Gym & Health

Research the plans offered by your employer. Many companies offer health insurance plans for full-time employees. You can also use these plans to cover an entire family, though you'll have to pay some monthly fees based on the plan that you choose and the number of people you are covering. Companies typically offer these types of plans.

• Health Maintenance Organizations, or HMOs, are the least expensive option. In this type of health plan, you have a primary care physician who takes care of all health issues and refers you to a specialist when necessary.
• Preferred Provider Organizations, or PPOs, are more expensive, but give you more freedom in your choice of doctor. You are able to see any doctor within the organization without a referral.
• Point of Service, or POS, plans offer discounted rates for providers that are within a network, but you are free to pay higher rates to see a doctor outside of the network.

Consider COBRA for temporary insurance. The Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows individuals to continue an insurance plan after losing health insurance. While you will receive the same coverage, you will be responsible for the full payment of the insurance premiums. If you are leaving a job, your company will give you information about COBRA.

Look into individual insurance plans. Most insurance plans offer an option for individuals and their families. This can be a good option for people who are self-employed or who don't get health insurance through their company. Premiums vary based on a number of factors, such as your age and whether you smoke. There are 3 ways that you can find health insurance for individuals:

• By contacting insurance providers directly. In many areas, there are only a few health insurance plans available. Ask nearby hospitals and clinics which types of insurance they accept and contact those companies.
• Through an insurance agent. Look for insurance agents in your area that represent a number of insurance companies rather than just one.
• With comparison sites on the Internet. These sites take your information and compare the costs of health insurance plans in your area.

Find out if you can join your parents' insurance plan. Under the Affordable Health Care Act, a child under the age of 26 may join their parent's health insurance plan if that plan covers children.^[1] You may join your parents' plan even if you are:

• Married
• Not living with your parents
• Enrolled in school
• Financially independent
• Eligible to enroll in an employer's plan

Join professional organizations to find group health insurance. Group health insurance is less expensive than individual insurance. If you are surprised by the high cost of individual health insurance, check with professional organizations to see if they offer a group plan. Your local Chamber of Commerce may also offer plans for local business owners.

Consider a high-risk pool if you have a pre-existing condition or are considered a high-risk individual. High risk pools are private and self-funded, and even though they are organized by the state, they are governed by their own boards and administrators. They are designed for individuals who meet enrollment criteria and do not have access to group coverage.

• You can apply for high-risk insurance pools through an insurance broker, or directly through the state in some cases. High-risk pools generally work with an insurance carrier or third-party administrator, so your paperwork and claims may not even appear to be distributed by the high-risk pool.
• High-risk pools are, in many ways, analogous to traditional health insurance coverage. Common coverage includes a comprehensive plan with a range of deductible options. Additionally, because many of the constituents of high-risk pools suffer from chronic illnesses, these plans often have excellent disease management programs.^[2]
• High-risk pools cost, on average, about $25 to $50 more than traditional insurance plans for individuals.
• 33 states currently have high-risk pools. To check whether your state offers risk pool insurance, visit this website.

Be aware of the Medicare Part D Coverage Gap. Medicare beneficiaries who pay significant amounts of out-of-pocket money for prescription drugs should know that some subsidies lapse for prescription drug cost after a threshold limit is reached. This threshold is called the "coverage gap," or informally, the donut hole.^[3]

• Once you and your Part D plan have paid the total amount of $2,960 for prescription drugs in a calendar year, your insurance shifts to the coverage gap. For each prescription drug paid for thereafter, you pay no more than 65% of the cost of generic drugs, and no more than 45% of the cost of brand-name drugs. You pay these rates until the total amount spent by you and your Part D plan total $4,700 in year-to-date out-of-pocket costs, after which time you enter the catastrophic coverage stage.^[4]
• In order to delay the donut hole, you can do a number of things:
  
  • Switch to Tier 1 and Tier 2 drugs
  • Commit to large quantities of drugs only when you know how you'll respond to them
  • Use Pharmacy Saver, in which some of your drugs may be subsidized
  • Use a mail service pharmacy, in which the cost of drugs may actually be less

Talk to your employer's HR rep about joining a company insurance plan.Your HR rep will guide you through the paperwork of joining a company insurance plan. Your company will generally offer several different plans from at least one, perhaps several, insurance carriers. In filling out your application, you may need information pertaining to:

• Your previous insurance plan
• Any enrolling eligible dependents
• Any serious illnesses

Fill out an application for an individual insurance plan. After deciding which hospitals near you accept which carriers, choose a health insurance plan that works for you. Nowadays, the most efficient and easy way to sign up is online. In your online application, you may need to submit information pertaining to:

• Your previous insurance plan
• Your medical history, including any prescriptions or medications you may take
• Any previous plans or past doctors

If you are applying not under a company insurance program, wait for your application to get vetted by the insurance company. Depending on the insurance company, and on the thoroughness of the information provided on your application, you can expect to get either accepted or denied from the insurance company in several weeks to several months. If you have any questions about the plan, or contingencies that have cropped up, call the company.

Wait to hear about your enrollment date. If accepted, your insurance company will give you information about your enrollment date, which is the date that you can start using your health care insurance to pay for medical expenses such as doctor visits. The enrollment date can sometimes be several weeks after you get accepted by the insurance company.