It happens to almost everyone – that moment when you realize that you need health insurance. Maybe you turned 26 and have to say goodbye to your parents’ coverage. Or you might be between jobs and the COBRA rate from your previous employer is too expensive. You could be finally calling the shots as your own boss or just looking for better coverage than what you have now.
No matter why you need health insurance, it’s easy to get coverage. There are a lot of companies that want you as a member, which means there are many options to choose from. And those options can be found on insurance marketplaces, through brokers and even from insurance companies themselves.
Fortunately, by taking a two-step approach, you can put yourself in the best position to find the right coverage at the right price for you and your family. Even better, you can make your decision knowing that you’re taking advantage of financial help that may be available to you. Our guide to shopping for health insurance will take you through those two steps while describing the different ways you can buy coverage. We’ll show you what to look for and where to search.
A quick note about enrollin – if you’ve recently lost health insurance from an employer or family member, had a household change like a marriage or divorce, or moved, you may be able to enroll in a new plan sooner. Qualifying life events like these make you eligible for a Special Enrollment Period. If not, you may have to wait for the annual Open Enrollment Period to join a new health insurance plan.
Step 1: Check out your state’s health insurance marketplace
When it comes to shopping for health insurance, your first stop should be your state’s health insurance marketplace. Some states will have their own marketplace, like Minnesota’s MNsure, while others go directly through the federal exchange at HealthCare.gov. There are several excellent reasons why you should point your web browser here before anywhere else:
- Wide selection of insurers and plans – Whether it’s through your state’s marketplace or through the federal exchange, you’ll find a market with many insurers competing for your membership. You’ll find local, regional and national companies offering many kinds of plans.
- Plans that are easy to compare – These marketplaces classify plans into four different “metal” levels – Bronze, Silver, Gold and Platinum. The higher up in the metal scale, the higher the plan’s cost and the higher the amount of care the plan covers. (The scale only compares costs and coverage – NOT the quality of care you’ll receive.) This makes comparing plans easier, giving you a true “apples to apples” way to stack plans up against each other.
- Save money with financial help– This is the biggest reason why you should start with your state’s marketplace. You could be eligible for financial help that could lower the costs of your plan – sometimes significantly. These are only available through the marketplaces, so it’s best to check your eligibility here first.
Discounts for Minnesota shoppers
For shoppers in Minnesota, your state health insurance marketplace is MNsure. This is the only place where Minnesota residents can check to see if they qualify for financial help with health insurance costs. That’s why it’s so important to start any health insurance search here.
At MNsure, you can also see if you qualify for other low-cost or public assistance health insurance options like MinnesotaCare or Medicaid (also known as Medical Assistance).
Eligibility for plans can depend on qualifications like income and family size. The best way to find out if you qualify is to start at MNsure. Just enter your coverage year, ZIP code, birthdate, annual household income and a few other details. You’ll get an estimate of your eligible savings, as well as any low-cost plans you might be able to join.
Discounts for Wisconsin shoppers
Because the state doesn’t have its own marketplace, Wisconsin shoppers can use the federal health insurance exchange at HealthCare.gov. This is the only place where Wisconsin residents can find out how much they’re eligible to receive in financial help, making it an ideal place to start any search.
Your eligibility for financial help, as well as how much you’ll receive, depends on qualifications like income and family size. Fortunately, it’s easy to get that information on HealthCare.gov. At the prompts, enter your ZIP code and state, the number of people in your household, and your household income. The website will then show you the financial help that’s available to you. Depending on your information, you may qualify for low-cost or public assistance health insurance options like Medicaid (also known as Medical Assistance).
Step 2: Shop around
Once you’ve looked at your state’s health insurance marketplace to check out your financial help eligibility, you’ll come to a fork in the road:
If you’re eligible for financial help, keep shopping on the state or federal marketplace. You can only take advantage of financial help if you buy your plan on the state or federal marketplace.
If you’re NOT eligible for financial help, there are other places you can continue your search. But that doesn’t mean you should shut the door completely on the state or federal marketplace. It’s a good idea to look at the available plans to get a good, baseline idea of what kind of coverage you want and how much you want to spend on a plan. Then you can take this information and use it to compare with what you find elsewhere.
If your search takes you outside of the state or federal marketplace, there are a few places to look.
Buying directly from a health insurance company
To shop insurance companies directly, rather than through a marketplace, you’ll need to go right to the source(s). This means visiting the websites of insurance companies or calling representatives that work exclusively with the company’s plans.
By having direct access to the most current and comprehensive information about their plans, insurance company websites and advisors can answer nearly any question you might have. With their help, you can readily see which doctors and prescriptions their plans cover. You may even find plans offered directly with the insurer that aren’t available on state or federal marketplaces.
A health insurance company representative can also help you pick a new plan by reviewing your past costs and how you use your current plan. That way, you can use your previous experience to make a good choice for what you’ll likely need in the future. By comparing plans and weighing costs, you can be confident you’re enrolling in what’s right for you.
Working with a health insurance broker
When it comes to shopping for plans, another good option is to work with a licensed agent, also known as a broker. With personalized service and connections to many insurers at once, you can think of brokers as true “personal shoppers.”
Instead of representing just one insurance company, brokers work with a large variety of insurers. Also, since brokers are local to your community, they can confidently present you with plans from regional and national insurers that work with doctors and specialists close to you.
Once you and your broker find a plan that meets your needs, the broker can guide you through the sign-up process. Brokers can also help with questions and guidance after you enroll.
Going to an internet broker website
If you like the convenience of shopping online but don’t have the time to research individual health insurance companies on your own, you can use an internet broker website. These sites specialize in combining multiple plans from many insurers, all in one place.
These sites are different from the state and federal health insurance marketplaces – they operate independently from the exchanges and can’t offer financial help. However, like the marketplaces, they make it easy to look at different plans from different insurers, giving you a chance to do your own side-by-side comparison shopping.
Once you’ve found the right plan, the site can help you enroll. However, once you sign up, all service and questions are handled by your new insurance plan, not the broker website.
Getting help with health insurance
Still not sure how or where to start? HealthPartners is here to help. We work with people throughout Minnesota and Wisconsin to help them find the right plan with the right coverage.
Whether it’s time for open enrollment or you’re eligible for a special enrollment period, we have the information and staff to help make things simple. We can help you take a clear look at the care you need to stay healthy, as well as what kind of plan is right for your budget.