As I worked with my stepson on obtaining insurance quotes, I thought it would be a bit easier. As a healthcare professional with many years of experience, I intuitively knew what he needed but I found myself grasping for words and analogies to interpret the concept of “out of pocket”, “co-insurance” and other necessary insurance terms to understand pricing and select the right product. I found all the sites we reviewed for quotes had excellent descriptions but could still be overwhelming without an initial conversation or dare I say, learning session, hopefully with a parent or guardian. I did my best, still stumbled, but we got through it and purchased a good product that met his needs at the time.
The “Truisms” of Young Adult Individual Healthcare Insurance (as of 2012)
Some geographical areas offer short-term medical coverage (less than six months) and ongoing medical coverage (greater than six months.)
Similar to auto insurance, you will pay a monthly premium. The premium amount may be based on your gender, age, height, weight, smoker status and at this point, pre-existing serious conditions.
Healthy, young adults generally pay less than older adults.
Costs may vary based on how much you want to pay out of pocket beyond the monthly premium throughout the year.
Costs may vary based on if you want:
1) Basic coverage to cover you for inpatient hospitalizations and outpatient surgery in case of a major accident or serious illness
2) Comprehensive coverage to cover you for doctor visits, prescriptions and preventative care.
There are many plans to choose from with variations on coverage, deductibles and out of pocket.
Generally, high deductible plans have lower monthly premiums. You are basically betting you will not need to use the insurance but you have it if you need it.
Low deductible plans have higher monthly premiums because you are basically paying more up front for the coverage. These plans are available if you have a greater need to go to a specialist or frequent a primary care physician, need preventative care, tend to have more frequent prescription needs, etc.
As you work through the plans, you will need to consider how and where you can get the extra money for out of pocket and deductibles should you become ill and use the insurance.
As a young adult working through this process, think about your medical history:
- Over the last year, do you feel you have been relatively healthy as compared to your peers?
- How frequently have you gone to the doctor in the past two years?
- Have you parted with your tonsils and appendix?
- Do you stay current with annual immunizations through other resources such as pharmacies and convenient care clinics?
- Do you have frequent upper respiratory or stomach infections or skin conditions requiring treatment?
- Do you participate in higher-risk recreational activities such as skiing?
- Do you plan to travel outside the country?
- Are you frequently around people who may be sick or are contagious with illnesses that generally need formal medical treatment?