How to buy health insurance for the first time

Your first time buying health insurance on your own can feel overwhelming trying to understand all of the options and how they all work together.  When you’re still new, networks and copays and medically necessary all sounds foreign and it can be frightening trying to make sense of it all.  Having resources you can count on is important.

Use the following information to help guide you on your journey.

Who needs to buy individual health insurance?

Most first time buyers are just turning 26 and no longer counted as dependents on their parent’s plan.  Others are just venturing out and forming a start-up and have never needed anything other than the employer-sponsored insurance before.  Some people just want more insurance and feel the need to buy a secondary policy.

The reasons are many, but the process to finding the right plan is still the same.

Where can you buy health insurance?

You can purchase health insurance through the Marketplace or through private insurance companies.  Both have their benefits and drawbacks, and depending on what you are looking for, one may be better than the other for you.  9 times out of 10 however, the Marketplace is best place to start looking.  You can browse those plans here.

When can you buy health insurance?

Normally you can only buy insurance during Open Enrollment between November 1 and January 15.  This is the time of year you can either buy a plan, or change you plan, for the next year. 

Outside of that, there are Special Enrollment Periods, which you get anytime something big happens in your life.  Examples of these are getting married, moving, losing your other insurance, or having a child.  Any of these SEPs would allow you to potentially change your health insurance pan even if it was not during Open Enrollment.

What should I look for when I choose my first health insurance plan?

Like most things, health insurance comes down to price and budget; how much do you want to spend?  There are things you can do lower your cost, but generally, the more you pay the more you’re going to get.

You also need to figure out what type of insurance plan you want.  If you are young, a catastrophic plan may work well for you.  If you have a family, will they need to be added onto the plan?  Do you have any current prescriptions you are taking?  These are all things that need to be talked about, and a good broker will help guide the conversation to cover this.

What questions you should ask of yourself

This is a great place to start if you want to know what to think about before you actually buy.

The big questions are 

  • Do you have a doctor that you see now and do you want to keep them?
  • If you need care, do you want to be able to pick where you go, or are you ok with the plan you choose deciding that for you?
  • What is your budget?
  • How much money did make last year and are making more or less this year?

With these three questions answered, you can narrow down your monthly premium & cost-sharing, what type of network you should be looking at, and if you qualify for any subsidies, which will help pick a metal tier for your plan.

Review the SBCs and compare to your priorities.

The Summary of Benefits & Coverage has most of the details about the plan.  Comparing multiple at the same time will allow you to get a side by side view and make a more informed decision.

Other Resources

Ready to explore your options?

When you are ready to take the next step, feel free to reach out to us and we can talk.

Aaron
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