Chauncey grew up on a farm in rural northern California. At 18 he ran away and saw the world with a backpack and a credit card, discovering that the true value of any point or mile is the experience it facilitates. He remains most at home on a tracto.
Chauncey Crail ContributorChauncey grew up on a farm in rural northern California. At 18 he ran away and saw the world with a backpack and a credit card, discovering that the true value of any point or mile is the experience it facilitates. He remains most at home on a tracto.
Written By Chauncey Crail ContributorChauncey grew up on a farm in rural northern California. At 18 he ran away and saw the world with a backpack and a credit card, discovering that the true value of any point or mile is the experience it facilitates. He remains most at home on a tracto.
Chauncey Crail ContributorChauncey grew up on a farm in rural northern California. At 18 he ran away and saw the world with a backpack and a credit card, discovering that the true value of any point or mile is the experience it facilitates. He remains most at home on a tracto.
Contributor Les Masterson Deputy Editor, InsuranceLes Masterson is a deputy editor and insurance analyst at Forbes Advisor. He has been a journalist, reporter, editor and content creator for more than 25 years. He has covered insurance for a decade, including auto, home, life and health. Before cove.
Les Masterson Deputy Editor, InsuranceLes Masterson is a deputy editor and insurance analyst at Forbes Advisor. He has been a journalist, reporter, editor and content creator for more than 25 years. He has covered insurance for a decade, including auto, home, life and health. Before cove.
Les Masterson Deputy Editor, InsuranceLes Masterson is a deputy editor and insurance analyst at Forbes Advisor. He has been a journalist, reporter, editor and content creator for more than 25 years. He has covered insurance for a decade, including auto, home, life and health. Before cove.
Les Masterson Deputy Editor, InsuranceLes Masterson is a deputy editor and insurance analyst at Forbes Advisor. He has been a journalist, reporter, editor and content creator for more than 25 years. He has covered insurance for a decade, including auto, home, life and health. Before cove.
| Deputy Editor, Insurance
Updated: May 9, 2024, 8:07am
Editorial Note: We earn a commission from partner links on Forbes Advisor. Commissions do not affect our editors' opinions or evaluations.
Getty
It can be challenging to find a health insurance plan that stays within your budget.
Here are the ways to get health insurance so you make sure you and your family are properly protected.
Health insurance coverage comes in four major types: employer-sponsored health insurance, individual or private plans, Medicare and Medicaid.
More than half (57%) of private sector employees are covered by a work-based health insurance plan, according to the Kaiser Family Foundation.
Private health insurance that’s not through an employer has become more common since the Affordable Care Act (ACA) went into effect in 2014. The ACA created a health insurance marketplace that lets consumers compare health plans available in their area. The law also created premium tax credits and cost-saving subsidies to reduce health insurance costs for people who buy in the ACA marketplace at Healthcare.gov..
Employer-sponsored group health insurance is a health plan chosen and primarily paid for by your employer. These plans are also offered to or can include your dependents. Your employer chooses the available plans and typically picks up most of the health insurance premiums costs. Employees typically pay premiums, which are taken out of your check on a pre-tax basis, which lowers your taxable income.
The health insurance marketplace at Healthcare.gov provides insurance plans to individuals, families and small businesses. Through this online resource, you can learn more about health insurance, compare plans, enroll in a plan and figure out how much you can save through premium tax credits and subsidies.
You can purchase a health plan through the marketplace even if you’re offered insurance by your employer; however, you may not qualify for subsidies if you have access to employer-sponsored coverage.
To buy a policy through the marketplace, you must apply during open enrollment or special enrollment. Open enrollment coverage begins Nov. 1 for the marketplace and runs until Jan. 15 in most states.
Some state exchanges may have slightly different open enrollment periods. If you miss open enrollment, you may qualify for a special enrollment period due to a major life change like moving, getting married, having a child or losing your existing health coverage.
To begin your search for insurance through the marketplace, head to Healthcare.gov during open enrollment or after you qualify for a special enrollment and enter your ZIP code. It will direct you to either your state’s exchange or to the federal marketplace where you can begin shopping.
A health insurance broker or agent can help you navigate the wide range of insurance options and enroll in the best health insurance plan for you. You don’t pay any fees when working with agents or brokers, as they’re paid on commission by insurers.
To find a broker or agent, you can use the federal government’s Find Local Help tool to set up in-person, phone or email appointments. You can also enter your phone number or email address to be contacted by an agent or broker to talk about plan choices. Agents and brokers must be licensed in their states to sell health insurance.
Some people can find plans that better fit their specific needs or budget by shopping directly with health insurance companies. These plans may meet ACA requirements or you may find a cheaper plan that doesn’t offer as comprehensive coverage that’s found on the ACA marketplace. Purchasing a health plan outside of the marketplace removes the opportunity for premium tax credits or other subsidies that are available through the marketplace.
People who don’t have employer-provided health insurance, are self-employed, are unemployed or own small start-ups may still be eligible for a group health insurance plan. These health plans require membership to a professional, trade or membership organization. You can check to see if your organizations offer association health insurance. Association health plans let freelancers, small businesses and self-employed people band together to buy group health insurance at discounted rates.
Be wary of plans provided through some membership organizations that are “health services discount” plans rather than actual health insurance. These plans may save you money on prescriptions but they don’t have broad coverage.
Consumers shopping outside the marketplace should also be cautious of health care-sharing ministries, where individuals of a shared faith contribute money to a health care cost pool distributed by a ministry to pay for certain health-related expenses. This is not health insurance and doesn’t cover pre-existing conditions or guarantee reimbursements.
The best time to sign up for health insurance is before you need it. Open enrollment for private health insurance through the federal marketplace (and many state marketplaces) begins on Nov. 1 every year and runs until Jan. 15.
You may qualify to enroll in health insurance during what’s called a special enrollment period if you have a qualifying life event. Qualifying events for special enrollment include:
Special enrollment periods typically last 60 days after your qualifying event, so begin applying for special enrollment as soon as possible to avoid missing the window.
If you don’t qualify for a special enrollment period or need to purchase health insurance outside of the open enrollment period, a short-term health insurance plan may be available to you. These plans often don’t meet the ACA’s minimum essential coverage requirements or cover pre-existing conditions. These plans are regulated to last up to 364 days with the opportunity to renew a policy twice and are not available in every state.
A Forbes Advisor analysis of unsubsidized ACA marketplace premiums found that the average monthly cost of health insurance on the ACA marketplace is:
The exact cost for an ACA plan varies by age, type of benefit design, metal tier and how many people are covered on the plan. Health insurance companies can’t use your health status or pre-existing conditions when setting rates for health insurance.
Common health insurance scams include robocalls and phishing emails that push “comprehensive” health plans that meet the requirements of “Obamacare.” Some emails feature the logos of well-known insurers or organizations like AARP.
During open enrollment, callers impersonate representatives of the insurance marketplace, offering special rates or encouraging you to join an association or union to get covered. Government representatives will never call to try and sell you insurance, nor will they push you with high-pressure sales pitches.
Was this article helpful?
