Low-Cost Health Insurance

Health insurance isn't known for being overly cheap, but that doesn't mean it's impossible to find affordable plans that will properly cover you and your loved ones. Here are a number of options to consider.

piggy bank on money and stethoscope

So you want cheap health insurance? Or at least you want a health plan that doesn't charge you an arm and a leg whenever you see a doctor, fill a prescription, or receive treatment for an illness or injury?

Well, you're in luck. There are tons of low-cost health insurance options on the market these days.

Heads up: you probably won't be able to make use of all of them. Some are only for Americans who have specific financial or medical needs. Others are limited to those in certain age ranges or employment situations.

Still, you should be able to take advantage of at least one of the types of health plans that are detailed below.

Employer-Sponsored Health Plan

What it is

As the name hopefully suggests, employers provide this kind of health insurance plan to their employees. You may have seen or heard it referred to as "job-based" health insurance, too.

Whatever you call it, it's likely going to be one of your best bets as far as low-cost or cheap health plans are concerned.

It's not always affordable, though, especially these days. That's because more and more employers only offer high-deductible health plans to the people who work for them. Also playing a role here: it's becoming increasingly common for companies and organization to not pay all or even some of their employees' health insurance premiums.

If you have access to a good job-based health plan with reasonable premiums, deductibles, think twice before passing on it. If your goal is to obtain health insurance that'll save you money or keep your expenses in check, this is one of your best options. In such circumstances, you're unlikely to find anything cheaper by heading to the government-run marketplace or by approaching an insurance company directly.

What makes it a low-cost health insurance option

As mentioned above, it isn't unusual for employers to pay for some or all of their employees' health insurance premiums. That alone can save you a lot of money.

How much? It's impossible to give an exact amount due to how differently companies tackle this situation and due to the wide variety of job-based plans and coverage options.

It is possible to give you a general idea, however. According to a recent Kaiser Family Foundation survey of employer health benefits, the average annual premiums for job-based health plans in 2017 were $6,690 for single coverage and $18,764 for family coverage. That same survey also found that Americans with employer-sponsored plans paid an average of $1,213 toward single-coverage premiums and $5,714 toward family-coverage premiums last year.

And that's only one factor that can impact what you pay for health insurance. If your job-based plan comes with low deductibles, copayments, or co-insurance charges, you may pay even less. 

Who should buy it

Anyone employed by a company or organization that offers good, affordable health insurance to its employees.

Who shouldn't buy it

The only reason you should drag your feet on enrolling in job-based coverage is if it seems like it'll be overly expensive. You've got to be careful in these situations. If you have access to health insurance via an employer, you probably won’t qualify for a premium tax credit or other savings should you change to, say, a marketplace plan instead.

"Bronze" ACA Marketplace Plan

What it is

Well, look at what we have here--one of the just-mentioned marketplace plans. These, of course, are the policies you can buy through the government-run health insurance marketplace, or exchange, established by the Affordable Care Act (also known as the ACA or Obamacare).

Something you may not know about these plans if you've never enrolled in one: they're divided into four different "metal" categories on the so-called marketplace. Specifically, they're divided into bronze, silver, gold, and platinum offerings. They all offer the same "quality of care," but they differ in terms of how you and the plan you choose split the costs of that care. For example, platinum marketplace plans pay about 90 percent of your medical costs (you pay the remaining 10 percent), while bronze plans pay around 60 percent (you pay 40 percent).

Keep in mind: the figures above don't take into account the monthly premiums associated with these plans. That's a big deal, as if you go with a bronze marketplace plan, your monthly premium will be pretty low. If you go with a platinum plan, it'll be fairly high.

What makes it a low-cost health insurance option

Thanks to the low monthly premiums tied to them, bronze-level marketplace plans can be surprisingly affordable if you're healthy and rarely need to see a physician.  

Who should buy it

Young people. Also, people of any age who have few health problems and who only visit their physicians for annual physicals or the odd illness or injury.

Who shouldn't buy it

Are you and your doctor best friends? Or are you in her office so often that you might as well be best friends? If you can answer either of those questions with a "yes," you should stay away from bronze marketplace plans, as they'll make you pay through the nose for all of that medical care and attention.

"Silver" ACA Marketplace Plan

What it is

Silver marketplace plans are the next step up from the bronze plans explained earlier. What does that mean? For starters, it means they pay around 70 percent of your healthcare costs (rather than 60 percent, like bronze plans), while you pay about 30 percent of them.

Also, if you enroll in a silver instead of a bronze marketplace plan, you'll pay a slightly higher monthly premium than you would if you went with the lower-level offering.

