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You’re probably thinking back to your 16th, 18th or 21st birthday and remembering how exciting it was to reach a new milestone. Turning 26 is kind of like that, but a little more terrifying. 26 is when you’ll be officially kicked off your parent’s health insurance plan – yikes!
Depending on the insurance you have through your parents, you’ll either be cut off at the end of the tax year, the end of the month or immediately.
If your parents have great insurance, you’re probably stressed about finding an affordable alternative. If they don’t, then this is the chance to get onto a better plan.
Don’t worry, the world of health insurance seems terrifying at first, but after reading this article you’ll be ready to go out and get insured.
If you’ve been reading up on how to get health insurance, you’ve probably seen a lot of these terms thrown around. These definitions will help you to understand what insurance companies are actually talking about.
Premium: The price of your insurance. This is the monthly or yearly amount that you pay to your insurance company.
Deductible: The amount you have to pay before your insurance kicks in. For example, if you have a $2500 deductible and undergo three separate $1000 operations, you will have to pay the first two in full, but only $500 of the last one.
Maximum Out-Of-Pocket: The absolute maximum amount you will have to pay. This is usually a little higher than a typical deductible but it means that you this is the MAXIMUM you’ll need to pay when your “deductible” is finished.
Co-Pay: A set fee you pay for different treatments, like $30 for a doctor’s visit or $250 for an emergency room visit. These co-payments don’t usually count towards your deductible.
Co-Insurance: Same idea as co-pay but instead of a flat fee, it’s a percentage of your bill. If your co-insurance is 20% and your doctors visit costs $100, you’ll pay $20. This can be substantial if your treatment costs $10,000 – i.e. you’ll need to pay $2,000 out of pocket.
Assuming you got through all of the definitions, you’re probably wondering if getting health insurance is even worth the trouble – are you kidding me!?
At 26, you’re still young and invincible, right? Unfortunately, medical emergencies can happen to anyone at any time.
Let’s say you’re in perfect health and decide to stay uninsured. What’s the point of paying over $100 a month for insurance if you never get sick or need prescriptions? Next thing you know, you’re biking to work and get into a serious wreck. You wake up to $75k+ in bills for physical therapy, prescriptions, x-rays, medical equipment, and the hospital visit. Suddenly that $100 a month doesn’t sound so bad.
Regardless of the health risks, being uninsured is expensive! With fees ranging from $695-2085 for those who opt out of insurance and the cost of a full medical bill, being without insurance is crazy! Insurance means that you pay a small amount of money to an insurance carrier for when you need to use a large amount of their money. So many people buy insurance on their cell phones, computers, domestic appliances, automobiles, etc. You’re already playing in the insurance game so why mess with what would be a much larger cost to you than a broken cell phone!
Currently, you can only apply for health insurance from November 1 through December 15. This is called the open enrollment period, and if you forget to submit your application you’ll have to wait until next Fall to reapply.
Fortunately, there are two ways around this rule.
First, when you turn 26 you get a special enrollment period which lasts 120 days. You can sign up anytime from 60 days before and 60 days after your birthday.
Second, alternative healthcare coverage options like O’NA HealthCare™ offer 365-day open enrollment which means you can apply at any time during the year, even if you’re not 26!
There are a few important factors to consider when deciding which health insurance or coverage plan to choose.
First, look at what the plan covers. Some insurance providers will only cover a handful of conditions and procedures. The best plans will include medical, dental, and holistic treatment.
Second, decide if you’d rather have a low monthly premium or a low monthly deductible. A low premium means you’ll pay less each month, but you’ll probably have to pay more upfront. This is great for people who are generally healthy and don’t have any prescription medications or regular procedures. A low deductible means you’ll pay more each month, but you’ll have to pay less upfront if you need expensive treatments. This is better for people who may expect to undergo an expensive procedure during the year.
Third, choose between a PPO, HMO or HDHP. These aren’t as confusing as they sound!
The most popular plan is an HDHP (high deductible health plan). Having an HDHP allows you to open up a Health Savings Account (HSA), which is a new bank account where you can save up for medical expenses without getting taxed. As the name implies, HDHPs generally have higher deductibles, which means they’re perfect if you don’t have many recurring health expenses.
An HMO (health maintenance organization) means you choose one approved doctor, and you go to them for everything except emergencies. If you develop a skin condition, you wouldn’t go to a dermatologist directly, you would go to your provider and they would refer you to a professional in their network.
A PPO is more flexible, and you can go to any care provider in the network without a referral within the state you have health insurance. There are good benefits to each, but PPO’s are often preferred due to their open provider network.
There are a few different ways to apply for health insurance depending on the provider you choose.
The easiest way to sign up is to apply for a healthcare coverage plan like O’NA HealthCare™. Instead of dealing with enrollment periods, you can apply 365 days a year. The application process itself is also a lot less complicated. Just fill out an application and start receiving coverage!
Another way is to ask your employer if you are eligible for health insurance through your job. Depending on the company, your years at the company, and your salary, you may or may not be able to get insurance through your employer.
If you don’t have an employer but you’re still in school, check if they offer a student health plan. This is usually a very easy and affordable way to get insurance.