Health insurance is essential to protect yourself and your budget. Have you read about getting health insurance in the past? If so, you may be afraid of high premiums and discounts. Fortunately, there are many companies that offer affordable health insurance plans that you can use to get coverage for yourself and your family.
We'll look at how health insurance works in Florida and explain what health insurance does and doesn't cover, and some of the best companies that offer low-cost plans. Affordable health insurance in Florida
Affordable health insurance in Florida:
- Best overall in Florida: Aetna
- The cheapest health insurance in Florida: Humana
- Best Fixed Income: Florida Blue
- Best Prescription Drug Coverage: Cigna
What is health insurance?
Health insurance is a type of coverage that partially pays for your health-related costs. Unlike car insurance, you don't have to have health insurance. However, it is important to have some form of insurance to protect you from bearing the costs of prescriptions and medical care on your own.
You make a fixed payment to your health insurance company every month. This is called a monthly payment. In return, your health insurance company will cover a percentage of your Medicare costs after they meet your deductible amount. A deduction is the amount of money you need to spend before your health insurance kicks in and begins to cover your expenses. Once you meet your deductible, you only need to pay your coinsurance, which is a small percentage of your costs of care.
For example, let's say you have a deductible of $ 3,000. You will have to spend $ 3,000 out of pocket on your care before insurance can cover it. If you have a 20% coinsurance, your insurance will pay 80% of your medical bills after paying your deductible. You must pay the remaining 20% out of pocket.
Average cost of health insurance in Florida
The average Florida citizen pays about $ 393 a month in health insurance premiums if they have an individual plan. The average premium is $ 1,021 per month if you have a family plan. However, the exact amount you will pay for coverage depends on a number of factors, ranging from whether or not you smoke to the type of plan you have.
Types of health coverage
There are many types of health insurance plans. The type of plan you choose will determine how much you pay, whether you need a referral to see a specialist, and which health care providers you can see. Let's take a look at the three most popular types of health insurance plans: HMO, PPO, and point-of-sale plans.
- HMO plans: HMO plans require you to see only doctors, specialists and caregivers within the organization's network. You cannot see any out-of-network healthcare provider and must get a referral to see a specialist. HMOs are the most affordable type of plan, but they give you the least amount of freedom to choose the caregivers you see.
- Preferred Provider Organization (PPO) Plans - PPO plans offer a network of doctors and professionals, but they don't require viewing. You will pay an additional fee if you see a health care provider outside of your network. You do not need a referral to see a professional who has a PPO. PPO plans are usually more expensive than HMO plans.
- Point of Service (POS) Plans - Point of sale plans are a mix between HMO and PPO. You can see doctors and specialists outside of your network with a POS plan, like the PPO. However, you will still need a doctor's referral to see a specialist as you would the HMO. Point of sale plans can allow you to see the caregivers you want at lower rates than PPOs.
What does health insurance cover?
Every health insurance plan can include or basically rule out any type of coverage it wants before the ACA is introduced. This made comparing plans incredibly tedious because there was no standard of coverage among the dozens of options. Now, the ACA dictates that any permanent health insurance plan must include at least the following ten "basic benefits":
- Outpatient Services - This is outpatient care that you receive outside of the hospital.
- Emergency Services: Your health insurance provider must cover emergency care at any hospital, regardless of whether the hospital is in-network or not. Also, your health insurance provider cannot ask you to contact the hospital before you receive emergency care. You should visit the hospital closest to you in case of a real emergency.
- Hospitalization - This includes things like staying overnight, medications prescribed by a doctor or nurse, as well as surgeries.
- Care during pregnancy, maternity and newborn - This includes prenatal and postnatal care. It also includes complications of labor and pregnancy.
- Mental health and substance abuse treatment: Your health insurance provider must provide coverage for behavioral therapy, inpatient mental health services, and substance abuse treatment. Your health insurance provider cannot set a lifetime or annual limit for the treatment of a specific disorder or substance use problem.
- Prescription Drugs: Although health insurance providers can't rule out prescription drug coverage, they may ask you to try less expensive general remedies before moving to more expensive or habit-forming drugs. This is called "step therapy."
