At the time this post was written, open enrollment for 2022 was in full swing. People with existing health insurance plans were considering changes for the coming year while those new to the health insurance game were trying to figure it all out. Meanwhile, millions of others were looking at open enrollment through federal exchanges. Needless to say, the last two months of the year are a busy time for health insurance carriers.
America is somewhat unique in that our healthcare system is largely privatized. We do not have a single-payer healthcare system like other countries do. Rather, we rely heavily on health insurance to pay medical bills. But there isn’t just one type of health insurance. There are many.
Americans basically have access to five health insurance options:
1. Employer-Sponsored Plans
The majority of American workers with health insurance obtain that insurance through their employers. Employer-sponsored plans are operated by the largest carriers and administered by insurance brokers. According to Dallas-based BenefitMall, those brokers may work independently or through general agencies. They rely on industry data, technology, and their own experience to lead clients to the right health insurance options.
A typical employer-sponsored plan splits the costs between employer and employee. The employee’s portion is covered through withholding, meaning a certain amount is withheld from each paycheck and combined with the employer’s contribution to pay monthly premiums.
2. Individual Health Insurance
Workers unable to obtain health insurance through their employers can buy plans on the individual market. The self-employed utilize the individual market as well. Individuals can go directly to health insurance companies or, if eligible, the federal exchanges established by the Affordable Care Act (ACA). A self-employed person who belongs to the local Chamber of Commerce or another small business association may be able to obtain insurance through that organization.
3. Medicare and Medicaid
The federal government’s two health insurance plans are known as Medicare and Medicaid. Medicare is designed for retirees and those with certain disabilities. Medicaid is a health insurance plan for people who cannot afford to purchase health insurance on their own. Both plans have eligibility requirements.
It should be noted that seniors must obtain health insurance through Medicare once they reach qualifying age, which currently stands at 65. At that age, they are no longer eligible for traditional health insurance through the individual market. They may still be eligible for employer-sponsored plans should they still be working.
4. Health Share Programs
While technically not health insurance, millions of people in the U.S. participate in health share programs. These are programs where all participants pitch in to pay one another’s medical bills. Some base their services on annual premiums while others ask for donations on a case-by-case basis. A health share program may be considered risky by some people, but others think it is the best way to go.
5. Doing Without
The fifth and final option for health insurance is to simply do without. Tens of millions of people choose to go this route every year. Some do without insurance because they cannot afford monthly premiums and don’t want to be enrolled in a government program. Others would rather save the money and just pay for their healthcare services out-of-pocket. The nice thing is that Americans have the freedom to make the choice for themselves.
So, what is your situation? In all likelihood, you get your health insurance through your employer. But if not, one of the other four options is open to you. How you handle health insurance and paying for healthcare services is entirely up to you.