How to shop for health care when you're in tip top shape

Health insurance 101

The federal penalty for not having health insurance was eliminated at the end of 2018, so many within the young and health population are wondering “what is the point of buying health insurance?” It’s a valid question, considering that health insurance requires a monthly premium that many would rather spend on other things. That said, not carrying health insurance can actually be costlier than the total cost of monthly premiums over the span of a year. We look at a few reasons why purchasing is worth it — even for the young and healthy — and how to shop for a health plan that makes sense for you.


Accidents happen

On the surface, it’s easy to assume that skipping on health insurance is a way to save money if you’re young and healthy. The problem with that logic is that stuff happens. Whether it’s an unexpected illness or a broken leg from snowboarding, unforeseen health events can add up fast if you don’t have health insurance. The average cost of a 3-day hospital stay runs about $30,000 and even fixing a broken leg can rack up $7,500 in medical expenses. Not carrying health insurance means you are not shielded at all from these expenses, leading to extraordinary debt in some cases.

Health plan shopping tip: At a very minimum, carry catastrophic coverage. You must be under 30 years old to qualify (or get a “hardship exemption”), so it’s an ideal minimum coverage option for the young and healthy. The premiums are the lowest among all health care plans, while the out-of-pocket costs, copayments, and coinsurance are higher. These plans cover 3 primary care visits each year and offer a cap to what you will spend for the year on health care if something does happen.

Today’s health does not guarantee tomorrow’s health

While you may be young and healthy now, the best way to ensure you stay healthy is to take advantage of the many preventive services offered with health insurance. Most plans are required to cover certain preventive services (via an in-network provider) under the Affordable Care Act (ACA), including routine physicals, immunizations, and screening tests. Taking advantage of these services can help you catch any health issues or conditions before they become serious, so you can maintain your health as you get older.

Health plan shopping tip: Even the cheapest health plans (think: bronze plans) cover preventive care, so take advantage of these services. Map out your budget for health insurance and consider if a bronze plan may provide adequate coverage for you. Bronze plans often provide a good balance between reasonable monthly premiums and covered health care services. Hint: Decent’s Pathfinder Bronze plan offers free primary care, so you can see your primary care physician as many times as you’d like each year — at no cost to you. It’s a higher deductible plan that can result in lower expenses overall. Preventative care screenings and procedures are also free, so you can preserve your health over time.

Affordable healthcare for all. But how? copy

You might qualify for subsidies

If your annual income is below certain levels, you may qualify for health coverage at a reduced cost. If you live in a state with expanded Medicaid coverage and your household income falls below 138% of the federal poverty level (FPL), or if your income falls between 100% and 400% of the FPL, you may qualify for subsidized coverage or premium tax credits. In general, those with annual incomes of under $50,000 could be eligible for subsidies.

Health plan shopping tip: Do your homework and see if you qualify for a subsidy, which can significantly lower your health plan costs. Hint: If you don’t qualify for a subsidy, you may want to consider Decent’s Trailblazer silver plan, which is a very affordable health plan. Just like our Pathfinder plan, the Trailblazer offers free primary care, so you can see your primary care physician as many times as you’d like each year — at no cost to you. Our silver plan also offers low copays for specialist visits, generic and preferred brand drugs, labs, emergency room visits, and urgent care.

Being in good health is something to be happy about — but it’s also not a great reason to skip on health care coverage. Everyone gets older, and unexpected health issues or accidents can jump out of nowhere. Purchasing a reasonable health plan can ensure that you are covered if something happens and that you can take advantage of preventive services to keep your good health streak running.

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