Origin of Health Insurance

There are a variety of health insurance companies and products that you can choose from.

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Public Plans

Public health insurance programs are run by the State or the Federal Government. These plans include Medicaid, Illinois Connect, or various options levels on the HealthCare.gov site. There are fixed open enrollment times. However, an individual with a qualifying event (i.e. loss of coverage, marriage) may enroll outside of these fixed enrollment times. There is usually a delay to confirm enrollment. It is prudent to purchase a short term plan for 1-2 months so that there is no gap in coverage.

Cost of Public Plans

Medicaid and other state health insurance plans for low income individuals/families are available at low cost. Some public plans require individuals to pay enrollment fees or co-payments. For the HealthCare.gov federal plans, individuals will need to pay a premium, which will depend on the insurance option chosen. For example, the bronze plan provides a lower level of covered benefits, whereas the silver, gold and platinum plans provide a greater level of coverage and benefits respectively.

Private Plans

Health insurance plans that are run by private insurance companies range from Affordable Care Act (ACA) compliant to non-ACA plans such as catastrophe short term plans. Private plans are usually classified as “individual plans,” meaning a single individual or a family can enroll for specified time period. Individuals or families can select from a variety of plans that offer high deductibles and low premiums or vice versa.

Cost of Private Plans

Private health insurance plans are funded by premium payments. Insurance companies should provide information about the frequency and type of payment required for premiums. In addition to premiums, those healthcare services that are covered will likely also require payments, typically either co-payments (a flat dollar amount fee for a service), co-insurance (a percentage of the fee for a service), or the entire fee for a healthcare service (if the plan requires payment of all costs, aside from preventive care, until a deductible level is reached).

Employer Plans

Health insurance plans that are run by private insurance companies, in which the employer pays for a portion of the insurance premium.

Cost of Employer Plans

Private health insurance plans require premium payments. The insurance company should provide information about the frequency and type of payment required for premiums. In addition to premiums, the healthcare services that are covered will likely also require payments, typically either co-payments (a flat dollar amount fee for a service), co-insurance (a percentage of the fee for a service), or the entire fee for a healthcare service (if the plan requires payment of all costs, aside from preventive care, until a deductible level is reached).

Parent Plans

Health insurance plans that are Affordable Care Act compliant (ACA) mandate that children may stay on the parent's health insurance plan until the age of 26 years.

Cost of Parent Plans

These plans usually are through the parent’s employer. Family premiums cost more, but there should be no change in coverage. It is best to prepare to migrate a child to a new plan before the child turns 26 years and can no longer access insurance through a parent’s plan.

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