How to get affordable health insurance

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Employer-sponsored health insurance is usually how to find the most affordable health insurance with comprehensive benefits, but health insurance marketplace plans may also be an option if you may qualify for tax credits and subsidies to reduce the cost of Affordable Care Act (ACA) plans. 

Health insurance can be exorbitantly expensive, especially if you don’t have group coverage offered through an employer. But it may be possible to find affordable health insurance options if you do your homework.

These options can include a subsidized health insurance marketplace plan, a short-term health insurance plan, a high-deductible health plan, or a Medicaid plan. Take the time to research your choices available in your state and learn more about ways to save money on health insurance.

How to get affordable health insurance

The trick to paying less for health insurance without necessarily sacrificing coverage is to shop around and compare plan types, policies, and prices carefully during open enrollment.

In general, the least expensive health insurance with comprehensive coverage you can choose — assuming you don’t qualify for Medicaid or have group coverage through your employer — is a catastrophic health plan. However, those plans are limited to people age 30 or younger or those who are going through severe financial problems, such as homelessness.

The plans have very high deductibles but lower premiums. Catastrophic health plans are offered through the ACA marketplace and provide comprehensive coverage similar to an ACA plan at low premiums. 

A high-deductible health plan (HDHP) can also be affordable. These plans often boast the lowest premiums and higher deductibles, making them popular choices for younger, healthier plan members who don’t need much health care. 

An HDHP deductible is at least $1,400 for an individual or $2,800 for a family before your insurer starts to pick up the tab. An HDHP’s out-of-pocket in-network costs usually can’t exceed more than $7,050 for an individual and $14,100 for a family. So, you pay less upfront in premiums, but more out-of-pocket when you need care. 

Another lower-cost option is a short-term health plan. These plans have low premiums but high out-of-pocket costs. They also provide limited benefits, so you may not be able to find a plan that covers things like prescription drugs and mental health treatment. Short-term plans last a year in most states, but members can request two extensions to stretch coverage for three years. 

Tips for finding affordable health insurance through an employer

An employer-sponsored health care plan is typically your best option if you want to pay the least for coverage, says John Bartleson, owner of Health Benefits Connect in Englewood, Colorado.

That’s because employers often pay a large portion of your premiums (usually at least 50% of your premium). Members benefit from lower overall costs thanks to more affordable pricing, especially when several employees are involved.

“Employees generally pay the monthly premium through a pre-tax payroll deduction. Employer plan options are usually chosen by the owner of the company or the company’s administrator, not the employee,” says Bartleson.

Consider, as well, that employer-sponsored health insurance is heavily tax-advantaged.

“Employees pay with pre-tax payroll contributions, and the employers often receive large tax write-offs for offering the plans,” notes Marshall Darr, vice president of marketing for Decent in Austin. “Employer-sponsored health insurance will save you a ton of money, but you will have fewer options in terms of plans to choose from, and it’s contingent on you remaining employed with your employer.”

If your employer offers you a plan choice, investigate the total costs and compare plans carefully. You may be able to save money by choosing a health maintenance organization (HMO), point of service (POS), or exclusive program organization (EPO) rather than a preferred provider organization (PPO). HMO, EPO, and POS plans have restricted provider networks and more restrictions than PPOs, but those limits also come with lower costs. 

You can also trim premium costs by opting for a plan with a higher deductible.

Tips for finding affordable health insurance marketplace plan

If you don’t qualify for an employer-sponsored plan, you likely have individual and family coverage options through the health insurance marketplace, also called Obamacare.

“The premiums can be quite low if you qualify for a tax credit payment discount, depending on your tax household’s annual income, although without the payment discount, your premiums may be much more expensive than if you opt for private health insurance elsewhere,” Bartleson explains.

There are four metal tiers in the marketplace based on costs. You can save on premiums if you choose a Bronze or Silver plan versus a Gold or Platinum plan. 

“Platinum policies generally have the highest premiums and lowest out-of-pocket costs for care. Bronze plans have the lowest premiums and highest out-of-pocket expenses for care,” says Brian Martucci, finance editor for Money Crashers in Minneapolis.

Best affordable health insurance companies for 2021

The way to pay less for health insurance is to investigate many different options, including specific insurers offering coverage. Here are some of the top health insurance companies: 

Best for price: Kaiser Permanente

Insure.com’s customer satisfaction survey found that the top-rated health insurance company for 2021 is Kaiser Permanente. 

This insurer topped the best health insurance company list this year with members, especially thanks to price and customer service. Gen Xers ranked it best overall as well as for price, customer service, and website/app. The insurance carrier also tied with Humana for the top health plan overall among Baby Boomers.

Kaiser Permanente boasts over 12 million members and 39 hospitals, and it has more than 700 medical offices. Kaiser Permanente is an integrated health system that incorporates health insurance with providers and facilities under one umbrella, which can make it simpler to navigate the health care system.

Best for short-term health insurance: UnitedHealthcare

UnitedHealthcare is the largest health insurance company in America, offering an extensive provider network and a range of short-term insurance plans. It ranked fifth in the 2021 Insure Best Health Insurance Companies survey. 

The Minnetonka, Minnesota-headquartered insurer garnered its highest marks for claims payments, pricing, and customer service (fourth place in each category) in 2021. UnitedHealthcare was also chosen as the top insurer by Midwest survey respondents.

This carrier offers short-term plans underwritten by Golden Rule Insurance Company. Its plans cover 100% of medical costs after a deductible is met ($2,500, $5,000, $7,500, $10,000, or $12,500; 0% coinsurance), or you can choose options with 20%, 30%, 40%, or 50% coinsurance until you hit the yearly maximums. Max benefits span from $1 million to $2 million (exclusions apply). It also has a large provider network that accepts short-term insurance. 

Best for Medicare Advantage: Humana

This insurer tied for first overall with Baby Boomers in Insure.com’s customer satisfaction survey and was tops in the South. Members praised the company’s pricing in particular. Humana is the second-largest Medicare Advantage insurer in the country, earning an A + rating from the Better Business Bureau. Only UnitedHealthcare has more Medicare Advantage members than Humana. 

Medicare Advantage plans through Humana offer the same benefits as Original Medicare and may include extra perks, including dental, prescription medication coverage, preventive care, wellness resources, and vision services. 

In addition, Humana plans may provide mail-delivery pharmacies, caregiver support, and fitness programs. Members can qualify for affordable and $0 premium plans in some areas.

How much does health insurance cost by state?

The actual cost you pay for health insurance depends on multiple factors. Factors that cause prices to fluctuate, depending on the state, including what providers charge patients in that area, the other plans in your area, the degree of competition among providers and facilities, and health insurance claims in that area. One factor that insurers can’t use is your health. 

Curious about what you can expect to pay for health insurance in your neck of the woods?  Here are the average lowest Bronze plan and average Silver benchmark plan, which is the second lowest cost Silver plan in the marketplace. 

Affordable health insurance — Florida

An ACA marketplace may be a wise choice for individuals and families if you qualify for subsidies and tax credits — and don’t qualify for an employer-sponsored health plan. 

The average annual premiums for the lowest cost Bronze plan in Florida is $4,152 and the benchmark Silver plan is $5,472. That’s without subsidies and tax credits. 

If you qualify for subsidies, you may pay much less in monthly premiums for a Silver plan. The subsidies and tax credits are for people with household income below 400% of the federal poverty level. Also, the federal government is capping health insurance costs for marketplace plans to 8.5% of household income. That can also lead to savings. 

Another way to get comprehensive coverage at a low cost is through a Medicaid plan. Medicaid is a federal/state program for people with low incomes. If you qualify, you pay based on your income. Most states have expanded Medicaid eligibility, but the Sunshine State has not. However, in Florida, Medicaid eligibility is more generous for children and pregnant women than everyone else. 

If you want to pay low premiums and feel you don’t need comprehensive coverage, you can also get a short-term health insurance plan. Short-term plans offer low premiums. That also comes with limited coverage. For instance, mental health, prescription drugs and maternity coverage aren’t usually part of short-term health plans. 

Affordable health insurance — Texas

Medicaid is usually the best way to get comprehensive coverage at the lowest rates. However, most people don’t qualify for Medicaid.

Medicaid is a federal/state health insurance program for low-income Americans. About five million Texans have either Medicaid coverage or a Children’s Health Insurance Program plan. 

Eligibility is based on household income and each state has its own rules. Texas hasn’t expanded Medicaid eligibility, which has happened in most states. That said, children and pregnant women have lower eligibility limits than everyone else in Texas, which makes them more likely eligible for Medicaid. 

Another route is to see if you can get a subsidized marketplace plan. The average annual cost for the cheapest Bronze plan in Texas is $3,672. The average annual cost of a Silver plan is $5,088 in the Lone Star State. That’s without subsidies. 

You may pay much less if you qualify for subsidies. People with household incomes below 400% can be eligible for subsidies and tax credits to reduce the cost of ACA marketplace plans. 

