If you’re having trouble getting health insurance you can afford, you’ll find more options now because of the Affordable Care Act. We listed Low Cost Health Insurance Plans and how you can get them.
Whether you’re a student, a stay-at-home mom or a single professional, every person needs to have health insurance.
As everyone knows, health insurance provides security, preventing you or your family from having to experience serious financial burdens as a result of expensive medical bills. With the rise of medical insurance costs, most people look for low cost health insurance plans that will ensure quality medical attention at the time of need, but at a price they can afford.
If you’re new to health insurance in the United States, you’ll find it’s expensive. But cost isn’t the only problem for beginners trying to get health insurance. It’s also a complex system with multiple entry points.
Since you can potentially get health insurance from many different sources, such as the government, from your job or university, or from a private insurance company, it’s not always clear where you should start looking when shopping for low-cost health insurance.
Before exploring your options for low cost health insurance plans, understand one thing: health insurance is never really free and is rarely truly low-cost. Health insurance that’s free or low-cost to you means one of two things:
- Someone is subsidizing the monthly premiums so that you’re not paying the full cost yourself. If you qualify for this sort of subsidization—usually from an employer or the government—this is a great way to obtain health coverage that fits your budget.
- The benefits have been reduced so the coverage you’re buying isn’t comprehensive health insurance; it’s less robust coverage. These types of coverage may be appealing at first glance, but they can leave you in the lurch if and when you have a significant medical claim.
Low Cost Health Insurance Plans: How To Apply
Below, you’ll find several Low Cost Health Insurance Plans, along with a description of who is eligible, how to apply, and what to expect.
Medicaid is a social-welfare program that provides comprehensive government-based health insurance to low-income people. Medicaid is free health insurance for those who qualify. In most cases, there are no monthly premiums, and there is no or minimal cost-sharing in the form of deductibles or copayments.
Medicaid works slightly differently in each state, but to be eligible, you must meet low-income guidelines, which vary depending on factors such as age, pregnancy, and whether you’re disabled. In many states, adults under the age of 65 will qualify for Medicaid if their household income is no more than 138% of the federal poverty level. Pregnant women and children can generally qualify for Medicaid with household incomes well above that level, but people age 65 and older generally need to have lower incomes as well as low asset levels in order to qualify for Medicaid.
However, some states have stricter eligibility criteria for adults under the age of 65. In those states, you must meet low-income guidelines and also be a member of a medically vulnerable group (people who are pregnant, parents/caretakers of a minor child, elderly, disabled, and children). In other words, there are some states (14 as of early 2021, although it will only be 12 as of mid-2021) where being low-income by itself will not make you eligible for Medicaid.
Medicaid may be available to immigrants who have been legally residing in the United States for five years or more if they meet eligibility requirements.
Medicaid isn’t usually available to undocumented immigrants, although there may be exceptions such as short-term limited Medicaid coverage in emergency situations, and emergency coverage for people who are pregnant. And again, Medicaid eligibility varies from state to state. California, for example, has chosen to extend Medicaid eligibility to undocumented children and young adults who otherwise meet the income criteria for eligibility.
Medicaid is paid for by federal and state taxes, and administered at the state level (which is why coverage and eligibility rules vary from one state to another). If you receive Medicaid, your friends, neighbors, and fellow citizens are paying for your health care with their tax dollars.
Although Medicaid is government health insurance, the vast majority of care provided to Medicaid recipients is provided by private businesses and healthcare providers. If you get Medicaid, you’ll likely be cared for at the same hospitals and by the same physicians as your neighbors with private health insurance.
And most states contract with private insurance companies to administer the coverage, which means your coverage ID card may display the name of a well-known private health insurer.
You can apply for Medicaid through your Affordable Care Act health insurance exchange or by contacting your state’s Medicaid program directly.
2: Short-Term Health Insurance
Short-term health insurance frequently costs less than comprehensive health insurance. For this reason, it’s an attractive option to people looking for temporary coverage.
Short-term plans can be sold in some states with terms of up to 364 days of coverage, and in some cases, these plans can be renewed for up to a total of 36 months.
But some states do not allow short-term plans to be sold at all, and others place more restrictive limits on their duration. And even in states that don’t limit short-term plans beyond the federal minimum requirements, insurers can choose to offer plans that are non-renewable or that have shorter durations.
Although short-term health insurance can be a low-cost health insurance option, it isn’t right for everyone. Short-term health insurance plans don’t have to follow the Affordable Care Act’s rules.
For example, a short-term health insurance policy can place a cap on benefits, limiting the insurer’s potential losses if you become seriously (and expensively) ill while you’re covered.
Short-term health insurance also doesn’t have to cover the essential health benefits. For example, most short-term plans do not cover maternity care or mental health care, and many exclude coverage for outpatient prescription drugs. Almost all short-term plans also exclude coverage for any pre-existing conditions.
You can even be turned down for coverage entirely if the insurer feels you’re too big of a risk to insure. However, if you’re young, healthy, and pose little risk of expensive claims for the insurer, short-term health insurance can be a surprisingly low-cost health insurance option.
You can buy a short-term health insurance policy directly from a health insurance company, use your own insurance agent, find a health insurance agent or broker at the National Association of Health Underwriters website, or use a non-governmental private online exchange such as ehealthinsurance.com.
Short-term health insurance is not sold on Affordable Care Act health insurance exchanges such as HealthCare.gov.
Short-term health plans are also not considered minimum essential coverage. If you experience a qualifying event that would otherwise trigger a special enrollment period to enroll in an ACA-compliant plan, you would not be able to do so if the rules require you to have had minimum essential coverage in place prior to the qualifying event.
For example, although involuntary loss of coverage is a qualifying event that normally allows a person to enroll in an ACA-compliant plan, loss of a short-term plan does not. And if you move from one area to another, your move will not trigger a special enrollment period if you had coverage under a short-term plan prior to the move (you must have had coverage under a plan that counts as minimum essential coverage prior to the move in order to qualify for a special enrollment period triggered by your move).
3: Spouse’s Health Plan
If your spouse has job-based health insurance, you may be eligible for the same coverage. Most employers extend the offer of job-based health insurance to their employees’ spouses, children, and step-children. You can sign up for this coverage during the initial enrollment period when your spouse first gets the job.
If you miss this opportunity, you’ll have another opportunity during each annual open enrollment period. You’ll also have an opportunity to join your spouse’s plan if you experience a qualifying event, such as losing your own health plan or having a baby.
If your spouse’s employer offers the company health plan to you and your children, you’re not obligated to accept it. If you can find a better deal on health insurance coverage for you and the kids, it’s OK to let your spouse’s employer cover your spouse only, while you and the kids opt for other coverage.
But it’s important to understand that if your spouse’s employer offers family coverage and the coverage is considered affordable for just the employee (i.e., without taking into consideration how much gets payroll deducted for the rest of the family’s coverage), nobody in the family is eligible for premium subsidies in the exchange.
This is known as the family glitch, and it leaves some families without a truly affordable health insurance option.
Although employers generally subsidize an employee’s job-based health insurance by paying a portion of the monthly premiums, the employer might not subsidize spousal or family coverage (most employers do subsidize family members’ coverage, but overall, employers pay a smaller percentage of the total cost of family health insurance, versus employee-only coverage).
If your spouse’s employer offers health insurance to their family members, your share of the premiums will be deducted from your spouse’s paycheck automatically.
If you don’t still know where to start, contact your local community health center or county health department and explain your situation. If they can’t help you, they can probably direct you to an organization that can. You can also call your state’s 211 Helpline, which offers free and confidential information about health care and other services.