- Rehabilitation services and devices - This includes things like physical therapy, occupational therapy, and mobility devices.
- Lab Services - This includes outpatient blood tests and pictures that you get at a medical facility or hospital (such as X-rays or upper GI tract scans).
- Preventive Services and Health Checkups - This includes things like physical checkups, shots, and booster shots. Many health insurance plan providers offer these services for free.
- Pediatric Services - Health insurance plan providers must provide health, vision, and dental services for the children in their plan. However, dental and vision benefits are not required by ACA adult plans. You may be able to purchase additional plans through your insurance provider.
Your plan should also include the following benefits for women:
- Lactation support: includes counseling and equipment for nursing mothers.
- Birth Control - ACA-compliant plans must include prescription and FDA-approved contraceptives. This includes emergency contraception, but does not include drugs intended to terminate an already viable pregnancy.
Your employer may be exempt from covering some contraceptives if you work in a place of worship or a non-profit religious establishment.
What does health insurance not cover?
Most health insurance plans do not cover the following benefits:
- Male birth control: Barrier and vasectomy methods are not covered by most plans because female birth control is a primary feature.
- Travel vaccinations: Your insurance company should only cover routine vaccinations that are medically necessary. Travel vaccinations are generally considered an optional preventative and are not covered by most plans.
- Dental and Vision Coverage: Only insurance providers should cover these services for the children on your plan. If you want to cover adults, consider purchasing an additional plan.
- Weight Loss Surgery - No federal state requires insurance providers to cover bariatric surgery. However, many insurance companies choose to include this coverage. If you or someone on your plan needs bariatric surgery, be sure to check with your representative and make sure you have it covered before signing up.
- Plastic Surgery: There is no type of health insurance plan that covers plastic surgery because these procedures are not medically necessary.
Unless a specific treatment is a primary benefit, most insurance providers will not cover it. These are just a few of the treatments and services that are generally not covered. If you are concerned about coverage for a particular treatment or service, contact your health insurance provider and ask about it.
Florida's Cheapest Health Insurance Provider
Let's take a look at some of the best cheap health insurance providers in Florida.
1. Aetna
Aetna is one of Florida's most affordable health insurance plan providers offering low-cost plan options for individuals, families, and businesses.
ACA certified plans are available for as little as a few hundred dollars a month and make Aetna one of the best health insurance options for those on a tight budget. Are you eligible for Medicare or Medicaid?
Aetna also offers special low-cost plans for you and has student health plans available if you attend a two- or four-year college.
2. Humana
Humana offers HMO and POS plans in Florida at competitive rates.
Humana's plans are also among the lowest if you are over 45 years old.
Some of Humana's more affordable plans also include home health care, which is a rare addition to the required ACA plans. Medicare plans are also available to those who qualify.
3. Florida Blue
Florida Blue is a subsidiary of Blue Cross, a national provider of health services. Florida Blue offers PPO plans, which give you the greatest freedom to choose your doctors and health care providers.
This can be helpful if you have a chronic illness or long-term relationship with a healthcare provider and don't want to start treatment with a new doctor.
Florida Blue offers affiliates to help you lower the cost of health care if you live on a stable income.
Florida Blue ACA compliant plans also include free preventive care like physicals, shots, and mammograms.
4. Cigna
Cigna health care plans are affordable and include all ACA-compliant benefits. Four out of 5 people who choose the Cigna plan qualify for some form of federal support to lower their premiums.
Cigna plans include free preventive care - you pay nothing for vaccinations, checkups, and even some medically necessary preventive drugs.
You can even unlock discounts on gym memberships, health clubs, and more to help you stay healthy.
Protect your health at an affordable cost
Choosing a health insurance plan over ACA means endless comparison between plans and a reading of what is covered and what is not. Now, permanent health insurance plans must offer at least 10 basic ACA benefits. However, this regulation only applies to plans that comply with the ACA. Be sure to read carefully what is covered and what is not covered before choosing short-term health insurance or a coverage plan without coverage.
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