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The Smart Patient

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Alexandra Nguyen

A Guide to Healthcare Insurance for Young Adults

by Alexandra Nyguen

Turning 26 marks the age that a person can no longer be covered by their parent’s health care insurance; some get taken off much earlier. The world of health care insurance is confusing and complex, especially for young adults who are often not taught on the topic. With a range of plans, prices, and logistics, discerning the best option can be an obstacle. Health care insurance can be daunting, so this is a guide to help navigate through health care insurance for young adults.

 

Here is the Healthcare Insurance Information Every Young Adult Should Know.

 

What is health care insurance?

  • Protection is bought to cover a range of medical needs, whether it be an annual check-up or an emergency room visit.

 

How does it work?

  • Health care insurance is similar to a layaway plan, with the buyer paying the company a set amount of money each month. This prevents the buyer from having to pay expensive hospital bills all at once.

 

Why is it necessary?

  • Things happen, especially as young adults. Nobody is accident-free and healthcare issues can occur when least expected.

  • Without it, hospital bills may pile up becoming a financial burden.

 

How is it acquired?

  • For most young adults it is given by their parents. This coverage usually ends once the individual turns 26.  

  • Another common way young adults acquire health insurance is through their employers. Workplaces often deal with the insurance companies receiving the coverage at lower costs. This is a crucial thing to keep in mind while job hunting!

  • You could also buy the plan as an individual policy. This may mean that it could be more expensive, as you are not buying coverage as a part of a group, like employees.

  • A short-term policy is a great option for young adults. This plan is acquired by purchasing an insurance plan that is short in a contract. This allows for the young adult to still be insured before they have their first job that offers health insurance. This policy allows for coverage without any long-term commitments and without any expensive costs.

  • For young adults under 19, health insurance can be provided through the subsidized state program. Being uninsured and with a certain family income level, the state could offer you a plan.

  • Medicaid is another way in which health insurance can be acquired by those who are low-income or who have disabilities. It is government-funded, so the rates and coverage depend on one’s needs and residence.

 

There are many types of insurance plans because they all cover different things. These are the three most common plans:

Managed Care Plans

A person who receives health insurance through their employer oftentimes gets this plan. The insurance company makes an agreement with healthcare providers to offer care to those covered at lower rates.    

 

The Types of Managed Care Plans: 

 

Point of Service: This plan allows you to have a doctor approved by the network. It also allows you to see someone outside of your insurance’s network, sometimes at a higher cost.

Health Maintenance Organization: This means you have a primary care doctor. The only doctors or hospitals you can use are the ones covered in your plan.

Preferred Provider Organization: This plan is similar to an HMO. However, it offers a wider range of options as you could see any doctor you want, not just your primary.

Exclusive Provider Organization: Similar to a PPO, this plan offers the same coverage but is more limited with a smaller pool of doctors to choose from.

Consumer-Driven Health Plans

This plan offers the member more financial freedom, as the member chooses how much money they want to put into their health insurance savings.

Indemnity Plans

These follow a reimbursement structure. A person with this plan could see a doctor whenever needed. After the health care service, the doctor would send the claim to the insurance company which will reimburse you for a part of the cost.

 

Which one is right for you?

In short, discerning which plan is right for you is choosing the one with the most benefits with the smallest price tag. Different plans cover different forms of health care, like mental health services, prescriptions, and childbirth. So, reading, researching, and comparing plans before choosing one is essential to ensure that it covers your health care necessities.

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Alexandra Nguyen is currently pursuing a Bachelor’s of Arts in Journalism at Loyola Marymount University. From a young age she had a passion for writing, which would later develop into focusing on how her words can make an impact on the world. The world of healthcare was exposed to her through her volunteer work at the Veterans Affairs Hospital in Palo Alto. Working side-by-side with patients and doctors, this role gave her a glimpse into public health. Alexandra combines her passions and experiences to write for Today’s Patient in efforts to educate society on lesser-known topics, especially young adults.

February 2023  page 5

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