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What Is Health Insurance?
Health insurance is a contract between you and an insurance company that helps pay for your medical expenses. In exchange for monthly premiums, your insurer covers a portion of your healthcare costs — including doctor visits, hospital stays, prescriptions, preventive care, and more.
Without health insurance, a single emergency room visit or unexpected diagnosis could result in thousands of dollars in bills. Health insurance protects you and your family from these financial shocks while giving you access to quality care.
How Does Health Insurance Work?
You pay a monthly premium to your health insurance company. When you need medical care, the insurer pays a portion of the costs based on your plan's terms. You may also pay out-of-pocket costs like deductibles, copayments, and coinsurance until you reach your annual out-of-pocket maximum.
Most plans cover preventive services like annual checkups, vaccinations, and screenings at no additional cost. Once you meet your deductible, the insurance company begins covering a larger share of your expenses.
How to Choose the Right Plan
Start by evaluating your healthcare needs. If you visit doctors frequently or take regular prescriptions, a plan with lower copays and a broader network may save you more. If you're generally healthy, a high-deductible plan with lower premiums could be the better fit.
Compare monthly premiums, deductibles, out-of-pocket maximums, and covered services. Check if your preferred doctors and hospitals are in-network. Don't forget to factor in prescription drug coverage and any extras like dental or vision.
Can I Get Coverage With Pre-Existing Conditions?
Yes. Under the Affordable Care Act (ACA), health insurance companies cannot deny coverage or charge higher premiums based on pre-existing conditions. This applies to all ACA marketplace plans, Medicaid, and most employer-sponsored plans. Conditions like diabetes, asthma, heart disease, and mental health disorders are all covered.
Short-term health plans and some non-ACA plans may have exclusions for pre-existing conditions, so it's important to read the fine print. If you have a pre-existing condition, ACA marketplace plans are typically your best option for comprehensive, guaranteed coverage.
Frequently Asked Questions
Have questions? We've got answers.
Is health insurance mandatory?
While the federal individual mandate penalty was reduced to $0 starting in 2019, some states still require residents to have health insurance or pay a penalty. Regardless of mandates, having health insurance protects you from catastrophic medical bills and ensures access to preventive care.
Can I get coverage today?
It depends on timing. During Open Enrollment (typically November through January), anyone can sign up for an ACA marketplace plan. Outside of Open Enrollment, you may qualify for a Special Enrollment Period if you've experienced a qualifying life event such as losing other coverage, getting married, having a baby, or moving to a new state.
What does health insurance cover?
ACA-compliant plans must cover 10 essential health benefits including hospitalization, prescription drugs, maternity and newborn care, mental health services, preventive care, emergency services, laboratory tests, pediatric services, rehabilitative services, and outpatient care.
Can I include my family on my plan?
Yes. Most health insurance plans offer family coverage that includes your spouse and dependents under age 26. Family plans typically have higher premiums than individual plans but cover everyone under a single policy with shared deductibles and out-of-pocket maximums.
Do you offer ACA marketplace plans?
Yes, we help you compare plans available through the ACA marketplace as well as off-marketplace options. Depending on your income, you may qualify for premium tax credits or cost-sharing reductions that significantly lower your monthly costs.
Can I get dental and vision coverage?
Many health plans offer dental and vision as add-on options. You can also purchase standalone dental and vision plans. Pediatric dental coverage is included as an essential health benefit in all ACA marketplace plans.
What if I'm self-employed?
Self-employed individuals can purchase health insurance through the ACA marketplace and may qualify for premium subsidies based on income. You can also deduct your health insurance premiums as a business expense on your taxes, making coverage more affordable.
How much does health insurance cost?
Costs vary widely based on your age, location, plan type, and coverage level. On average, individual plans range from $200 to $600 per month before subsidies. Many people qualify for premium tax credits that reduce monthly costs to under $100. The best way to find out your actual cost is to compare quotes.
Disclaimer: This website is operated by a Multiservices Agency. Licensed agents we work with help compare Marketplace and private health plans from multiple carriers. Availability varies by state. This is a solicitation for insurance. By submitting your information, you consent to being contacted by one of our licensed agents.
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