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Not all health insurance is created equal, and frankly, that’s something we’re proud of at Friday Health Plans. We love when people choose a plan that delivers on the benefits they value most.
Below we’ve outlined a quick shopping guide for retirees and self-employed adults under the age of 65 looking to purchase a health plan on their own. Enjoy and let Friday Health Plans know if you have any questions! We’re here to help.
Find the right-sized plan for you and your family
A smart way to approach saving on health insurance isn’t always by just 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.
Consider what healthcare services and drugs you are 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.
Expecting to give your insurance card a workout? Consider a Silver or Gold plan
Friday’s Silver and Gold health plans offer the lowest deductibles and may be worth the higher premium for anyone who has their eye on maximizing benefits and services after hitting their deductible. If you plan to hit your deductible in the next year, all services (except for the ER) are covered at 80% by Friday, and you pay 20%, until you hit your out of pocket maximum. Once that maximum is reached, all other services are $0 to you. You'll also appreciate the unlimited free in-network primary care, virtual doctor visits and in-network mental health visits, plus affordable drugs.
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 limit 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 hefty 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 refers to health plans that offer benefits for a broad-range of healthcare services that meet the requirements established by the Affordable Care Act. To shop ACA plans, visit the Exchange.
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.
Take advantage of those free ACA preventive adult healthcare screenings
With every ACA health plan, you’ll have access to a wide range of free preventive drugs and vaccines to stay healthy year-round, in addition to free generic drugs on certain plans, offered by your health insurance carrier’s formulary. Here’s Friday’s list of drugs, for example.
ACA plans cover dozens of preventive screenings and services at $0 for adults. This includes crucial $0 screenings such as: Blood pressure screenings, cholesterol screenings, colorectal cancer screenings, obesity counseling, and dozens of vaccines to prevent everything from the flu to Hepatitis A and B. You can see the full list here.
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 health insurance in the area.
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. Certain circumstances, such as job loss and other qualifying life events, 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 looking for a new health insurance plan after leaving their job; it is not a long-term healthcare services solution for freelancers. It is often much more expensive than buying an individual ACA plan, and leaving a job opens a special enrollment period of 60 days when you can buy new insurance.
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 choosing 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. Explore the Friday health network to see which physicians, specialists, and hospitals are in-network for you.