Is There Health Insurance for Healthy People?

Fran Majidi
November 3, 2020

Are you healthy and see your doctor once or twice a year tops? There are health insurance plans for you. One is called the high-deductible health plan. Or a bronze-tier plan. A deductible is the amount you pay for covered services before your insurance plan starts to pay. High-deductible health plans generally only cover preventative services, and after that a big deductible gets applied to everything else so you will be paying out of your own pocket for any medical care beyond preventative services. But if you are healthy and looking for a couple of preventative care checkups a year, you may want to consider a high-deductible health plan or a bronze tier plan. You’ll like the cost of the premiums for high-deductible health plans, they are low. But you also will want to put money aside in case something happens and you need medical care. You need the cash to cover that big deductible. One option is to open a health savings account that lets you set aside money on a pre-tax basis to pay for medical expenses. You’ll be able to use money in a health savings account to pay for deductibles, copayments and coinsurance. So it is a good fit with a high-deductible health plan. Let’s take a look at other health insurance options for healthy people.

Healthy and Under the Age of 26

If a parent’s health insurance plan covers dependents you usually can be added to their plan and stay on it until you turn 26.

Your parent can add you to their insurance plan during the health plan’s open enrollment period. Your parents should check with their health plan or the benefit department of their employer for more information on enrolling you.

You can join a parent’s health plan even if you get married, have or adopt a child, start or leave school, live in or out of your parent’s house, aren’t claimed as tax dependent and turned down an offer of job-based coverage.

Piggybacking off your parent’s health insurance is a smart way to go and it is a benefit you may as well use up to your 26th birthday. If you're healthy, you will only need to use the plan a couple of times a year so it's a good strategy if Mom and Dad agree.

Healthy and Happy with a HMO Plan

HMO stands for health maintenance organization. An HMO health plan tends to be an affordable health care option for a healthy person as long as you don’t mind having your medical needs guided by a primary care physician.

With HMO health plans you typically have lower monthly premiums. You also can expect to pay less out of your own pocket for your healthcare. This is especially true if you are healthy and have no need for recurring doctor visits.

With HMO plans, you get fewer medical options and more savings. The bronze-tier plan is the cheapest option with an HMO.

With HMO plans, all of your healthcare services are coordinated by your primary care physician. Want to see a specialist? With a HMO plan, you must first schedule an appointment with your primary care physician and he or she then provides a referral to an in-network specialist. With a HMO plan, you are not able to reach a specialist directly on your own; you need a referral from your primary care physician first.

HMOs don’t offer coverage for care from out-of-network healthcare providers. The only exception to this rule is a true medical emergency. So get care from in-network providers as much as possible and do so at the discretion and recommendation of your primary care physician.

And be aware that any routine care that you choose to get outside your network will come out of your own pocket. So work with your primary care physician and stick with in-network providers whenever you need a referral.

Here’s another nice advantage to HMO plans. Since HMO plans only allow you to visit in-network providers, it’s likely you’ll never have to file a health insurance claim for the medical services that you receive. This is because your insurance company pays the provider directly. So there is no need for you to make a claim. This is a nice benefit.

Choosing a Plan

So which of the three options is right for you?

If you are under the age of 26, you can’t go wrong with being added to a parent’s health plan. This is a free health plan if Mom and Dad doesn’t mind adding you to their plan. And free is a good option for a young and healthy person.

Does your employer offer an HMO option? Step right up to a very affordable healthcare option. You may not have a lot of choices since your primary care physician directs your care and you’ll need him or her to sign off on any specialists. And you’ll need to get your care at in-network providers only, otherwise you’ll pay out of your own pocket.

But with HMOs, monthly premiums are low. And HMOs are affordable choices that may easily work for a healthy person who only wants routine, preventive services.

Do you like the idea of a high deductible health plan with preventative services covered and a big deductible you will need to clear for everything else? These plans can work for healthy people but to be on the safe side put some money aside in case you need to pay for medical expenses beyond preventative care. A health savings account will work and you’ll get the tax benefits too.

Whatever health plan you choose, putting a small emergency fund aside for medical expenses is a smart financial move. That way when it is time to pay a deductible the money will be there when you need it. Even a healthy person needs additional services once in a while and if there should be an emergency it will be good to have cash on hand to pay for it.

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