New job? Now it’s time to pick your health insurance.
Your first day of work may feel a little like your first day of school. There's a lot to learn – from where to find the coffee machine to all your new coworkers’ names. One of your most important tasks might be picking a new health plan.
Sometimes that choice may feel straightforward. For example, if your job offers one option or no coverage at all, that might be a simple answer. But if your employer offers 3 options, it may be harder. Or what if they offer a plan that covers you but not the whole family? Figuring out what to do gets a little trickier – you may need to weigh your options and crunch the numbers around costs.
It’s a good idea to have some type of health insurance plan so you don’t get stuck with a big bill. One in 10 American adults have medical-expense debt.1 Choosing the right plan can help you be prepared for whatever health expenses might come your way.
Luckily, there’s a way to streamline the decision-making process. Here’s how to weigh your options and end up with the plan that best meets your needs.
Employer-based health insurance
About 3 in 4 American workers can get health insurance through their jobs.2 If your employer offers it, you may want to look there first. “Employer plans will usually, but not always, have stronger and richer networks, so you’ll want to start there,” says Evan Tunis, an insurance broker with Florida Healthcare Insurance in Coral Springs, Florida.
These plans tend to cost less because your employer pays part of the premium. The part of the premium you pay comes out of your paycheck, typically before taxes. You often get the most benefits for your money with these plans.
Which plan you choose depends on how much money you’re willing to spend up front, notes Red Taylor, an insurance broker with Red Taylor Insurance in Atlanta. There are high-deductible plans with lower monthly premiums. Or plans that cost more per month, but may be a better value depending on your medical needs.
You’ll also need to consider whether to add family members. You’ll probably discover that your spouse and children cost more than just you. And some employers subsidize your coverage, but not the rest of your family.
Insurance through ACA Marketplace plans
If your employer doesn’t offer health care coverage (or you don’t want the coverage they’re offering), you can look into Affordable Care Act (ACA) plans. ACA plans must cover essential health benefits, like preventive care, hospitalization and prescription medications.
With ACA plans, there are 4 levels of plans: bronze, silver, gold and platinum. Bronze has the lowest monthly premiums and typically has the highest deductibles. As you step up toward platinum, your premiums increase, but the copays and deductibles decrease.
Another option is to keep your work insurance for you and put your family on an ACA plan. Taylor recommends this to many clients. “It achieves two important goals,” he says. “Everyone in the family has benefits and protection, and you save money.”
Short term insurance plans
Think of short term plans as gap plans. You might consider a short term plan if you’re between jobs or you’ve missed open enrollment for an ACA plan. (For federal-based marketplace coverage, open enrollment is November 1 to January 15, though some states may have different dates.) These plans might be a good idea if the insurance from your new job hasn’t kicked in yet.
Depending on where you live, with a short term plan, you can be covered for up to 3 years. “The nice thing about the short term plans is they’re month to month,” Tunis says. “So you can cancel at any time.”
Short term plans focus more on major medical expenses, such as hospital bills, as opposed to routine care. They also usually exclude preexisting conditions. So they may not be the best solution if you need treatment for any type of chronic condition or serious illness.
Weighing your insurance plan options
Whether you choose an employer plan or an ACA plan depends a lot on what your costs will be. Keep these things in mind as you read over the fine print, says Tunis:
- Do your regular doctors accept this plan? If you like your primary provider, but they don’t accept this insurance, you’ll have to switch doctors or go out of network, which can get expensive. Go to the insurance company’s website to find out which providers are in the plan’s network.
- Are your prescription medications covered? If you’re not taking any medications or only take 1 or 2 generic medications, this may not matter to you. But it could be important if you take multiple medications or have been diagnosed with a new condition that requires brand-name medication.
- Are the local hospitals in network? Go on the insurer’s website to see which hospitals take this insurance. Make sure you feel good about going to those hospitals in case of an emergency.
- Do you travel a lot for work or family reasons? Check on each plan's coverage for out-of-state care before you make your choice.
It might seem like a lot to figure out, but luckily, there are ways to get help. If you need help choosing a plan, talk with the HR department at your job. Or reach out to a health insurance broker. They can help you pick a plan – and their services are often free.
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