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.
Individual Health Insurance
Health plans for individuals not covered by employer plans.
Family Health Insurance
Comprehensive coverage for your entire family.
Short-Term Health Insurance
Temporary coverage for gaps between plans.
Catastrophic Health Insurance
Low-premium plans for worst-case medical scenarios.
HSA-Compatible Plans
High-deductible plans paired with Health Savings Accounts.
Medicare Supplement Insurance
Medigap plans that fill coverage gaps in Medicare.
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
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