Health Insurance

Medical coverage for doctor visits, prescriptions, and hospital stays.

Typical cost: $3,000 – $8,000+ per year

What Is Health Insurance?

Health insurance pays for medical, surgical, and sometimes dental expenses. It can reimburse you for expenses from illness or injury, or pay providers directly. Medical costs without coverage can be devastating—a single hospital stay can cost $10,000-$100,000 or more.

Types of Plans

HMOs require a primary care physician and referrals but have lower premiums. PPOs offer more flexibility with higher premiums. HDHPs pair low premiums with high deductibles and HSA eligibility. EPOs work like PPOs but with no out-of-network coverage except emergencies.

ACA Marketplace

The Affordable Care Act established Health Insurance Marketplaces where individuals can shop for coverage. All plans must cover ten essential health benefits. Premium subsidies based on household income make coverage affordable for millions of Americans without employer-sponsored insurance.

What's covered

Preventive Care

Annual check-ups, immunizations, and screenings covered at no cost under ACA-compliant plans.

Hospitalization

Covers inpatient hospital stays, surgeries, and intensive care.

Prescription Drugs

Covers medications organized into tiers with varying copayment levels.

Emergency Services

Covers ER visits and ambulance transportation, even at out-of-network facilities.

Mental Health

Psychiatric care, counseling, therapy, and substance abuse treatment.

Maternity Care

Prenatal visits, labor and delivery, and postnatal care.

Rehabilitation

Physical therapy, occupational therapy, and other rehabilitative services.

Laboratory Services

Blood tests, imaging, X-rays, MRIs, and diagnostic work.

Specialized coverage

Explore specific health insurance options.

Pros and cons

Advantages

  • Protects against catastrophic medical expenses
  • Preventive care covered at 100% under ACA plans
  • Marketplace subsidies make coverage accessible
  • Out-of-pocket maximum caps annual spending
  • Mental health parity ensures equal coverage
  • Employer plans often cover most of the premium

Considerations

  • Monthly premiums can be expensive without employer contributions
  • High-deductible plans require significant out-of-pocket spending first
  • Network restrictions limit your choice of doctors
  • Prior authorization can delay necessary treatments
  • Plan options are complex and confusing to navigate

Frequently asked questions

Related coverage

Stay informed

Weekly insurance tips and coverage insights. No spam.