Health insurance in a nutshell
The United States health insurance system is the opposite of simple and easy. Unfortunately, there’s no standard process for getting health insurance. Your coverage options are determined by a long list of factors including age, income, employment status, the state you live in… the list goes on.
At the end of the day, your options essentially boil down to two main kinds of health insurance coverage: Public plans and private plans.
Public health plans
Public health insurance plans are funded by the government and delivered through programs like:
- Medicare (coverage for Americans 65 or older)
- Medicaid (coverage for low-income households)
- Veterans benefits
Public plans like these cover roughly 34% of Americans. Think you may qualify? Catch can help determine if you’re eligible in a few minutes.
Public health plans
If you don’t qualify for health insurance through a public plan, then you’re one of the roughly 216 million Americans that needs coverage through a private health plan.
For many, that private health insurance plan may be available through your work or your spouse’s work. Known as “employer-sponsored” plans, these health plans are chosen by an employer and offered as an option to their employees and their families. An employer may pay for some or all of the monthly premiums to provide you that coverage. Since employer-sponsored plans are often the most affordable option, many employees choose to go this route.
If you don’t have access to employer-sponsored coverage or that coverage is too expensive, you’ll need to purchase an individual health insurance plan. Thanks to the Affordable Care Act (ACA, or “Obamacare”), states are now required to have an online marketplace where you can buy certain individual health plans.
So if you’re looking for an individual plan here with Catch, what can you expect? Catch offers the best way for you to quickly and accurately find the individual health insurance coverage you need, at the best possible price. Every plan sold through Catch is ACA compliant. We think it’s important to have comprehensive medical coverage and not be left wondering what you’re actually getting when you enroll.
What are “ACA Compliant” plans?
A plan is considered ACA Compliant if it follows requirements from the Affordable Care Act, including limits on deductibles and copayments. ACA compliant plans also cannot deny you coverage if you have a pre-existing condition.
All qualified health plans must cover these 10 essential health benefits:
- Preventive and wellness services and chronic disease management
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Prescription drugs
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Pediatric services, including oral and vision care
- Birth control and breastfeeding coverage
- Laboratory services
Importantly, these are minimums that plans must cover. Many plans provide additional choices in coverage and costs.
Navigating your options
Choosing a health insurance plan can feel like a big commitment. After all, unless you experience a qualifying life event (like moving or having a child), you can only change your coverage during Open Enrollment. This means that the plan you choose is most likely locked in for 12 months.
Choosing the right health plan often comes down to the type of coverage you need. Here are some examples of how coverage may differ across plans:
- Some plans limit care to a specific network of doctors, meaning your preferred doctor may not be covered.
- Certain plans require referrals to see a specialist like a dermatologist or a Neurologist
- Prescription drug coverage varies by plan
Health insurance plans also differ in how much of your healthcare costs are covered by the insurance company and how much you may need to cover. Plans are categorized by “metal tiers” that indicate the average amount of health care costs covered under the plan.
- Bronze plans have the lowest monthly premiums, but the highest costs when you need care. These plans are a good choice if you want a low-cost way to protect yourself from worst-case medical scenarios, like serious sickness or injury.
- Silver plans have moderate monthly premiums and moderate costs when you need care. These plans are best if you’re willing to pay slightly more per month to have more of your routine care covered.
- Gold plans have high monthly premiums but low costs when you need care. These are a better option than Bronze or Silver if you use a lot of care or are willing to spend more just for peace of mind.
- Platinum plans have the highest monthly premiums, but the lowest costs when you get care. These plans are best if you anticipate using a lot of care and are willing to pay more per month to cover most costs when you receive care.
Cutting through the noise
Feel overwhelmed by all of this? You’re not alone. Health insurance in the United States may feel like a maze, but Catch can help guide you to the most affordable options, fast.
You and your family deserve comprehensive health coverage without having to study every detail of the health insurance industry.
We’ve made it super easy to estimate your monthly savings, find the plan that’s right for you, and enroll in coverage. Answer a few basic questions and find health plans based on:
- Your monthly budget
- The doctors you want to see
- The prescriptions you need to be covered
- The kind of care you need covered