Why health insurance is important, how it works and how to get it

Life is often unpredictable. No matter how hard we work to take care of ourselves and our loved ones, our circumstances can change in an instant. While most of us understand the need for health insurance to protect our health and financial security, why does it have to be so confusing? The number of options and all the variations between plans can leave us feeling overwhelmed.

Here, we’ll go over some health insurance basics to help you get started. Peace of mind, medical care when you need it, and financial protection are all excellent reasons to weigh your options against your current situation.

Why health insurance is important

Taking care of our health can be expensive, especially when a problem arises. While no one plans to get sick or injured in an accident, most people will need medical attention at some point. Health insurance helps you provide financial protection when you need it.

Health insurance can help:

  • Contribute to a longer and healthier life
  • Get financial help for medical bills and avoid major debt
  • Maintain wellness services such as regular check-ups, check-ups and vaccinations
  • Save money when you use in-network doctors and services
  • Get the affordable care you need close to home
  • Give you access to health information and other benefits to maintain a healthy lifestyle

How health insurance works

Although complicated, health insurance works much the same way as home or car insurance. You (or your employer) choose a plan and agree to pay a monthly premium. In return, the insurer agrees to pay a portion of your covered medical expenses.

What health insurance covers—and how much—varies depending on the plan you choose. The best health insurance plan for you may be different than what works for someone else.

When considering which plan might be right for you, consider:

  • Where you can get care
  • What is covered
  • How much will it cost

Apart from the monthly premium, other out-of-pocket costs should be understood before choosing a plan:

Is there a deductible?
A deductible is a set amount you must pay each year before insurance will pay for covered services.

Is there co-insurance?
Coinsurance is the percentage amount you’ll be responsible for after you’ve met your deductible. You will have a rate to pay and so will your insurance.

Is there a surcharge?
A surcharge is a fixed fee that you are expected to pay at the time of service. If a policy requires a co-payment, the amount usually varies depending on the type of service.

What is your out of pocket maximum?
Your out-of-pocket maximum is the most you’ll have to pay for covered expenses during your plan term, usually one year.

Learn more with a user’s guide to understanding health care prices.

Five things to consider when weighing your insurance options:

  1. Your health and how often you may need care. How often will you need to see the doctor? Do you have chronic diseases that require constant treatment?
  2. Premiums vs. Benefits: How much money are you willing to spend to get what you need?
  3. Your current doctor and healthcare services. Are they in network with the policy you are considering? If not, are you willing to change doctors or look at a different plan?
  4. What else does the plan include? Are there convenient care options, self-service and virtual services, healthy lifestyle programs or discounted fitness deals?
  5. Are there additional coverage options you may need to consider, such as prescription, vision or dental coverage?

Figuring out which plan is right for you and your family can be challenging. Our Financial Counseling Specialists are trained in financial counseling specifically for medical services. They can help you navigate your current insurance, show you which plans and networks are accepted by Nebraska Medicine, and help you choose which Marketplace plan may be best for your situation.

“If you have questions or need clarification about a bill, claim or insurance coverage, don’t hesitate to contact us,” says Kim Stuve, Supervisor of Patient Financial Services at Nebraska Medicine. “We’re here to answer your questions and help you understand the process.”

How to get affordable health insurance

There are several ways to get health insurance:

  • Employer-based: through your job or your spouse’s job if the requirements are met
  • Health insurance marketplace during the open enrollment period (usually November through mid-January)
  • Public coverage through Medicaid or Medicare
  • Individual health insurance purchased directly or through an insurance broker
  • Children’s Health Insurance Program
  • If you are under the age of 26, you may be able to continue coverage under your parent’s insurance plan

“If you need financial help or feel like you can’t afford health insurance, contact us,” Stuve says. “Our financial advisors are here to answer your questions and help you navigate your options.”

Need to speak with a Nebraska Medicine financial advisor?

A call 402.559.3140 or 888.662.8662 to schedule an in-person or virtual meeting.

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