What makes it a low-cost health insurance option

You're probably wondering how a silver marketplace plan can be a more affordable or cost-effective health insurance option than a bronze plan. One reason is the deductibles associated with silver plans usually are lower than those associated with bronze plans. Another reason, though, is that you're only able to take advantage of the marketplace's cost-sharing reductions if you enroll in a silver-level plan. Those cost-saving reductions can cut your deductibles, copays, co-insurance charges, and out-of-pocket maximums--to the point that you may end up paying less for a silver plan than you would have paid for a bronze plan.

Who should buy it

People whose annual income qualifies them for the cost-sharing reductions detailed above.

Who shouldn't buy it

Those who don't qualify for a cost-sharing reduction. Without it, you'll likely find a bronze plan to be a better value.

Off-Marketplace or Private Health Plan

What it is

You buy these health policies directly from insurance companies, as opposed to from the government-run marketplace. Some of them meet the ACA's requirements and count as "qualifying health coverage." (This means you can enroll in one and not pay a penalty for being uninsured or underinsured that year. Granted, 2018 is the last year the federal government will penalize Americans in such a way.) Others, like the short-term health plans you'll read about in a minute, do not.

We'll focus on the off-marketplace plans that do meet the ACA's requirements here and focus on short-term plans in the next section.

What makes it a low-cost health insurance option

Like job-based or employer-sponsored health plans, off-marketplace or private ones are all over the map when it comes to what they cover and how much they cost. That makes it tough to specify how much you'll pay for one.

Still, there are times when plans bought directly from an insurer cost less than plans bought from the ACA marketplace, so they're worth considering if you're looking for affordable health insurance.

Who should buy it

Do you make too much to qualify for the premium tax credits or other savings that can take some of the sting out of marketplace health insurance? Checking out off-marketplace policies could be well worth your time and energy.

As always, though, do your homework. Dig into the details of any plans that seem especially appealing. Don't just look at their monthly premiums; look at their deductibles, copayments, co-insurance charges, and out-of-pocket maximums, too. All of those components have to add up if you want to succeed at acquiring low-cost health insurance.

Who shouldn't buy it

Most people who qualify for the premium tax credits or other savings via the government-run health insurance marketplace probably shouldn't buy a private plan instead. In general, a silver marketplace policy plus a premium tax credit or cost-sharing reduction will be cheaper than a comparable off-marketplace policy.

That isn't true in every single situation, though, so make sure you cover all your bases while you shop for health insurance--especially if your goal is to get an affordable plan.

Short-Term Health Plan

What it is

Short-term health insurance plans do just what their name implies: they cover people for a short period of time. (This is why some folks prefer to call them temporary or term health plans.)

For now, the law only allows short-term health insurance plans to cover Americans for three months at a time. If a rule proposed by the Trump administration is finalized, though, they'll be able to provide coverage for up to 12 months. (For more information on this type of policy, read our article, "Short-Term Health Insurance.")

What makes it a low-cost health insurance option

The biggest feather in the cap of short-term or temporary health plans is that they usually cost less than Obamacare or marketplace plans. Specifically, it isn't unusual for their monthly premiums to be quite a bit more affordable than the cheapest ACA-compliant "bronze" plan in an area. (To learn more about the different "metal" categories of marketplace policies, see this article: "Which Type of Obamacare Plan is Right for You?")

For example, Consumer Reports recently reported that "the cheapest unsubsidized ACA plan available to a 55-year-old man living in Indianapolis costs $563 a month. He can buy a short-term plan through that company for $103 a month."

Of course, there are reasons why short-term health plans tend to cost less than marketplace plans. One is that many either don't cover, or charge extra for, things like prescription drugs, maternity care, mental health care, or substance abuse care. Another is that the law doesn't limit how much the insurance companies who sell them can charge for deductibles, copayments, or co-insurance. As a result, those amounts can be much higher than are typical for job-based or marketplace plans.

Who should buy it

People who are young and healthy are the most likely to be able to find short-term health insurance plans that are cheap all around (meaning they don't just come with low-cost premiums, but low-cost deductibles, copays and co-insurance, too). The same may be true if you're somewhat older but still relatively healthy. If you fit into either of those categories, these policies could hit your affordability sweet spot.

Another group of Americans that should at least consider short-term plans: those who mostly care about the price of their health insurance premiums. If you rarely go to the doctor or need medical care, the low monthly payments tied to these policies could help you save a lot of money.

Who shouldn't buy it

Short-term plans probably won't be your best health insurance option if:

  • you're older
  • you have a lot of health issues
  • you rely on insurance coverage for things like prescription drugs, maternity care, mental health care, or substance abuse care

The same is true if you approach an insurer about one of these policies and you have any pre-existing conditions. Unlike all marketplace and most private health plans, short-term plans don't have to cover such illnesses or diseases. If they do, you can rest assured they'll charge you a pretty penny for it.

Coverage for Specific Situations or Illnesses

What it is

Another good way to save money on health insurance, or to find low-cost health plans, is to forget about comprehensive coverage and instead focus on policies that cover specific ailments, diseases, or healthcare situations.

