Everything You Need to Know About Shopping for Health Insurance

By law, everyone must have health insurance.

If you’re not insured through your employer:

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3 months is how long you can legally go
without health insurance

If you’re not insured after that, you could pay a tax penalty. If you need to shop for your own insurance, avoid the penalty and start considering your options today.

Let’s get started

Health Insurance: The Basics

Everyone’s different, so the best plan for you
will depend on a number of factors.

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Step 1 Get an idea of costs

Head to a health insurance website
and input your:

  • zip code
    ZIP code
  • gender
    Gender
  • birthdate
    Birthdate
  • tabacco
    Tobacco status
  • dependants
    Spouse or any
    dependants
    (if they need coverage also)
  • Income
    Income
figure
cost
Your health
insurance cost
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Step 2 Consider tax subsidies vs. overall cost

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71% of Americans who buy their own health insurance may be eligible for a tax subsidy.

You might qualify for this if you make less than $30,000 a year, but requirements vary from state to state.

However...

It’s best to comparison shop between the government and
private exchanges – the private marketplace can be cheaper.

Click to find
out more
plan

Step 3 Consider the costs based on plan

Understand how much you have to pay in addition to your monthly premium cost.

Lower
Monthly Costs
Higher
Monthly Costs
  • BRONZE

    Pay 40% of
    healthcare costs

  • SILVER

    Pay 30% of
    healthcare costs

  • GOLD

    Pay 20% of
    healthcare costs

  • PLATINUM

    Pay 10% of
    healthcare costs

20%
65%
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Step 4 Check the deductible

A deductible is a fixed amount you have to pay
before any benefits from your policy can be used.

The lower the deductible, the higher cost the policy will be.

  • Average Individual Deductible
  • Average Family Deductible
  • $0
    $0
    Bronze plan
  • $0
    $0
    Silver plan
  • $0
    $0
    Gold plan
  • $0
    $0
    Platinium plan
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Step 5 Consider your healthcare needs

Do you go to the doctor frequently?
If not, you may prefer a high deductible policy,
and to pay for smaller procedures yourself.

Consider this:

  • Bronze plan
    $0 /month
    Deductible: $0
  • OR
  • Silver plan
    $0 /month
    Deductible: $0
Plan includes x5 $35 office visit copays a year

If you plan to visit a doctor
several times a year, a more expensive plan
with office copays can work out cheaper.

Step 6 Check prescription coverage

Do you have many prescriptions?
If so, check the plan’s coverage.

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    Copayment

    You pay a set amount (e.g. $10) for all drugs on a certain tier.

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    Coinsurance

    You pay a percentage of the cost (e.g. 25%) of the drug.

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Step 7 Look at the network

Do you want to stick to a particular doctor or hospital?
Or are you more concerned about costs?

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Step 8 Buy a plan

You’ve weighed up all your options
– now it’s time to buy your plan.

Tips

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Compare insurance plans both on and off-exchange.

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Think about your health care needs and do the math to decide if a high-deductible plan is right for you

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Answer application questions truthfully. You can no longer be penalized for pre-existing conditions.

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If you don’t receive your insurance company ID cards within 3 weeks, contact the company.

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Make sure the insurance company is billing you each month. Glitches occur – you could lose your coverage for non-payment because of a billing error.

Next steps
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