew it, BAM! You are 26. Twenty-six seems to be the ultimate age of “adulting.” And, while you can rent a car, you also have to think about finally paying for your own health insurance. Most young adults pay no mind to their health or what it could mean to not be covered, because it has always been their parent’s responsibility. The type of insurance your parents have dictates when you will be “cut off.” Some insurance companies will give you to the end of the tax year, but some will give you the boot before the birthday dust has even settled. For most young adults, their parents have great insurance, but unless you have an amazing job, you won’t be able to afford it. While the concept of health insurance seems overwhelming, you will be able to step out and get protected after reading this article.
Health Care Jargon To Know
As you were researching the right insurance company and policy for you, you may have come across a lot of terms that you don’t understand. Here is a list of insurance lingo to make things a little easier.
Premium: Your insurance price. That is the rate you pay to the insurance provider annually or monthly.
Deductible: The deductible is the amount paid out-of-pocket by you, the policy holder. This is the amount you must pay before your insurance company will cover any other expenses. For example, if you had a $1,500 deductible you would be required to pay the $1,500 in services before your insurance steps in to cover the rest of your medical expenses.
Maximum Out-Of-Pocket: The out-of-pocket maximum is a limit of what you pay in addition to your premium during your policy period. This includes deductibles, coinsurance and copayments. When you hit the out-of-pocket limit, the health plan must pay 100% of most covered health benefits for the remainder of the coverage period.
Co-Pay: A specific amount paid by you for covered services. Insurance companies often require co-pays for specific services, such as prescription drugs or doctor visits. Unfortunately, they typically don’t go toward your deductible.
Co-Insurance: Coinsurance means you’ll share a portion of the payment with your health provider for your health care expenses. For example, if a doctor’s appointment costs $100 and your co-insurance is 20%, once you’ve paid your deductible you will owe $20.
Why You, Yes Even You, Need Health Insurance!
Let’s presume you’re in good health and make the decision to remain uninsured. At 26, you assume you’re still young; you never get sick and don’t take any medications. Next thing you know, you’re walking, you slip and maybe break an ankle. You wake up to more than $75,000 in physical therapy bills, medications, X-rays, medical supplies and a visit to the hospital. All of a sudden, $100 a month seems like no big deal compared to what you are going to have to pay back for being uninsured. The bottom line is that being uninsured can get expensive. It is not uncommon for unexpected medical bills to exceed five figures. Health coverage means you pay an insurance provider a small sum of money for when you decide to use a significant amount of their money. So many people are buying protection for their mobile phones, laptops, home appliances, vehicles etc. If you will pay for coverage for your technology, why not cover your own wellbeing? Let’s take a walk on the wild side and see what you would pay for not being insured.
Surgery Costs Without Insurance
- Ambulance Ride: $400-$2,200
- Emergency room visit: $300-$3,000
- X-Rays: $5,000+
- Blood work: $3,000
- Broken bone (no surgery): $2,000+
- Broken bone (with surgery): $20,000+
- Back Surgery: $23,724
- Giving Birth: $17,000+
When Can I Sign Up?
Open enrollment for health insurance is November 1 through December 15. If you don’t apply during that time period, you will have to wait until the following fall to apply, but there are two ways around that. When you turn 26, you have a 120-day grace period to enroll. You have 60 days before your 26th birthday and 60 days after to sign up. Another way to apply is to find alternative medical coverage like Nova Pathfinder Healthcare, which offers 365-day enrollment; this allows you to apply anytime at any age.
Choosing the Correct Health Insurance or Coverage Plan
When determining which health care or service package to choose from, there are a few important factors to remember:
First, see what’s included in the plan. Most insurance plans can cover just a few treatments and practices. The right policies will cover medical, holistic and dental.
Premium & Deductible
Second, determine whether you want a low monthly payment or a low monthly deductible. A lower premium means you’re going to pay less per month but you’re definitely going to have to pay more upfront. This is a good plan for those who are usually safe or who have no prescribed medicines or routine procedures. A lower deductible ensures you’ll spend more per month, but if you require costly care, you’ll have to spend less up front. This plan is ideal for those who typically go through a costly year-round operation.
HDHP, HMO, & PPO
Third, decide on an HMO, PPO or HDHP. Those aren’t as daunting as they seem. An HMO (Health Maintenance Organization) means you’re selecting one licensed doctor, so you’re heading to them for all medical needs except emergencies. If you have a skin disorder, you wouldn’t go straight to a dermatologist; instead, you’d go to your doctor and they’d refer you to a doctor in their network. A PPO is a more accessible option, because it allows you to go to any treatment provider in the specified network without a referral. Each option has advantages, but PPO’s are mostly favored because of their vast network of providers. An HDHP (High Deductible Health Plan) is the most popular plan. Having an HDHP helps you create a Health Savings Account (HSA), which allows you to save money for medical expenses tax free. However, as the name implies, you will have a higher deductible.
Okay I’m Ready To Sign Up!
You can sign up several different ways. Nova Pathfinder Healthcare has open enrollment 365 days a year so you can sign up at your convenience. First, talk to your employer and find out if your employer or company offers health insurance. If you are still a student, check to see if they offer a student health plan. Tuition is expensive enough—don’t get yourself further into debt by not being covered!