How to Find Health Insurance That's Right For You for the First Time

This is a guest post from our friends over at Oscar.

From launching an idea to running a business, entrepreneurship can be as all-consuming as it is rewarding. Entrepreneurs have plenty on their plates without trying to navigate the often intricate and confusing world of health insurance and for many, this is the first time picking their own coverage.

Yet your coverage is an important decision to make: health insurance is the best way to make sure that care costs, even catastrophic ones, won't undermine your financial stability or adversely affect your credit. Given the growing number of options and changing premiums and benefits, here’s a handy guide to help you find health insurance plans that might be best for you in the early stages of your business.

We’ve also built a guide of important health insurance terms as well as details on different plans and costs. Download it for free here.

Three Common Choice Scenarios

There’s two main types of health insurance costs: the premiums and cost-sharing. The premiums are the fixed amounts you’ll pay every month, while cost-sharing is the portion of a medical expense that you’re responsible for (such as part of the cost for a specialist appointment).

Typically, the more you pay in monthly premiums, the less you’ll need to pay in cost-sharing, Premiums are defined by each insurer’s “metal levels” (bronze, silver, gold, platinum, or catastrophic). The categories are based on the percentage of average overall health costs that the insurer pays (bronze is the lowest, platinum is the highest, and catastrophic is a special category).

To make the best choice, review your family’s and your pattern of using services and medications over the past few years.

The 3 Main Profiles

• Young and healthy: Doctors, who? This is a good fit if you want some preventive and wellness services, but rarely use specialists, medications, emergency rooms, or hospitals. In this case we’d recommend catastrophic or bronze plans. If you’re under 30 or qualify for a “hardship exemption,” you have access to a catastrophic level plan, which is designed for worst-case scenario coverage. This has minimal cost, given the low likelihood of cost-sharing expenses. If you want more than minimal protection, bronze plans are the way to go.

• Relatively young, relatively healthy and/or families: This is a good fit if you know you will be visiting the doctor this year. You are the kind of guy or girl who sees specialists and gets medications several times a year. If you’re a parent, you plan for your children to have routine checkups and possibly get sick throughout the year. Silver or gold plans are a good fit because they may reduce your overall costs.

• Managing a serious condition/s: You (or a family member) expect to have routine doctor and specialists’ visits to manage and monitor one or more chronic conditions. In addition, you’re planning for blood tests, other diagnostic testing, and medication costs. Gold or platinum plan options are likely to give you the most financial protection, but keep in mind that they have higher, fixed monthly costs.

Pulling the Trigger

Before you make a decision, review your health history. No matter how healthy you are or think you are right now, it always helps to look at how often you’ve gotten care in the past, which is an important way to gauge expected out-of-pocket costs. Here are the things to consider:

• To get a sense of what those kinds of visits, medications, and services might cost in the year ahead, feel free to call Oscar’s member services department (1-855-OSCAR-68). Even if you’re just shopping and haven’t signed on yet, they’ll be happy to help you figure it out.

• Compare this to the deductibles (the amount you need to pay before your insurance kicks in and starts covering your care), copays (the amount you’re expected to pay for each instance of care after you meet your deductible, until you meet your out-of-pocket max), and coinsurance (the percentage of a medication or service you’re expected to pay after you meet your deductible, until you meet your out-of-pocket max).

• Next, factor in medications and treatments. For instance, if you’re a diabetic, check to see if the plan covers the kinds of drugs and services you typically use.

A Couple More Tips

• Look at preventive and wellness services. These can be critical to helping you avoid expensive treatments. Features like telemedicine (a network of doctors to help you over the phone), extra support for certain conditions, and even reimbursements for exercise or gym memberships can help drive down costs now and well into the future.

• What’s the word on the street? Reading what reputable magazines, newspapers, and blogs have to say about a company can help seal the deal on a wellness partnership whose results can last a lifetime.

Ready to take the next step? In addition to our other plans, this year Oscar is making things even easier by offering four deductible-only Simple Plans. All these options have the same free benefits, including 24-hour doctor calls, preventive care (including flu shots and some birth control), a $400 fitness reward, two primary care visits, and generic drugs. They also all connect you to the same large, high-quality network of doctors, hospitals, and other providers. The only difference is each plan’s max—the most you’ll pay per year if you need care. After that, Oscar health insurance covers everything. No co-pays, no co-insurance payments. Easy. Call 1-855-OSCAR-68 to get started or visit HiOscar.com