A few examples: accident-only plans, hospital-only plans, and plans that cover the diagnosis and treatment of a specifically named disease, like cancer. (Thinking of enrolling in that last one? Check out our article on the subject first: "11 Things to Consider Before You Buy Cancer Insurance.")

What makes it a low-cost health insurance option

Because these plans limit their coverage in various ways, the insurance companies behind them can and do sell them for less money than their more robust health policies. Granted, if you choose, say, a hospital-only or cancer insurance policy over a more full-featured one, you may be left in an uncomfortable position--or worse--should you need health care that's outside the bounds of that plan.

Who should buy it

Once again, these plans are best bought by people who are young, healthy, or both. Why? Young, healthy people don't need much, if any, medical care. So they don't have to worry about the out-of-pocket costs they'd pay if enrolled in this kind of coverage and had to go to the doctor for something a bit more typical.

Who shouldn't buy it

The money you'll likely save on monthly premiums won't mean much if you find yourself in a situation that requires a lot of medical care and isn't covered by your plan. In other words, you might be healthy now, but there's no guarantee you'll be healthy next month or next year. If you have any fears that you may be injured or become sick and need medical assistance for it, risking your financial well-being on one of these limited-coverage policies may not be the best idea.

Catastrophic Plan

What it is

Catastrophic health insurance plans exist so people can protect themselves from worst-case scenarios, such as getting seriously sick or injured. That's about all they protect the people who buy them from, however; they require policyholders to pay for most routine medical expenses out of their own pockets.

One exception is that catastrophic plans cover certain preventive services at no cost. (Learn more about this in our article about health insurance and preventive care coverage.) Another is that they cover up to three trips to a primary care physician per year--whether or not you've reached your deductible.

What makes it a low-cost health insurance option

In almost all cases, if you buy a catastrophic plan, you'll only have to pay a low monthly premium to maintain its coverage.

On the other hand, you'll also pay for most doctor visits or other medical treatments or services out of your own pocket thanks to the sky-high deductibles often attached to these plans.

In fact, the deductible for all 2017 catastrophic plans was $7,150, according to healthcare.gov. Sure, the plan pays for all covered services--you don't even need to worry about copays or co-insurance charges--after you reach that amount, but your goal is to get low-cost health insurance, right?

Who should buy it

Sorry to sound like a broken record here, but young and healthy Americans who don't need much health care are, or should be, the primary market for these kinds of policies.

Actually, you need to be fairly young to enroll in a catastrophic plan. Only people who are under the age of 30--or who qualify for an affordability or hardship exemption--can buy them at this time.

Who shouldn't buy it

You may want to think twice about buying a catastrophic health plan if you qualify for premium tax credit (that can be used on the Obamacare marketplace) based on your income. Not only can't you take advantage of those savings if you purchase a catastrophic plan instead, but they usually make either a bronze or silver

marketplace plan a more affordable option anyway.

You'll find a lot more information on these policies in this article of ours: "Cadillac vs. Catastrophic Health Insurance Plans."

Medicaid

What it is

Medicaid is a federal- and state-funded program that provides medical coverage to Americans in need. 

The main groups Medicaid currently helps in this way:

  • Children
  • Pregnant women
  • People with disabilities
  • Seniors
  • Low-income families

Some of the benefits Medicaid provides to these people:

  • Physician services
  • Laboratory and X-ray services
  • Inpatient and outpatient hospital services
  • Family planning services
  • Nurse midwife services
  • Home health services

For more information, see our article about Medicare vs. Medicaid.

What makes it a low-cost health insurance option

If you qualify for Medicaid, most of the medical care you receive will be free. You may be responsible for some small costs here and there, but you'll rarely, if ever, have to pay for covered services, treatments, or procedures.

Who should buy it

Actually, you don't buy Medicaid coverage like you do other kinds of health insurance. You apply for it, and if you qualify--usually based on your income, but not always--you're enrolled basically free of charge.

Given that, if you're struggling financially, or if you have a disability, you should contact your state Medicaid agency. Or you go to healthcare.gov. Enter your state and the size of your household into this tool and it'll tell you if your income qualifies you for Medicaid assistance.

Who shouldn't buy it

If you don't qualify for Medicaid coverage, you won't be able to buy it even if you want it. In such cases, check out the ACA or Obamacare marketplace. Depending on your income, you may find a bronze or even silver plan to be surprisingly affordable.

Frequently Asked Questions

Q: What determines how much I pay for health insurance? Or what goes into how much I pay for health insurance?

A: Insurance companies look at a number of factors when calculating what to charge a particular policyholder. Here are some of the most common:

  • your age
  • your height and weight
  • whether you do or don't use tobacco products
  • your profession
  • your marital status
  • your zip code (where you live)

To learn more about this process, check out our article about health insurance rate factors.

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