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If You Can’t Afford Health Insurance Here are Your Options in 2021

If you are one of the American’s who can’t afford health insurance – you are not alone. The past year has caused a level of financial insecurity for millions of Americans that haven’t been seen since the Great Depression of the 1930s. And, with lawmakers in Washington, as of yet, unable to agree on how to resolve the issue, out-of-work and low-income citizens are searching for healthcare solutions. 

Learn about the options available to individuals who find themselves without the ability to afford health insurance in 2021. Find out whether you can take advantage of existing assistance programs through the federal government or other entities. And, discover options for getting the coverage you need on an alternative basis to mainstream health insurance and the Affordable Care Act.  

Can’t Afford Health Insurance in 2021? These are Your Best Options

It’s no secret that there exists a gaping healthcare cost disparity in the United States, resulting in millions of Americans who can’t afford health insurance. Even with the ratification of the Affordable Care Act (ACA) or Obamacare, the gap between those with insurance and those without continues to grow. And, the unprecedented numbers of unemployment claims, as a direct result of the global COVID-19 pandemic have done everything to exacerbate the already widening gap between the insured, and the uninsured. 

For millions of Americans, simply going uninsured is not an option. Going uninsured might mean giving up access to essential medications or life-saving therapies. If you are one of the many Americans finding themselves without the ability to pay for health insurance, there are other options available to you. 

Option #1: Cost Assistance Program

Obamacare is prohibitively expensive for many Americans, but it offers a cost assistance program for those in need who qualify. Your income must fall within 100% to 400% of the federal poverty level to be eligible for assistance. But, for many earners put out-of-work due to COVID-19, this program may help. 

The ACA Cost Assistance program works to cover the costs of your insurance premium by providing a payment subsidy. The amount covered by the cost assistance program is determined by your income, as well as the cost of coverage in your area. By taking part in this program, the federal government sends your premium subsidy directly to your insurance provider, which deducts it from your premiums on medication and other medical procedures covered under your plan. 

If you make 100% to 250% of the federal poverty level you may be eligible for coverage with cost-sharing benefits. Cost-sharing benefits offer lower deductible costs and copays for individuals with higher financial need. Talk to an insurance expert to find out if you are eligible for ACA Costs Assistance. 

Option #2: Medicaid Healthcare Coverage

Medicaid is a joint program through federal and state governments that provides healthcare coverage for people with disabilities, those receiving social security, and low-income individuals. In general, Medicaid may be available to you if your household income falls below the 133 percentile of the federal poverty level. 

The eligibility qualifications and restrictions for receiving Medicaid vary by state, but it is an invaluable resource if you can’t afford health insurance. And, even if you don’t qualify for health insurance through Medicaid, the Children’s Health Insurance Program (CHIP) can likely offer coverage for your children. Talk to an insurance associate for help navigating your state’s Medicaid application process. 

Option #3: Catastrophic Healthcare Coverage

If you are under the age of 30 or qualify for a hardship exemption for financial reasons, you may qualify for catastrophic healthcare coverage. Catastrophic health insurance is cheaper than traditional health insurance plans and includes all the same coverage as your standard HMO. The drawback to catastrophic health insurance, however, is that the deductibles are higher than with a standard health insurance plan. 

Unlike with a standard plan, tax subsidies and tax credits are not eligible to use on a catastrophic health insurance plan through the ACA marketplace. If you have preexisting conditions or foresee the need for regular medical care, it is more efficacious to pursue a standard plan through the ACA marketplace. 

If you are in tough financial times and need help with your medical expenses, start by finding out whether or not you qualify for Medicaid. Navigating the ins and outs of healthcare coverage can be confusing and stressful – especially when your wallet is thin. If you can’t afford health insurance, a professional insurance assistant will help you find an insurer and plan that meets your needs.

Filed Under: Uncategorized Tagged With: health insurance

What Is Catastrophic Health Insurance? What You Need To Know In 2021

If you are looking for cheaper or limited coverage, catastrophic health insurance might be right for you. In general, catastrophic insurance plans are less expensive per month than a standard HMO insurance plan. But, how do you know if it is the right thing for you? 

Learn everything you need to know about catastrophic health insurance coverage. Find out how much it costs in comparison to a standard HMO plan, how much coverage it provides, and if you qualify for catastrophic health coverage. And, see whether this plan will serve your needs if you need medical attention for any reason in the near future. 

