Welcome to adulthood – the land of big decisions, bills, and suddenly caring about things like insurance deductibles and networks. Entering adulthood comes with all kinds of important decisions – choosing the right health insurance plan is one of them. But you’re young and healthy, do you really need health insurance?
Health Insurance: Do You Really Need It? (Spoiler: Yes!)
Short answer: Absolutely.
Long answer: Let’s break it down.
The reality is that no one ever plans to get injured or develop an illness. But life happens – sprained ankles, surprise illnesses, and freak accidents. Health insurance provides protection when the unexpected hits.
How Health Insurance Protects You
If you’re considering going without health insurance, ask yourself this – would you drive a car without auto insurance? No, of course not! After all, you need protection in case of an accident. Carrying auto insurance to protect a valuable asset – your vehicle – ensures that if a car accident happens, your vehicle will get taken care of.
Like auto insurance, health insurance operates as a safety net for the worst-case scenario. It protects you from financial hardship when an injury or illness occurs.
Injury & Illness
Even minor injuries can pack a financial punch:
Broken leg: Over $7,500
Add a hospital stay: $30,000+ (source: Healthcare.gov)
Health insurance can reduce the burden of medical bills substantially, protecting you (and your wallet) from financial harm. Once your deductible is met, health insurance will cover a portion of your health care costs.
It’s Not Just About Emergencies
In addition to providing security in emergency situations, health insurance also offers you preventive coverage that allows you to be proactive with your health and well-being. You can catch small problems before they become expensive, complicated ones – it’s the ultimate life hack. Preventive services include services like annual wellness checks, vaccinations, and cancer screenings at no cost to you.
Protect Your Wallet and Your Goals
As a young adult, you likely have financial goals in mind. Are you saving for a car, house, or university? Medical debt can throw financial goals out of reach. Health insurance helps protect your financial security in the face of medical emergencies and provides preventive coverage that ultimately saves you money.
What Health Insurance Covers
Health insurance provides coverage for numerous health-related services and needs, including:
- Primary Care visits
- Surgeries
- Physical Therapy
- Medications
- Hospital stays
- Emergency room visits
- Mental health providers
Choosing the Right Health Insurance Plan
Choosing the right health insurance plan is a huge decision. You may be wondering what kind of health care plans are available or have questions on choosing the right plan. There are several health coverage options available to young adults – the right plan for you will depend on a few circumstances.
Are You Under 26?
If you haven’t turned 26 yet, you can stay on your parents’ plan. Easy win.
Turning 26?
If you are about to celebrate a 26th birthday – congrats – you just unlocked the ‘find your own insurance’ quest. Most plans stop covering dependents at the age of 26. Because of that, turning 26 is considered a Qualifying Life Event (QLE), meaning you can enroll in health insurance outside of the traditional Open Enrollment dates.
26 and Older:
If you’ve passed your 26th birthday and now require your own health care plan, you’ll want to start looking around the time of Open Enrollment (usually September – December). Depending on your circumstances, you may have several options for enrollment available to you, including:
Affordable Care Act (ACA) Marketplace Plans
On the Affordable Care Act Marketplace, sometimes known as the ACA or Obamacare, you can shop for health insurance plans for individuals and families. The platform allows you to compare plans to find the best one to suit your needs.
Employer Plans
Nearly half of all Americans get their health insurance from an employer-sponsored plan. (healthinsurance.org) Typically, employer plans cover a significant portion of a health insurance premium, making the plan more affordable for employees.
Spousal Plans
If you are married, you may have the option to enroll in your spouse’s health care plan. Your spouse will want to confirm that they can add you to their plan.
Medicaid Plans
Medicaid plans provide coverage to eligible individuals. Eligibility factors typically consider state residency and income. Many states offer Medicaid plans specific to children, pregnant women, and disabled individuals. (Wyoming Department of Health)
Medicare Plans
Medicare plans typically offer insurance for individuals 65 and older, however, they may cover individuals younger than 65 who are disabled. (Social Security Administration)
Types of Health Care Plans
As you start exploring health insurance plans, you’ll likely find several different types of plans available to you. Here’s a breakdown of the most common types of plans:
PPO
A PPO plan, or Preferred Provider Organization plan, offers coverage with lower costs when using in-network providers. You can typically still see an out-of-network provider but may have a separate deductible to meet, and their services may be more expensive than an in-network provider.
HDHP
An HDHP, or High-Deductible Health Plan, typically has lower monthly premium costs, and higher deductibles. This plan is often selected as a safety net option by individuals with few medical conditions who are generally healthy.
HMO
An HMO plan, or Health Maintenance Organization plan, provides coverage for a network of providers. They typically have lower premiums than a PPO but have more restrictive options when it comes to selecting providers and usually require referrals to specialists.
POS
A POS, or Point of Service plan, is like a PPO in that you can see in-network providers for a more affordable cost than out-of-network providers. Like an HMO, these plans typically require referrals from a Primary Care Physician to see a specialist.
How to Pick the Right Plan
Selecting the right health insurance plan is a deeply personal decision – everyone’s needs are different. Consider these factors when choosing your health plan:
Budget
Do you need a more affordable monthly payment, or are you looking for the most comprehensive coverage? Weigh your budget options and the potential cost of medical bills when selecting your plan.
Health Care Needs
Do you have any medical conditions or upcoming medical procedures? Do any serious health conditions, like diabetes or high blood pressure, run in your family? Think about how often you may need to see a doctor throughout the year, or any prescriptions you may take regularly when deciding on the type of coverage you need.
Lifestyle
A fan of dirt biking? Enjoy high-intensity sports or outdoor adventures? If your lifestyle is prone to injuries, you should factor that into your health care plan selection.
Bottom Line
Health insurance is a critical part of protecting your most valuable assets – your health and well-being. It offers a safety net in case of an emergency illness or injury and provides coverage for preventive services that help keep you healthy. We’re here to help guide you through the process – set up an appointment with a local BCBSWY agent today to learn more about your health care coverage options and get your questions answered.
IMPORTANT RESOURCES
Blue Cross Blue Shield of Wyoming
Kaiser Family Foundation Health Insurance Marketplace Calculator | KFF