Affordable Health Insurance

Affordable health insurance with broad coverage options is available now. Learn the benefits of having health insurance and how to find affordable plans.

Carrying health insurance provides innumerable benefits for enrollees who find the best plan for their needs at an affordable price. Different plans include different coverage options, however, at a wide variety of costs. Knowing what a health insurance plan includes prior to making a purchase commitment is essential to protecting your healthcare needs as well as your finances.

Healthcare in the U.S. has changed significantly in recent times. More options are available now than ever before through private and government-sponsored providers. Plans for single, married and family enrollees are also available at varied pricing tiers nationwide. Finding an affordable plan which includes the coverage options you need is possible to do if you compare prices, plans and providers online. Continue reading to learn about the benefits of having health insurance and how to find an affordable plan today.

Health Insurance - What Does It Include?

Most health insurance plans cover treatments, procedures and expenses deemed by insurance providers as medical necessities. Some plans cover more albeit usually at an additional cost. Commonly, each insurance provider offers different coverage options (even when at similar price ranges). It is important to review the benefits of each plan before enrolling. The federally sponsored Health Insurance Marketplace website is a trusted resource for price and benefits comparisons. Please note: Both government-sponsored (federal and state) and private health insurance providers are available through the Health Insurance Marketplace with a wide variety of plans and price-points.

Essential Benefits vs. Preventative Services

Due to regulations as set forth by the Affordable Care Act (ACA), all health insurance providers selling plans through the Health Insurance Marketplace are required by law to include a minimum of ten essential health benefits (EHBs) in their plans. EHBs must also include dental coverage for children. Dental coverage for adults is optional and commonly involves additional out-of-pocket expenses. The following is a list of EHBs typically covered by insurance providers through the Health Insurance Marketplace:

  • Outpatient care not involving admission to a hospital (ambulatory patient care and services).

  • Hospital emergency room and other emergency healthcare services.

  • Hospitalization (serious illness, surgery, etc.)

  • All pregnancy and childbirth-related care including for newborns.

  • Behavioral health, mental health, substance abuse treatments and services (including counseling, therapy, etc.)

  • Prescription medications (commonly includes some out-of-pocket costs).

  • Laboratory testing and related services.

  • Pediatric care and services (including dental and vision).

  • Management of chronic disease (including preventative and wellness coverage).

  • Habilitative and rehabilitative services (includes applicable treatment devices and services designed to assist with recovery from chronic conditions, disabilities, and injuries; also designed to assist with the recovery of physical and mental skill sets).

Please note: The ten EHBs covered by health insurance plans sold through state-facilitated marketplaces might vary from those sold through federally facilitated marketplaces. Additional coverage might also be included in certain plans. For example, coverage for visits to your primary care physician (PCP) is commonly included albeit with varied out-of-pocket costs. Coverage of preventative services also varies greatly per plan and provider.

What are preventative services?

Preventative services assist in the detection and prevention of serious diseases, illnesses, and additional health issues. Providers selling health insurance on the Health Insurance Marketplace are required to include coverage for certain preventive services in their plans without charging enrollees any copayment. The preventative services applicable to you are largely dependent upon your family/medical history plus your gender and age. Child-based preventative services also vary greatly with age.

Adult preventative services covered include blood pressure screening, depression screening and colorectal cancer screening (adults fifty through seventy-five years of age). Diabetes Type 2 screening (overweight adults forty through seventy years of age) and diet counseling for adults at risk of chronic disease are also covered. Women and pregnant women are covered for anemia screening, folic acid supplements and cervical cancer screening. Female-based preventative services also cover breast cancer chemoprevention counseling, preeclampsia prevention and screening and contraception. Several other preventative services covered as required include: 

  • Fall prevention services for adults sixty-five years of age and older.

  • Immunization vaccines.

  • Hepatitis B and C screening for higher-risk individuals.

  • Domestic/interpersonal violence screening and counseling services.

  • Tobacco use and alcohol abuse screening and intervention services.

  • Lung cancer screening (for higher-risk adult smokers fifty-five through eighty years of age).

  • Urinary tract infection (UTI) screening.

Benefits of Having Health Insurance

Some people choose to not enroll in health insurance because they either do not want to pay the costs or believe those costs are unaffordable. Having health insurance provides countless benefits, however. Conversely, not having health insurance significantly increases the risks to your health - and finances. For example, a trip to the emergency room costs an average of $700 per adult in the U.S. today. This price does not include the costs of tests and extended hospitalization. Falling and breaking your leg might cost you over $7,500 out-of-pocket if you do not carry health insurance. Hip replacement procedures cost approximately $32,000.

Health insurance helps prevent overwhelming medical bills, which damage your credit and put a strain on your household. Having health insurance gives you access to the care you need - close to home. Every health insurance provider supplies a convenient list of in-network providers, so you always know which doctors, hospitals, specialists and more are available for you. You also get the benefit of having peace of mind, knowing you (and your family) are covered in the event of an emergency or serious illness.

Plans Available for Single, Married and Family Enrollees

Health insurance plans are available for single, married and family enrollees. Coverage options in these plans vary in price per plan and provider. Coverage options also vary based on the ages of all people enrolled in the plan and additional criteria. Health insurance might also be available through your employer. Benefits packages offered by employers vary greatly in coverage options and prices. Many enrollees enjoy the convenience these types of plans provide, however. Enrolling is typically done at work during specified enrollment periods. Premiums are also typically deducted straight from your paycheck, which eliminates the need to make separate payments.

Cost of Health Insurance Plans

Multiple factors influence the cost of health insurance plans today. Federal and state laws regulate what coverage requirements, while simultaneously limiting their costs to you. The type of insurance plan you purchase also impacts your costs. For example, prices for employer-provided health insurance are likely to differ from plans you purchase outside of work. Additional factors impacting health insurance costs include your state, county, age, and use of tobacco.

The national average cost of a health insurance plan is approximately $450 per individual and $1,150 per family (per month). Premiums for family health insurance plans average approximately $21,300 although employers (when applicable) cover approximately seventy-three percent of those costs. Prices also vary greatly between premium and more affordable options.

Affordable and Premium Options

Your income level also impacts the costs of your health insurance plan. Certain enrollees might qualify for Medicaid, which is offered to qualified individuals and households with verifiable low income. Medicare insurance coverage is also granted automatically to people sixty-five years of age and older. Medicare is also provided to people with qualifying medical, physical or other applicable disabilities.

Premium plans such as Preferred Provider Organizations (PPOs) typically cost the highest prices. The Health Insurance Marketplace also offers plans in tiers based on coverage options and pricing. The most affordable of these options is the Bronze plan. The additional plan tiers from lowest to highest (premium) in price include: