As a member of the Highmark social media team, I’ll admit that I have more knowledge about health care than most people my age (23, if you’re wondering). But it wasn’t long ago that I knew next to nothing about health insurance. It was easy to stay in the dark because I was on my parents’ health insurance plan and didn’t have to worry about it.
Then I graduated college. I moved to Pittsburgh, got a job, and my parents started asking about my company’s benefits plan. I took the hint; it was time to make my own health insurance choices.
For me, it was a pretty easy decision; I work for a health insurance company that offers affordable coverage. But it got me thinking a lot about my friends whose part-time jobs, full-time educational pursuits, and job hunts don’t make their health insurance choices so cut-and-dry, even though we’re all around the same age.
Having grown into a bit of a health care nerd, I started asking them what they were doing about their health insurance and if there was anything they didn’t quite “get” (yes, in casual conversations … don’t judge me). And despite the general awkwardness of segueing a conversation about football into one about health insurance, it turned out a lot of my friends had questions.
So, if you’re like them, and you’re not quite sure what to do — or even what you can do — about your health insurance, here’s the good news: You’ve got options (here they are, in no particular order).
Under the Affordable Care Act, young adults can choose to stay on their parents’ health insurance plan until they turn 26 — no ifs, ands or buts. That means you can stay on your parents’ plan whether or not you:
For some, this is ideal, as plans that cover families may be less expensive per person than individual plans. Others, in their quest for independence, choose to purchase their own insurance before they turn 26 (I’m guilty of that).
If you do stay on your parents’ plan, you might want to help them out and take on the financial responsibility of paying for your own health insurance. You can work out a system with them to pay your portion of the monthly premium, and your share of co-pays and costs toward your family’s deductible.
If you’re attending a college or university, you may be able to enroll in that school’s student health plan. These plans tend to be relatively inexpensive, and are a good option if your parents don’t have health insurance, or if you don’t want to stay enrolled under their plan.
Find out if your school offers health insurance options by poking around its website or calling the financial aid office.
You don’t have to wait until you’re 26 to enroll in one of the health insurance plans offered by your employer. Depending on where you live and what you can afford, the coverage your employer offers may suit your situation better than your parents’ insurance plan.
If your employer does offer coverage, it’s a good idea to at least look at what they offer and compare it with your current plan. For what it’s worth, though you may have to pay a little more monthly than you have before, it feels really good to be paying for your own health care coverage. I know, it sounds crazy, but it’s true. Plus, you’ll be saving your parents some money — an angle you can easily cash in for brownie points.
If your employer or school doesn’t offer insurance, the Healthcare Marketplace is the second-easiest way to shop for an individual health insurance plan online. Simply visit www.healthcare.gov to see your options and sign up for a plan. Don’t forget to see if you’re eligible for financial help to pay for coverage.
Whether you sign up during open enrollment, which ends Feb. 15 this year, or are eligible to buy or switch plans later in 2015 during a special enrollment period, you’ll be able to compare plans offered in your area and select one that fits your needs. Certain life events, like turning 26, getting married, or having a child, can qualify you for special enrollment.
I called the Marketplace the second-best place to prepare to shop for health insurance online because I’m partial to www.DiscoverHighmark.com. Sure, as a member of Highmark’s social media team, I may be biased. But the DiscoverHighmark website was designed to streamline the process of signing up for health insurance, let you know if you could be eligible to receive financial aid from the government for your plan, and provide tons of easy-to-read background information on health care and insurance. It makes the process of choosing and signing up for your own insurance easier, and — with its live-chat option — also a lot less lonely.
In either case, when you’re choosing your own plan, be sure to consider all of your options. A low monthly premium may look appealing, but it may mean you’re agreeing to pay a higher share of any health care costs that arise during the year. Always think about your total health care costs rather than just the premium. If you anticipate needing a lot of medical care, or wouldn’t be able to cover a higher deductible if you had an unexpected medical issue, choosing an option with a higher level of coverage may be smarter, and less costly.
Depending on your annual income and other criteria, you could be eligible for Medicaid coverage through your state’s Medicaid program.
Medicaid is the state and federal program that helps to cover medical costs for Americans living with limited income or resources.
As someone under 30, you could be eligible to sign up for a “catastrophic health insurance plan.” Catastrophic plans are designed to protect you in worst-case-scenario medical situations. With a plan like this, you’ll be paying for all medical care you may need up to a maximum amount (your “deductible”).
Though catastrophic plans can have lower-cost monthly premiums than other plans, their deductibles are often significantly higher. Catastrophic plans do cover three visits to a primary care physician per year before you meet your deductible, as well as certain preventive services with no cost sharing, so you don’t have to worry about paying for those. But they also don’t apply to meeting your deductible.
Before selecting a catastrophic plan, consider the risk factors in your life that may require you to be more accident or illness prone or to need medical care. Do you smoke? Play contact sports? Ride a motorcycle? Are you managing a chronic condition? Any of these could increase your risk of needing medical care that a catastrophic plan wouldn’t cover until you’ve paid your deductible.
It’s worth noting, too, that catastrophic plans aren’t eligible for financial help through the Healthcare Marketplace, so an eligible silver-level plan could end up being a better option, with more robust coverage for an equal or lower cost.
If you’re thinking about enrolling in a catastrophic plan, take a look at the sidebar on the right of this page for advice from one of our Highmark Direct store experts.
I work in the industry, and there’s still a lot that I find confusing about health insurance and health care. But I have the advantage of being able to reach out to experts in the organization any time I need to understand something better. The good news is: so do you.
In addition to the Discover Highmark chat function I mentioned earlier, you can also set up a call, or — if you’re in Pennsylvania — make an appointment for a 1-on-1 conversation with a licensed, non-commissioned expert at one of our Highmark Direct stores. Every one of these consultations is free and confidential.
In any case, always keep in mind that what kind of coverage you get is your decision. Choice is a good thing. And with all of the options available, and a little expert help to understand them, you should be able to find a plan that meets your coverage needs and your price range.
If you do find yourself needing a little extra help or insight, feel free to reach out with a comment below and I’ll try to answer your questions or get you connected with an expert who can.
If you have a member service question that involves personal health or insurance information, do not use the "comments" feature; please call the number on the back of your Member ID card.