Buying Individual Marketplace Health Insurance Plans

Healthcare Writer

Published on April 1st, 2024

Fact checked by: Colleen McGuire

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Finding the right health insurance might sound tricky, but it’s not as hard as it seems. Follow this guide to help you make a smart decision about your health insurance.

Getting Started:

  •  Get together some basic info, like your birthday, where you live, and your Social Security number.
  •  Estimate how much money your household makes in a year.
  •  Have your tax info ready, especially if you’re an immigrant.

Understanding Your Health Needs:

  •  Think about how often you go to the doctor.
  •  Do you have a favorite doctor or hospital? Make sure they’re covered by the plan you’re thinking about.

Important Things to Think About:

  •  Can you still see your current doctors with this plan?
  •  Will the plan pay for your medications?
  •  Look for plans that let you see doctors without costing too much.

Getting Help with Costs:

 If you don’t make a lot of money, you might get help paying for your insurance.

Where to Look for Plans:

 Check out websites that compare health plans. Start with places like the ACA marketplace or healthcare.com.

 You usually buy insurance during the Open Enrollment Period unless something big changes in your life.

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Short-Term or Marketplace Plans:

 Short-term plans might be cheaper, but they don’t cover as much.

 Marketplace plans often give you better coverage, especially if you can get help paying for them.

Choosing the Right Plan:

 Learn about different types of plans like HMOs, PPOs, EPOs, and POS plans.

  • HMOs – Health Maintenance Organizations:  Primary doctors manage care and need referrals from specialists.
  • PPOs – Preferred Provider Organizations: -: More flexibility; specialists can be seen without referrals.
  • EPOs – Exclusive Provider Organizations: Limited network, no out-of-network coverage, lower costs.
  • POS plans – Point of Service plans:  Blend of HMO and PPO, referrals for specialists required.

 High-Deductible Health Plans (HDHPs) with a Health Savings Account (HSA) can save you money if you’re young and healthy.

 Catastrophic Health Insurance might be enough if you’re young and don’t need much medical care.

Looking at Costs:

 ACA plans come in different levels, like Bronze, Silver, Gold, and Platinum. Pick one that fits your needs and budget.

Thinking About Money:

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 A plan with higher monthly payments might be better if you often see the doctor.

 A plan with lower payments could be good if you’re usually healthy.

Before You Decide:

 Read all about the plan in the Summary Of Benefits.

 Make sure the plan covers what you need, like certain meds or if you travel a lot.

Steps to Buy Insurance:

  •  Figure out what you need and how much you can spend.
  •  See if you can get help paying for your insurance.
  •  Look at your choices: ACA, short-term plans, or others that might fit your situation.
  •  Apply for the plan you want and finish all the sign-up steps.

By taking it one step at a time and thinking about what you need, buying health insurance isn’t as scary as it seems.

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