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Common Questions About Shopping for Health Insurance

Health Insurance Buying Guide: How to Shop Health Insurance

There are three main ways to get health insurance coverage: through your employer, Medicare or Medicaid or your state’s health insurance marketplace. Depending on your situation, a few other less common options are also worth considering, like short-term and direct-to-carrier health insurance.

1

Get health insurance coverage through your employer.

Employers are the largest source of health insurance for most Americans. About half of Americans receive health insurance through an employer, whether their own or a family member’s. Purchasing health insurance through an employer tends to be less expensive since employers often cover some of the cost of health insurance premiums.

However, depending on what your employer offers, you may have more limited insurer and policy types options. The biggest downside to receiving health insurance through an employer is that you’re only insured for as long as you’re employed; if you lose your job or change jobs, you’re no longer able to access health insurance coverage through your old plan.

2

Get health insurance through the government with Medicaid or Medicare.

Government-backed health insurance coverage — through Medicaid or Medicare — is the second-largest source of healthcare coverage in the U.S., with about one-third of Americans receiving coverage through these programs. These are some of the most affordable health insurance plans out there.

Medicaid covers low-income Americans, but specific eligibility requirements depend on where you live. Some states have expanded Medicaid coverage to include all low-income Americans, regardless of age, parental status or disability. Others have more stringent requirements.

Medicare covers Americans 65 and over, as well as some younger people with disabilities. Coverage involves several different parts, including:

  • Part A: Medicare Part A helps cover hospital, hospice and skilled nursing facility stays. It also helps cover home health care.
  • Part B: Medicare Part B helps cover outpatient services, doctor’s visits, home health care, durable medical equipment and some preventative services.
  • Part C: Otherwise known as Medicare Advantage, Medicare Part C is offered by private insurers and combines Part A and Part B coverage along with other benefits.
  • Part D: Medicare Part D helps cover the cost of prescription drugs.
3

Compare health insurance on your state’s insurance marketplace.

Suppose you don’t receive health insurance through an employer and aren’t eligible for coverage through a government program like Medicare or Medicaid. In that case, you can still purchase coverage through a health insurance marketplace. The Affordable Care Act made it possible for Americans to shop for insurance coverage either through the state or federal marketplace. Some of the best health insurance plans can be surprisingly cheap.

Depending on your income, you may be able to receive a tax subsidy that lowers the cost of insurance premiums on plans purchased through the marketplace. You must earn between 100% and 400% of the federal poverty level, be a U.S. citizen or legal resident and have no access to other health insurance to qualify for a subsidy.

4

Consider alternate options, such as direct-to-carrier and short-term health insurance.

Under certain special circumstances, there are a few other types of health insurance options worth considering. Some of these options may not be compliant with the Affordable Care Act or offer the same level of consumer protection as the options outlined above.

  • Stay on your parent’s plan: Under the ACA, you can remain on your parent’s health insurance plan until you turn 26.
  • Direct-to-carrier insurance: If you prefer not to purchase a plan on the marketplace, you can buy a plan directly from an insurance company.
  • Short-term health insurance: Short-term health insurance can help bridge gaps in your insurance coverage (e.g., your coverage stops because you've changed jobs) but tends to be expensive and provides limited coverage.
  • Health sharing ministry: While not legally considered insurance, health sharing ministries function similarly to an insurance policy but with no guarantee of coverage.
  • Military benefits: Military service members and their families are eligible for a health insurance program called TRICARE.