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I’m about to turn 26, how does finding health insurance work?

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Welcome to your first quarter-life crisis—finding health insurance. It’s basically an adulting rite of passage. Debt from medical bills plagues billions of Americans and we know you have better things to do with your money. It’s a daunting-adulting task, but we’re going to help you find health insurance so you can protect your health (and your wallet).

You’ve probably heard of ‘Open Enrollment’ when it comes to health insurance. It’s a magical window of time, typically in the late fall/early winter where anyone can sign up for a health insurance plan or make changes to an existing one. Here’s what you might not know, turning 26 is a qualifying life event (you’re in the big leagues now). You’re able to bypass the open enrollment period and sign up anytime because you’re losing your health insurance.

Let’s look at your two cheapest options for health insurance first (because who wants to pay more than they have to?)

Riding the coattails of your partner’s health insurance plan

You may be able to get on your sig figs health plan. If you’re married, you can definitely get on their plan as long as you can show proof of your union. Otherwise, those in long-term relationships are at the mercy of the employer’s policy. Tell your boo to reach out to their human resources department to see what your options are.

Using your employer’s health insurance plan

The second most affordable option is typically provided by your employer. That’s because your company will be paying a portion of your premium. Shoot an email to HR and request information on the health insurance plans. While you’re at it, let them know the date you will be losing coverage (your b-day) so they can prep the paperwork.

If you strike out with both of these options, you’re going to need to do some shopping around for a health insurance plan. Start at the Health Insurance Marketplace. This is a hub that allows you to review and enroll in a health insurance plan that works for your own situation. When you complete your enrollment forms, the Marketplace will automatically tell you if you qualify for free health insurance (Medicaid and CHIP) or if you need to choose from one of the many state and private plans.

When you review any health insurance plan you will want to look at:

Networks: Review the health network and if they have locations that are easy for your access. Most private insurance plans only allow you to see ‘in-network’ providers on the plan. If you opt to see someone else outside of the network you could end up with a hefty bill and no coverage.

Premiums and Deductibles: Your premium is how much you pay each month for the health insurance plan. Your deductible is how much you will need to pay out of pocket before your full insurance coverage kicks in. Typically the lower your monthly premium the higher your deductible.

Co-Pays: Beyond the deductible, some health insurance plans will require a flat fee for certain services (called a copay). For example, even when your deductible is met you may always pay $25 for a doctor visit.

Out of Pocket Expenses: Out of pocket expenses include your copay and deductible, but they can also include items not covered on your plan like bloodwork, prescriptions, and hospital stays. A common approach is to have an 80/20 split for services like this where 80% is covered by your insurance and 20% is covered by you.

The Marketplace will connect you with the most comprehensive health insurance plans, but you can always look at the alternative health plans to compare coverage, deductibles, and monthly premiums. Common options include Health Share Ministries and PPO’s within a specific industry. The alternative plans each have strict eligibility requirements, so you will need to do some research to see if you fit the bill. Keep in mind that most alternative plans are more expensive and offer less coverage, but it is always possible to find a diamond in the rough.

Once you have secured your health insurance you may want to take your prep one step further by opening a Health Savings Account (HSA). These accounts are a great place to stash money for your deductible or other out-of-pocket medical expenses. They carry added tax benefits making them better than a High Yield Savings account when it comes to saving for the doctor.

You definitely don’t want to shrug off getting health insurance and count on your good genes or yoga obsession to keep you out of the doctor’s office. The unexpected happens and holding coverage will give some peace of mind the next time you crash while snowboarding or cutting your hand while opening a can of Chef Boyardee.

Still have questions?

Still have questions?

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