Why health insurance is important, how it works and how to get it

Life is often unpredictable. Even as we work to take care of ourselves and our loved ones, our situation can change in an instant. While most of us understand the need for health insurance to protect our health and financial security, why does it have to be so confusing? The number of options and all the variations between plans can leave us overwhelmed.

Here, we’ll cover some health insurance basics to get you started. Peace of mind, medical care when you need it, and financial protection are great reasons to weigh your options based on your current situation.

Why health insurance is important

Taking care of our health can be expensive, especially when something goes wrong. Although no one expects to get sick or injured in an accident, most people will need medical attention at some point. Health insurance helps provide financial protection when you need it.

Health insurance can help you:

• Contribute to a longer and healthier life
• Provide financial assistance for medical bills and avoid large debts
• Support wellness services like regular preventative screenings, health checkups and vaccinations
• Save money when using in-network doctors and services
• Get the affordable care you need near you
• Giving you access to health information and other benefits to support a healthy lifestyle

How health insurance works

Although complex, health insurance works in much the same way as home or auto insurance. You (or your employer) choose a plan and agree to pay a monthly premium. In return, the insurer undertakes to pay part of your covered medical expenses.

What health insurance covers — and how much — differs depending on the plan you choose. The best health insurance plan for you may be different from what works for someone else.

When thinking about which plan might be right for you, consider:

• Where you can receive care
• What is covered
• How much will it cost

Besides the monthly premium, questions about other out-of-pocket expenses should be understood before choosing a plan:

Is there a deductible?
A deductible is a fixed amount you must pay each year before insurance pays for covered services.

Is there co-insurance?
Coinsurance is the percentage you will be responsible for once you reach your deductible. You will have a percentage to pay, and your insurance too.

Is there a copayment?
A copayment is a flat fee that you are expected to pay at the time of service. If a policy requires copayments, the amount usually varies depending on the type of service.

What is the maximum disbursed?
The out-of-pocket maximum is the maximum you will pay for covered expenses during the period of your plan, usually one year.

Learn more with a consumer guide to understanding healthcare pricing.

Five things to consider when evaluating your insurance options:

1. Your state of health and how often you may need treatment. How often will you need to see the doctor? Do you have any chronic illnesses that require ongoing care?
2. Rewards versus benefits: How much money are you willing to spend to get what you need?
3. Your current doctor and health care services. Are they networked with the policy you are considering? If not, are you ready to change doctors or consider another plan?
4. What else is included in the plan? Are there convenient care options, personal care and virtual services, healthy lifestyle programs, or fitness offerings with discounted rates?
5. Are there additional coverage options you may need to consider, such as prescription, vision, or dental coverage?

It can be difficult to determine which plan is best for you and your family. Our professionals in the financial advisory service are trained in financial advice, specifically for medical services. They can help you navigate your current insurance, show you which plans and networks are accepted by Nebraska Medicine, and help you determine which market plan is best for your situation.

“If you have any questions or need clarification about a bill, claim, or insurance coverage, please don’t hesitate to contact us,” says Kim Stueve, supervisor of patient financial services for Nebraska Medicine. “We’re here to answer your questions and help you understand the process.”

How to get affordable health insurance

There are several ways to purchase health insurance:

• Employer-based: through your job or your spouse’s job if the conditions are met
• Health insurance market during the open enrollment period (usually November to mid-January)
• Public coverage through Medicaid or Medicare
• Individual health insurance purchased directly or through an insurance broker
• Children’s Health Insurance Program
• If you are under 26, you may be able to continue to be covered under your parent’s insurance plan

“If you need financial help or think you can’t afford health insurance, contact us,” Stueve says. “Our financial advisors are here to answer your questions and help you navigate your options.”