Millions of Americans who are self-employed, working for small businesses or -- increasingly in this economy -- jobless, are facing the difficult and expensive task of buying health insurance on the open market.
The options are dizzying, with premiums, deductibles and co-payments that vary widely among plans and costs that are not always obvious. People who are older may pay more, as may those who have children and women who are of child-bearing age. Anyone who has needed major medical care in the past might be denied a policy altogether or charged significantly more.
Choose the wrong policy and you could wind up without enough coverage to pay for a lengthy hospital stay or an expensive medicine.
We offer tips on navigating this tangled system and, in related stories, alternatives for those who don't qualify for private insurance or can't afford it.
There are seven key elements that consumers must weigh when choosing a health policy. And it's important to understand the interplay between them, said Shannon Fallick, director of consumer affairs at eHealthInsurance in Mountain View, Calif.
You can get a cheap premium, for instance, but probably only if you choose a high deductible or limited coverage.
"You need to be careful," Fallick said. "Mistakes can be really costly."
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What consumers must consider
Here are the key elements and what to expect with each.
Premiums, the amount you pay each month for the coverage, can range from $50 to more than $1,000. This vast difference reflects both a policyholder's age and health -- you're probably eligible for a really cheap policy only when you're fresh out of college and in scant need of care -- and the bells and whistles that you choose.
Those who choose high-coverage, low-deductible plans will pay more in premiums. Those who are willing to pay for their day-to-day care out of pocket can spend less on premiums, but they face large costs in years when they use a lot of medical services.
Deductibles are the amount you pay before insurance kicks in. If you're buying family coverage, you should know that some policies impose both family and individual deductibles. For example, an Aetna Managed Choice plan quoted at eHealthInsurance.com imposed a $2,500 individual deductible but a $5,000 deductible for the family. This plan also has a separate $500 deductible for some prescriptions.
