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What Is Health
Insurance?

Proper health insurance can be an essential part of staying healthy. With a comprehensive plan, you'll have the peace of mind that comes with knowing your family is covered in terms of medical emergencies or unforeseen circumstances. Without it, your entire life savings could be wiped out with a single medical bill.

Health insurance helps pay for medical expenses incurred through illness, injury, emergency surgery, and general health problems. Depending on your medical plan and scope of coverage, you might be required to immediately pay for these medical expenses at the hospital or doctor's office. You then make a claim, and the insurance company provides a reimbursement.

The good news? You're in the right place to learn about the options and plans available to you! With the right health insurance plan by your side, you and your family are fully protected, giving you one less thing to worry about.

With the help of Coverage Haven, you'll save on benefits such as preventive care and prescription drugs to ensure all members are always well cared for!

Health Insurance In The Affordable Care Act

The Affordable Care Act standardized health insurance plan coverage. Before the Affordable Care Act, benefits varied drastically from plan to plan. Now, when you shop for health insurance on the Marketplace, all plans are required to offer ten essential benefits. (thanks, Obama)
Ambulatory patient services (outpatient)
Hospitalization
Emergency services
Maternity and newborn care
Mental health and substance use disorder services
Prescription drugs
Pediatric services (oral and vision)
Laboratory services
Preventive and wellness services and chronic disease management
Rehabilitative and habilitative services and devices

Why Do You Need
Health Insurance?

Health care in the United States is notoriously expensive.

A single visit to the doctor can cost hundreds of dollars, and if a hospital stay is required with specialist care, tens of thousands of dollars can build up in the blink of an eye.

According to a recent analysis by independent nonprofit FAIR Health, those hospitalized with the coronavirus paid anywhere from $42,486 to $74,310 if uninsured or received care that's deemed out-of-network by their insurance company.

There aren't many individuals who could afford that bill. That's where health insurance comes in.

In exchange for a monthly premium, a health insurance provider shares the risk and covers a percentage of the expense – reducing your health care costs to a more manageable amount.

Cost Of Health Insurance

How much your 2021 health insurance plan will cost depends on a range of factors, namely, the state in which you live, the level of coverage you purchase, and your age.
In 2019, annual premiums for health coverage for a family of four averaged $20,576, but employers picked up 71% of that cost.
The Kaiser Family Foundation. "Employer Health Benefits 2019 Annual Survey," Pages 7-9. Accessed March 12, 2021.
The highest benchmark plan premium for a 27-year-old in 2020 was Wyoming's, at $723; the lowest was New Mexico's, at $282.
U.S. Centers for Medicare & Medicaid Services. "Plan Year 2020 Qualified Health Plan Choice and Premiums in HealthCare.gov States," Page 8. Accessed March 12, 2020.
Average Marketplace Premiums
Wyoming: $791

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What You Should Look At When Comparing Health Plans

The monthly premium isn't the only cost you'll have to think about when comparing insurance providers.

Picking The Best Health Insurance Company

The best individual health insurance providers blend fast claim processing, flexible options, affordable premiums, and responsive customer service.
Best for Health Savings Plan (HSA) Options:
Best Large Provider Network:
Best for Online Care:
Best for Employer-Based Plans:
Best for Telehealth Care:
Best for HMO Plans:
Best for Wellness Care:
It is easy to get roped into paying for insurance policies and medical plans you don't need. With our expertise, you'll find that paying for useless coverage is a wasteful habit of the past.
Our specialists will provide you with a breakdown of plans available from the best health insurance companies.

How to Compare Health Insurance Plans

When looking for the right health insurance plan, it's important to understand and compare all of its elements. It's all about finding a combination of coverage that fits your needs at an affordable price point!

Out-of-pocket costs

The portion of medical expenses you are responsible for paying when you actually receive health care. Separate from your monthly premium.

Annual deductible

The deductible is the amount of money you must pay in out-of-pocket costs before the insurer starts to pay their share of costs. If the deductible is $1,000, you would be required to pay the first $1,000 in health care you receive each year, after which the insurance company would start paying its share.

Copayment

A fixed upfront amount you must pay each time you receive care that is subject to a copay. For example, you might be required to pay a $30 copayment each time you visit the doctor.

Coinsurance

The percentage of costs you pay once you've met your annual deductible. A gold tier plan beneficiary, for example, pays 20% of costs once they have paid their deductible, with the insurer covering the remaining 80%.

Annual out-of-pocket maximum

The maximum amount of deductible, copays, and coinsurance you are responsible for the year. Once met, the insurance provider will cover 100% of your expenses for the remainder of the year.

How to Compare Health Insurance Tiers

Health insurance plans are separated into four different metal tiers: Bronze, Silver, Gold, and Platinum. The higher the tier, the higher the proportion of medical expenses the plan covers. However, increased coverage, of course, comes with a more expensive monthly premium.
Bronze
Insurance Company Pays 60%
You Pay 40%
Silver
Insurance Company Pays 70%
You Pay 30%
Gold
Insurance Company Pays 80%
You Pay 20%
Platinum
Insurance Company Pays 90%
You Pay 10%
Frequently Asked Questions
Health Insurance FAQs
How much is individual health insurance?

In 2020, the average national cost for health insurance was $456 for an individual and $1,152 for a family per month.

When can you buy individual health insurance?

You can buy individual or family coverage from the Affordable Care Act marketplace or directly from a health insurance company during the Open Enrollment Period, often referred to as the OEP. For most states, the OEP is from November 1 to December 15 each year.

How do you buy private health insurance?

If your company does not offer an employer-sponsored plan, and if you are not eligible for Medicare or Medicaid, the only option is to purchase insurance policies directly from private insurance companies. This can be done through your state's health insurance marketplace.

How do you read a health insurance plan?

When reading a health insurance plan, you want to know what you're paying for, how much it costs, and whether or not the coverage is good enough for your needs. There are five main types of plans:

Health Maintenance Organization (HMO)

An HMO provides enrollees with coverage through a specific network of healthcare providers. These plans are more affordable, but patients must use specific doctors and specialists to get the costs covered.

Preferred Provider Organization (PPO)

A PPO gives enrollees flexibility to see healthcare providers outside of the network without a referral, but the rates for doing so will be more expensive.

Point-of-Service Plan (POS)

A POS plan is a little of both. It operates like an HMO if you stay within the network but gives you the option of using out-of-network doctors if you receive a referral.

High-Deductible Health Plan (HDHP)

An HDHP has a higher deductible by typically lower premiums than other plans. This makes it ideal for young and healthy people who are unlikely to need medical care.

Catastrophic Plan

Catastrophic plans are available to individuals under 30 years old. The plans have low monthly premiums and prioritize protecting you from high medical bills for catastrophic health events.


These all have different pros and cons that can make one more attractive than another in certain cases. It's important to read up on these before deciding which plan is right for you!

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