How To Find The Right Health Insurance In Your 20s

If you're about to turn 26, or you've just secured a job that offers health benefits, it's time to consider the right health insurance coverage to meet your needs. 

For many 20-somethings, making important decisions about health care when you've never had to worry about health insurance can be confusing. It’s also not necessarily a top priority. But securing the right level of coverage can help protect you, potentially saving you thousands in the long run. 

Why insurance matters

In 2021, nearly 15% of Americans between the ages of 19 and 25 were uninsured. That number fell dramatically since the introduction of the Affordable Care Act, which allows for coverage for dependent children until they turn 26. Although you think you may not need health insurance in your 20s, if you fall sick or get injured, health insurance can help cover the costs you may not be able to afford to pay on your own. Given the high cost of healthcare in the U.S., having the right level of coverage can be essential.

Your insurance options

As a 20-something, you usually have a few options available to find the right level of health coverage for your needs. If you're lucky enough to work for an employer that offers an employer-sponsored health insurance plan, it's a good idea to find out what your coverage includes and if there are any limits or exclusions. Talking to your HR team can help you get the information you need. If your parent's policy covers you for a few more years, review each plan to determine whether it's better to stay with your parents or join your employer's plan. 

If you don't have an employer sponsored health plan available but you’re in a relationship with someone who has one, you can consider being added to your partner's health insurance plan. Alternatively, you may wish to consider purchasing a plan from the Health Insurance Marketplace. Or, if you’re working as an intern or an independent contractor, you may qualify for Medicaid, which offers healthcare for low-income Americans. 

Seeking advice from an independent insurance agent can be helpful. At Health Plans of NC, our locally based insurance agents can help you find the right plan based on your budget and health needs. 

What to consider when looking for insurance

When making your decision, it's essential to consider a few things, including:

Your health needs: many 20-year-olds haven't had a lot of health care needs, so a lower premium plan option could be a good choice if you don't anticipate much care. Alternatively, if you're considering making life changes like starting a family, getting a plan that covers all your needs is essential. 

Premium costs: your premium refers to the total cost of the health insurance plan, which is usually paid monthly or annually. The cost depends on the benefits included in your plan. You can control factors to help save you money, including your deductible, copay, and coinsurance.

Deductible: this amount is how much you need to pay before your insurance kicks in during your coverage period. Once you reach this amount, which varies by plan type and provider, covered medical expenses will be paid for by your health insurance company as per your policy. Generally, the higher your deductible, the less your premium. A higher deductible plan can be a good option if you don't require health care often. 

Copays: this refers to the amount you pay on top of your premium every time you access health care, including emergency room visits, urgent care, and buying prescription drugs. These don't apply towards your deductible and depend on how much you pay for your health insurance policy. Typically, the higher your premium, the lower your copay. 

Coinsurance: refers to the percentage of a bill you're responsible for paying after your insurance provider has paid their part. Coinsurance only applies after you meet your deductible and varies depending on your policy. 

Provider network: many health insurance policies have strict provider networks, meaning you're only eligible for coverage if you visit specific providers. However, the list of providers is usually available online, so you can easily check if your usual physician is in-network before purchasing a plan. 

Prescription drug coverage: if you need medication regularly, check the prescription formulary for your plan. You may be required to purchase the generic version of the drug or have to pay a copay. This could lead to high costs, so do your research before purchasing a policy.

Vision and dental: Many dental and eye procedures aren't covered by standard health insurance plans. Check your inclusions if you think you'll need coverage for these services, and consider purchasing a separate vision or dental policy if necessary. 

How to choose the right plan

With so many health insurance options available, choosing the right one can be difficult. First, consider what health benefits are essential to you and what you can afford to pay for your health insurance, including additional costs other than just your premium. Then, when searching for plans, compare different options to see the benefits available to determine the right one for you. 

The Health Insurance Marketplace plans offer different tiered private insurance options. Although the open enrollment period is fixed, if you experience a qualifying life event, like turning 26 years old and losing coverage, you have 60 days from your birthday to enroll in a plan. Be mindful that if you miss the 60-day cutoff, you'll have to wait until the next enrollment period.

Need help deciding on health insurance?

If you're unsure where to start to organize affordable health insurance, or if you want to know whether it's cheaper to stay on your parent's plan or get your own insurance if you're under 26 years old, then let Health Plans of NC help. 

Our experienced and local insurance brokers have extensive experience searching the Marketplace health insurance to find the right insurance for a 26 year old. We can help you choose the best health insurance plan for your needs and budget. Contact us today to find out more.