What is Catastrophic Health Insurance and Is It Right for You in 2021?

Only qualified individuals can get catastrophic health insurance (CHI), and there might be better health coverage options for you. The purpose of CHI is to provide essential medical coverage to individuals with financial hardship, or who are under the age of 30. CHI generally has lower monthly premiums to account for financial hardship or low-risk carriers. 

The catch, however, is that catastrophic health coverage carries much higher deductibles than that of a standard HMO plan. So, if you do end up experiencing a medical emergency, you pay a higher out-of-pocket fee before your catastrophic health coverage kicks-in. Depending on your situation and health, a CHI plan might sound perfect, or it may not be the right type of insurance for you.

Plenty of individuals are currently struggling to keep up with their high-premium insurance through the Affordable Cares Act (ACA) – also called Obamacare. Catastrophic health coverage is a good alternative for some. Generally, you would consider getting catastrophic health coverage if you cannot afford standard health insurance – but it is not the only budget health insurance option available.

Catastrophic Health Coverage, Premiums, and Deductibles

With a CHI plan, you get three primary care visits per year – just like most standard HMO plans. Outside of your three annual checkups, however, it does not provide conclusive coverage for most other medical procedures and care. You end up paying an out-of-pocket cost of up to around $8,000 before your coverage kicks-in.

The biggest consideration is whether or not a standard health insurance plan ends up being comparable to the cost of a catastrophic health insurance plan. If you qualify for CHI, you then must consider your likelihood of experiencing an unforeseen medical event. If you end up in the emergency room, your total out-of-pocket costs, in addition to your annual premium, can end up costing more than standard health insurance.

Who Should Consider Getting Catastrophic Health Insurance?

The two groups of people who generally are interested in a catastrophic coverage policy are those who want to pay as little as possible for the bare-minimum coverage, and those who have no other option due to financial hardship. So, either you don’t want to pay, or can’t pay for standard health coverage. 

Catastrophic insurance provides bare-minimum preventative medical coverage before you are responsible for up to $8,000 out-of-pocket. And, the likelihood of experiencing a medical emergency gets higher as you age. If implemented as a long-term solution, catastrophic coverage will likely end up costing you more than standard coverage in the long-run. 

As a way of easing the financial burdens imposed by the ACA’s Individual Mandate – if you are under the age of 30 with a clean medical history you can qualify for catastrophic health insurance. In 2019, however, the individual mandate was suspended, so there is no federal penalty for going uninsured in 2021. So, for individuals under 30, catastrophic health insurance is no longer as valuable a means by which to avoid penalty fees – since the penalties no longer exist. 

If you are over 30 and do not have financial hardships, you simply present too high of a health risk to make a catastrophic policy financially feasible for most private insurance companies. But, no matter your age, financial hardship remains a reason why catastrophic coverage can be helpful. To be approved for your hardship exemption claim you must meet a qualifying circumstance at some point in the past year, such as homelessness, eviction or foreclosure, bankruptcy, or overwhelming medical debt – among others. 

You can also qualify if you are ineligible for Medicaid due to your state’s restrictions on the expansion of ACA coverage. But, navigating the world of health insurance can be difficult, and you’re not on your own. Talk to an insurance specialist to get help with your coverage options, applying for Medicaid, or qualifying for catastrophic health insurance.

Filed Under: Uncategorized Tagged With: health insurance

Types Of Health Insurance and Health Plans: A Complete Guide for 2020

When it comes to health insurance, there are several different types of health insurance to choose from. Whether you are shopping for health insurance from your State marketplace, or through a health insurance broker, it helps to be familiar with the options that you will encounter. This is your complete guide to health insurance plans and options for 2020. 

Learn everything you need to know about the different types of health insurance coverage types and deductible levels. Find out what the differences are between the plan types offered through national insurers. And, see which combination of coverage options best serves your health needs and budget. 

Types of Health Insurance and Health Plans Available in 2020

Looking through the myriad types of health insurance available on the marketplace or through a broker can leave your head spinning. There are so many options available, so how do you know which one to choose? Here is everything you need to know in 2020 about the types of health insurance plans available to you.