Texas also allows short-term health plans. Short-term plans offer limited coverage at low premiums. You can keep a short-term plan for a year and can request two annual extensions. 

Short-term plans are meant as stopgaps between coverage and not a long-term health insurance solution. 

Affordable health insurance — Missouri

Finding affordable health insurance that’s comprehensive in Missouri often means qualifying for a program like Medicaid or subsidies in the ACA marketplace.

The average lowest-cost Bronze plan costs $4,260 annually in Missouri. The average annual Silver plan premium in Missouri is $5,304 without subsidies. That’s not affordable, but if you qualify for subsidies, you may pay much less. People with household incomes below 400% qualify for subsidies and tax credits. 

Missourians didn’t expand Medicaid eligibility, but pregnant women and children have lower eligibility requirements than others. Children and pregnant women can also get a Children’s Health Insurance Program plan if they’re in a household with income at up to 300% of the federal poverty level. 

The federal/state program offers comprehensive health insurance for low or even no costs. Medicaid offers all the benefits of standard health insurance, though doctors don’t always take Medicaid. 

A third option is short-term health insurance. These plans are meant as a stopgap between coverage. For instance, if you lose an employer-sponsored health plan, you may qualify for COBRA, but those plans are expensive. A short-term plan costs much less, but those plans have limited coverage and high out-of-pocket costs if you need care. 

If you’re healthy, don’t expect to need much care, don’t take prescription drugs, and only need coverage for a short time, a short-term health plan could be for you. 

Affordable health insurance — Michigan

Medicaid is often the best choice for comprehensive coverage at low costs — if you’re eligible. 

Medicaid eligibility is based on your household income. Michigan expanded Medicaid eligibility, which means people up to 138% of the federal poverty level can qualify for the program. Also, children and pregnant women have more generous eligibility requirements. 

Those with Medicaid pay health insurance costs based on income and may even pay nothing for Medicaid. 

Another avenue to affordable health insurance if you qualify is the ACA marketplace. People with household incomes below 400% may qualify for cost-saving subsidies and tax credits. Without those subsidies, the lowest cost Bronze plan costs on average $3,012 annually and the average Silver plan costs $4,080 annually in Michigan.

But with subsidies and tax credits, you may pay much less for a comprehensive ACA marketplace plan. 

Affordable health insurance — Arizona

The cheapest Bronze plan in Arizona costs an average of $3,768 annually and the ACA marketplace Silver plans cost an average of $4,680 in Arizona. That’s much more than you would pay if you have an employer-sponsored health plan. However, if you qualify for subsidies and tax credits, you can pay much less. 

You can find out if you qualify for subsidies by going to the marketplace website and entering your information, including household income and family size. ACA plans offer comprehensive coverage, including prescription drugs, maternity care, and outpatient care, but the plans can be pricey if you don’t qualify for subsidies. 

Another way to get comprehensive health insurance is through Medicaid. The federal/state program is for low-income Americans. More than two million people in Arizona have Medicaid. The state expanded Medicaid eligibility to make it easier for people to get coverage and children (between 133% and 147% of the federal poverty level depending on age) and pregnant women (up to 150% of the federal poverty level) also have lower eligibility requirements. Children in households up to 200% of the federal poverty level also qualify for a Children’s Health Insurance Program plan. 

Medicaid offers the same level of benefits you would find in a standard health insurance plan, but costs are based on household income. So, you may pay little to nothing for Medicaid coverage. 

A third way to get health coverage is short-term health insurance. However, unlike the marketplace and Medicaid, short-term plans offer limited coverage. Those plans don’t usually cover prescription drugs or mental health care. Plus, you may pay high out-of-pocket costs if you need care. 

Affordable health insurance — California

California has the most generous subsidies for people with ACA marketplace plans. The state allows people with income up to 600% of the federal poverty level to save on marketplace plans. That percentage is higher than other states. 

The cheapest Bronze plan in California costs an average of $3,924 and the average cost of a Silver marketplace plan is $5,004 in California, but the subsidies and tax credits can reduce that amount significantly. 

Another way the state helps with health insurance is through Medi-Cal, the state’s Medicaid program. Medicaid is a federal/state program that offers health insurance to low-income people. 

California expanded Medicaid eligibility so more people can get a plan. Nearly 13 million Californians have a Medicaid plan. In California, pregnant women (up to 208% of the federal poverty level) and children (up to 261% of the federal poverty level) also have lower eligibility requirements. 

Medi-Cal offers comprehensive benefits at low or no costs, but again, you have to qualify. 

