Life is often unpredictable. As much as 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 variety between plans can overwhelm us.
Here we’ll cover some health insurance basics to help you get started. Peace of mind, medical care when you need it, and financial security are excellent reasons to weigh your options with your current situation.
why health insurance is important
Taking care of our health can be costly, especially when problems arise. While no one plans on getting sick or injured in an accident, most people will need medical care at some point. Health insurance helps provide you with the financial security you need when you need it.
Health insurance can help:
- contribute to a longer, healthier life
- Provide financial assistance for medical bills and avoid huge amount of debt
- Support wellness services such as regular preventive check-ups, check-ups and vaccinations
- Save your money when using in-network doctors and services
- Get the affordable care you need close to home
- Give you access to health information and other benefits to support a healthy lifestyle
how does health insurance work
Although complex, health insurance works in a similar way to 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 from the plan that works for someone else.
When considering which plan might be suitable, think about:
- where you can get care
- what is covered
- how much will it cost
Apart from the monthly premium, questions regarding other out-of-pocket costs must be considered before choosing a plan:
Is there a deductible?
The deductible is a set amount you must pay each year before insurance pays for covered services.
Is there any co-insurance?
Co-insurance is the percentage amount you will be responsible for once you meet your deductible. You’ll have a percentage to pay, and so will your insurance.
Is there a copy?
A co-pay is a flat fee that you are expected to pay at the time of service. If a policy requires a co-pay, the amount usually varies depending on the type of service.
What is the out-of-pocket maximum?
The out-of-pocket maximum is the maximum you must pay for covered expenses during the term of your plan, usually one year.
Learn more with A Consumer’s Guide to Understanding Health Care Prices.
Here are five things to consider when weighing your insurance options:
- Your health and how often you may need care. How often will you need to see the doctor? Do you have chronic conditions that require ongoing management?
- Premium Vs Benefits: How Much Money Are You Willing To Pay To Get What You Need?
- Your current doctor and health care services. Are they in network with the policy you are considering? If not, are you ready to change doctors or look at another plan?
- What else is included in the plan? Are there convenient care options, self-care and virtual services, healthy lifestyle programs or fitness deals with reduced rates?
- Are there additional coverage options you may need to consider, such as prescription, vision or dental coverage?
Figuring out which plan is a good match for you and your family can be challenging. Our financial counseling service professionals are specially trained in financial counseling for medical services. They can help you navigate your current insurance, show you which plans and networks are accepted by Nebraska Medicine, and help you find which Marketplace plan is best for your situation. Might be possible.
“If you have questions or need clarification regarding bills, claims or insurance coverage, don’t hesitate to contact us,” says Kim Stuwe, Nebraska Medicine patient financial services supervisor. “We’re here to answer your questions and help you understand the process.”
How to get affordable health insurance
There are several ways to secure health insurance:
- Employer-based: Through your job or your spouse’s job if the requirements are met
- Health insurance marketplace during the open enrollment period (typically November through mid-January)
- public coverage through Medicaid or Medicare
- Individual health insurance purchased directly or through an insurance broker
- children’s health insurance program
- If you are under 26, you may be able to continue coverage under your parents’ insurance plan
“If you need financial assistance or feel you cannot afford health insurance, reach out to us,” says Stuwe. “Our financial advisors are here to answer your questions and help you navigate your options.”
Call 402.559.3140 either 888.662.8662 To schedule an in-person or virtual appointment.