Health insurance coverage is separated into categories that correspond to your level of deductible. A deductible is the amount of money you have to pay before your health insurance picks up the rest of the cost. In general, the less expensive your insurance plans monthly premium, the higher your deductible.

Types of Health Insurance Deductible Levels

Each level of health insurance is identified by a metal: platinum, gold, silver, and bronze. The top deductible coverage level – platinum – generally covers around 90% of your medical costs while you are responsible for a deductible of about 10%. Since platinum-level health insurance covers the vast majority of your medical costs, it carries the highest monthly premium.

The next highest level of coverage is gold, which covers about 80% of medical costs. Since gold-level plans cover fewer medical costs than platinum plans, gold carries a lower monthly premium than platinum, but higher than that of silver. Silver level plans cover 70%, leaving you a 30% deductible, and bronze level covers 60% of medical costs. 

Catastrophic policies also are available to supplement high deductibles. In 2020, catastrophic policies generally payout after you surpass about $8,000 in deductible costs. Also, catastrophic insurance has to cover preventative care and your first 3 visits to a primary care physician for free, regardless of your deductible level.  

Health Insurance Plans by Care Level

Most national big-brand health insurance providers – such as Anthem, Blue Cross Blue Shield, Aetna, United, or Cigna – offer certain types of health insurance plans. This coverage is spelled out in a health plans Summary of Benefits. Each type of plan exists to best fit your specific medical needs and budget. 

Health Maintenance Organization (HMO) Plan

A Health Maintenance Organization (HMO) plan is the most common type of health insurance coverage. With an HMO plan, you have the least freedom to choose a care provider, and the least amount of paperwork to fill out. Your HMO dictates the network of healthcare providers from which you can choose.

The upside of an HMO plan is that there is very little paperwork to fill out since you are not required to file claim forms. On the other hand, your health services are all provided through a predetermined network of providers and facilities. If you end up going to a provider outside of your HMO’s network, you have to pay the bill out-of-pocket. 

HMOs require you to pay a monthly premium, a deductible, and can often include copays. A copay is a flat rate you pay when receiving care and is usually around $15 to $30. You might also be responsible for coinsurance fees, which is calculated based on a percentage of the cost of care.

Preferred Provider Organization (PPO) Plan

A Preferred Provider Organization (PPO) coverage plan offers more freedom to choose your medical care provider, as well as to see a specialist without the need for a referral from an in-network physician. If you decide to see an out-of-network provider, however, you have to pay a higher out of pocket expense, as well as fill out more paperwork. Like an HMO, when using providers in-network for your PPO plan, there is very little or no paperwork involved.

With a PPO plan, you pay the same expenses as are required in an HMO, except for out-of-network care. If you receive care from out-of-network providers that charge more than the areas average, you might be expected to make up the remainder. PPO coverage requires you to pay an out-of-network provider before filing a claim for reimbursement to your PPO coverage provider. 

Exclusive Provider Organization (EPO) Plan

Unlike a PPO plan – Exclusive Provider Organization (EPO) plans do not cover the costs of care for out-of-network providers, except in the case of an emergency. But, the premiums for EPO plans are generally less expensive than that of a PPO plan. EPO plans offer less freedom to choose your provider than that of a PPO plan, but more choice than with an HMO. 

You are free to choose any care provider inside your EPOs network of providers. If you choose a provider outside of your network, there is no coverage from your EPO plan. And, with an EPO, most insurance carries little to no deductible. 

Point-of-Service (POS) Plan

A Point-of-Service (POS) health insurance plan allows for more freedom to choose your care provider. It combines features from an HMO plan and a PPO plan. You have a primary physician who may refer you to specialists within your POS network, and it provides minimal coverage for out-of-network care providers and facilities. 

If you receive care or see a provider outside of your POS network, you must file a claim for partial reimbursement. When receiving care from in-network providers there is little to no extra paperwork involved. Most POS plans charge a premium, copays, and a deductible associated with care outside of preventative services.

With all the options available, how do you know which one is the best choice for you? The right health insurance for you is the one that best suits your health needs and budget. If you want help learning about the types of health insurance available and which one best fits your needs, talk to an insurance professional today.

Filed Under: Uncategorized Tagged With: 2020, EPO, health insurance, HMO, POS, PPO

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