Another way you might find affordable health insurance is through your employer. Employer-sponsored health insurance is usually more affordable than unsubsidized marketplace plans. You might not get as many health insurance plan options through an employer, but companies help pay premiums, which significantly decreases the health insurance costs for employees. 

Affordable health insurance — Georgia

Low-income Georgians may qualify for Medicaid, which is the federal/state health insurance program that offers great benefits at low or no costs. 

Unlike most states, Georgia hasn’t expanded Medicaid eligibility, so it’s harder to get a Medicaid plan in the state. About two million Georgians have a Medicaid plan. Georgia allows pregnant women (up to 220% of the federal poverty level) and children (between 133% and 205% of the federal poverty level) to get Medicaid coverage at lower eligibility levels than others. Children are also eligible for a Children’s Health Insurance Plan if they live in a household with an income up to 247% of the federal poverty level. 

You may also get an ACA marketplace plan. The lowest cost Bronze plan costs an average of $3,648 in Georgia and the average annual cost of a Silver plan in Georgia is $4,728, but that amount can come down with subsidies and tax credits. Georgians with household income below 400% of the federal poverty level can qualify for tax credits and subsidies. 

To find out if you qualify, go to the marketplace website and enter your information, including household income and size. You can find out how much you would pay for health plans offered in your area.

Another option is short-term health insurance. Unlike Medicaid and marketplace plans, short-term health insurance provides limited coverage and has high out-of-pocket costs when you need care. However, if you’re looking for a cheap plan to fill a coverage gap until you get standard health insurance, you may benefit from a short-term health plan. 

Affordable health insurance — Ohio

Medicaid or subsidized marketplace plans are the best way to get affordable health insurance that offers all the coverage found in standard health insurance.

You need to qualify for Medicaid or to get a marketplace plan with subsidies and tax credits to get that coverage. Ohio expanded Medicaid eligibility to people up to 138% of the federal poverty level. The state also makes it easier for children and pregnant women to get Medicaid. Children have to live in households that have up to 206% of the federal poverty level; pregnant women must be in a household with income up to 200% of the federal poverty level. 

Medicaid plan costs are based on household income. You may pay little or nothing for Medicaid coverage if you qualify. 

Marketplace plan subsidies and tax credits are for people whose household income is below 400% of the federal poverty level. Those tax credits and subsidies can mean health costs much lower than the average annual lowest cost Bronze plan ($3,684) and annual Silver plan premium in the Buckeye State of $4,500. 

If you’re looking for coverage but don’t need as much as found in standard health insurance, a short-term health plan could be a good decision. Short-term plans cost less than standard health insurance but also don’t offer the protections found in those plans. 

Affordable health insurance — Alabama

Medicaid is usually the best option for comprehensive coverage at low costs. If you qualify, you may pay little to nothing for Medicaid.

A little more than one million Alabamans have Medicaid. The state didn’t expand eligibility for Medicaid but allows children and pregnant women to get coverage if they live in a household with an income of up to 141% of the federal poverty level. Children may also qualify for a Children’s Health Insurance Program (CHIP) plan if they live in a household with income up to 312% of the federal poverty level. 

If you don’t qualify for Medicaid, another option is an ACA marketplace plan. Marketplace plans in Alabama are expensive, with the average cheapest Bronze plan costing $5,016 annually and the average Silver marketplace plan costing an average of $7,164 annually. However, if you qualify for subsidies and tax credits, you may pay much less. 

People whose household income is below 400% are eligible for those cost savings. You can find how much you’d save by going to the marketplace website and entering in your household size and income. The site will then estimate your health insurance costs. 

Another low-cost option is short-term health insurance. Unlike a marketplace plan or Medicaid, short-term health insurance doesn’t offer much coverage. These health insurance plans are meant to help people bridge coverage gaps in health insurance, such as after losing coverage from a job. Short-term plans have low premiums, but you’ll pay more out-of-pocket than a standard health plan if you need care. Also, coverage that’s standard in regular health insurance, such as prescription drugs and mental health, aren’t usually covered by short-term insurance. 

Erik Martin

Contributing Researcher

 

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Erik J. Martin is a Chicago area-based freelance writer whose articles have been published by AARP The Magazine, The Motley Fool, The Costco Connection, USAA, US Chamber of Commerce, Bankrate, The Chicago Tribune, and other publications. He often writes on topics related to insurance, real estate, personal finance, business, technology, health care, and entertainment. Erik also hosts a podcast and publishes several blogs, including Martinspiration.com and Cineversegroup.com.

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