A Freelancer’s Guide to Buying Health Insurance

10.28.2022

At Friday Health Plans, we offer health insurance for those who choose their own path. Because we know there are some who don’t follow the herd. Self-starters. Freethinkers. Individuals who take pride in making their own decisions.

Whether you’re an entrepreneur starting your own business, a freelancer, or an early retiree, Friday is here to be a resource for you. Below, we’ve outlined everything you need to know before diving into the health insurance shopping period this upcoming Open Enrollment.

Open Enrollment starts on November 1st

Open Enrollment is the period of time when you can buy health insurance for the upcoming year. You can buy a plan either directly through a health insurance carrier, like Friday Health Plans, or through the health insurance exchange.

Find your state’s health insurance exchange here and be sure to check when end date and coverage start dates are.

Find the right-sized plan for you and your family

A smart way to approach saving on health insurance isn’t always by comparing monthly premiums. It’s by evaluating health plans based on how much you’re going to pay over the course of the year when you add up premiums (your monthly payment to have insurance) and the costs you pay for medical services and drugs.

Even if two plans have the same premium, if one requires you to pay a lower cost for doctor visits and prescriptions, it could save you money in the long run.

For example, some plans cover generic prescription drugs for free, which can save you hundreds of dollars annually compared with other plans with the same monthly premium.

Honestly assess what healthcare services and drugs you’re likely to use for the whole year. That will help you select a plan that covers what you need and avoid paying for plan perks you aren’t going to use.

Here’s a few points to consider in evaluating which plan level might work best for you:

• Does the plan allow you to access the services you use most at a cost that works for you?
• What’s the copay (flat fee you pay each time you see the doctor or buy a drug) or coinsurance amount (the percentage you pay for services after you’ve met your deductible) for the medical services you use most?
• If you are in good health and don’t anticipate any major medical procedures, consider a high-deductible plan that costs less per-month than plans with a lower deductible.

Young and healthy? Keep it simple, studly

If you’re pretty darn healthy and aren’t expecting any major medical procedures in the next year, consider getting a really basic plan, like a Catastrophic Plan* or Bronze Plan.

Being uninsured is a risky decision for several obvious reasons (read: potentially going bankrupt after a hospital stay), but it also isn’t great to be over-insured. That is, paying for insurance coverage beyond what is necessary based on how young and healthy you are.

Honestly assess what healthcare services and drugs you’ll likely use for the whole year. That will help you select a plan that covers what you need and avoid paying for plan perks you aren’t going to use. You can take a look at our generic and free ACA drugs here.

Make sure you are getting the real deal

Know the difference between ACA-compliant coverage and Health Care-sharing Ministries to avoid surprises down the road. Here is what you should know about both. 

Health Care-Sharing Ministries (HCSM)

Health Care-Sharing Ministries are organizations in the United States in which health care costs are shared among members who have common ethical or religious beliefs. While HCSMs may offer affordable coverage, they are not real health insurance. They are not regulated by the Department of Insurance, and do not guarantee essential health benefits or coverage for pre-existing conditions and may have limitations on what they will cover. Which means they can deny you coverage or drop you off the plan if you get sick or hurt, or deny covering you for anything related to a past medical condition.

They often have fixed annual limits on how much they will pay, leaving you on the hook if you have a big hospital bill. They also do not have partnerships with doctors and hospitals, so you are on your own to negotiate healthcare costs. Many doctors and facilities do not accept these plans for this reason.

ACA-compliant coverage

ACA-compliant coverage refers to health plans that offer benefits for a broad-range of healthcare services that meet the requirements established by the Affordable Care Act.

Major health insurance companies, like Friday Health Plans, offer ACA-compliant coverage. ACA-compliant coverage covers pre-existing conditions and guarantees access to essential health benefits like free annual wellness exams and preventive medications. There are also out-of-pocket maximums, which limits the amount you will spend in one year on medical expenses. Considering one night in a typical hospital averages about $10,000, quality health insurance can save you from bankruptcy after a serious accident or illness.

See if you qualify for financial assistance

Financial aid for health insurance, otherwise known as a subsidy, is a type of financial assistance that can lower your monthly premium or reduce your out-of-pocket medical costs.

Whether you qualify for subsidies depends on your income, family size, and the cost of the health insurance in the area. Many individuals qualify for financial assistance if their annual income is less than $51,040. A family of four that makes up to $104,800 is also likely to qualify.

See if you qualify now.

What about COBRA? Everyone keeps mentioning that

COBRA stands for The Consolidated Omnibus Budget Reconciliation Act and it gives workers and their families who lose their health insurance the right to continue group health plan benefits for limited periods of time. There are certain circumstances, such as job loss and other qualifying life events, that allow individuals to continue their current healthcare benefits. Employers with more than 20 employees are required to offer COBRA to individuals who qualify.

COBRA mainly serves as a bridge for folks who are looking for a new health insurance plan after leaving their job; it is not a long-term healthcare services solution for freelancers.

Own a small business with two or more employees? Consider getting a small business plan

Your employees are individuals who are all looking for different things in life and in their health insurance. With a small business plan, each member of your company can pick the plan that works best for them, eliminating your challenge of picking one plan for everyone. At Friday, we offer our simple selection of plans for businesses as small as two employees, so go ahead and take a look.

We’re also offering Individual Coverage Health Reimbursement Arrangements (ICHRA)

Businesses of all sizes can now offer health insurance options to more employees than ever before with Individual Coverage Health Reimbursement Arrangement (ICHRA). ICHRA allows any size employer to fund an account for each employee that then allows them to shop on the individual marketplace and purchase a portable health plan that works best for them. Learn more here.

Make sure your doctors and hospitals are “in-network”

A health insurance company’s health network is the team of doctors, hospitals, and other medical providers who have agreed to provide services at a discounted rate for insurance company members.

Some people just want to have doctors close to home and work in case they need them, while others wouldn’t think about switching their healthcare provider. Regardless of which one you are, you can see all the doctors and hospitals in a health plan’s network to make sure it meets your needs.

Go to the health insurance carrier’s provider search, and see which physicians, specialists, and hospitals are in-network.

Don’t take shortcuts. Going uninsured is risky business

Do you think since you haven’t been to the doctor in years and don’t have any prescriptions, it’s smarter to just skip insurance altogether?  Helpful Hint: it’s not smarter.

To give you an idea: One day at a U.S. hospital costs at least $2,000, and that’s before testing or surgery.

You’re leaving yourself open to financial catastrophe. Without health insurance, a car accident or major unexpected illness can turn into bankruptcy in a matter of weeks.

Every day you’ll need to worry about avoiding injury or illness—forget carefree skiing, travel, dance parties, bike rides or commuting with germy passengers. That’s a heavy burden to bear, not to mention the cost of getting treated if you do crash or get sick.

Get a comprehensive ACA-compliant plan, or risk saving a dime to spend a dollar (or a few thousand).

Ready to start shopping? Be sure to check out our shopping checklist and health plans. Have questions? Contact our friendly Friday Care Crew at questions@fridayhealthplans.com