Health Insurance FAQs (2024)

What is health insurance?

Health insurance is a type of insurance coverage that helps pay for the often-expensive costs of medical care—hospital visits, surgeries, emergency room stays, regular checkups, prescription drugs, all kinds of things. Sometimes called medical insurance, health insurance’s main job is to transfer risk from you to the insurance carrier (nice!). This way you don’t end up drowning in medical bills you can’t afford.

Who needs health insurance?

Everyone. If you’re alive on planet Earth, you need some form of health coverage. It’s the best way to protect yourself from the financial problems that can easily happen due to unexpected medical events. No one’s totally immune to serious medical situations. That’s whyhealth coverage is a must.

How much does health insurance cost?

Health insurance costs $7,470 a year for individual coverage and $21,342 for family coverage on average.¹Factors like your location, health conditions, age and gender all affect yourhealth insurance costs—and so does the type of health insurance plan you buy and the family members you cover. The good news is, you can findways to save money on health insurance.

How do I choose the best health insurance plan?

Take your time and compare multiple plans. Your health insurance affects your family, finances and quality of life. That’s a big deal! You need a plan that covers the care you’re most likely to need and fits your budget.

That’s why we recommend working with HealthTrust, a network of independent insurance agents who know the industry, and since they’re local, they know the laws in your state too. They’ll compare quotes and help you understand your options—all at no extra cost to you. Want a RamseyTrusted, vetted agent who’s guaranteed to put you first? Check out HealthTrust!

Why should I get insurance from an independent agent instead of shopping on my own?

The biggest reason is that independent agents are health insurance experts. Even if you’re generally well-informed about health insurance, they’re likely to know more than you—after all, it’s their job.

Independent insurance agents know all sorts of helpful things—like the fact that your state may have just changed its insurance laws. Or that Company A has better customer service than Company B. They’ll also know about discounts and coverage options you may not have heard of. And since they’re independent, they can get you quotes from all the top insurance companies in your area.

The key is finding an agent you trust. We wanted health insurance agents we could trust too—that’s why we recommend Health Trust, a network of licensed independent health insurance agents. We’ve done the legwork of checking them out, and we’re confident they’ll put your family’s needs first—period. Learn more about Health Trust.

How does health insurance work?

You'll pick and sign up for a health plan duringopen enrollment. You'll also sign up any family members who will be on your plan. Then, you'll pay a monthlypremiumto keep your policy active.

When you get health care services, you or your doctor's office willfile a claimwith the insurance company. The claim lets your insurer know how much you owe for the services, and they'll negotiate with your doctor's office to lower the costs. Depending on your plan, you’ll pay most or all costs until you hit your deductible. After that, your coinsurance kicks in—aka when the insurance company starts helping with the bill.

If you join a spouse or parent's health plan, ask them for a copy of the policy so you know exactly what’s covered.

How do you get health insurance?

Trying to figure out how to get health insurance can be super stressful. So many options, so little time. And while you know you need it—you might not know where to start.

That’s why we put together this helpful guide to show you how to get health insurance. You can get health insurance through the following:

• Employer-sponsored group plans
• Government-run marketplace
• Buying directly from health insurance companies
• Online health insurance exchange
• Health cost sharing ministries
• Work with an independent agent, like our RamseyTrusted partner Health Trust

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What and when is open enrollment?

Open enrollmentis the time when you can sign up for new health insurance or change your existing plan. For most plans, it happens in the fall. But some plans—like Medicaid—offer open enrollment year-round. You can also enroll in new or different health insurance any time you have aqualifying life eventlike getting married or changing jobs.

What are premiums?

Apremiumis the amount you pay each month to keep your health insurance policy active.

What are copays?

A copay is like a service charge you pay every time you use a health care service. It’s a fixed amount decided by your particular health insurance plan. Copays are different than deductibles and coinsurance because you pay a copay whether you’ve met your deductible or not.

What is a deductible?

Yourdeductibleis the amount you pay for health care services before your insurance company starts helping you cover some of the costs. Once you hit your deductible, you and your insurance company will start splitting the cost of your covered health care. (That’s called coinsurance.)

What is coinsurance?

Coinsurance is the percentage of health care services you’re responsible for payingafter you’ve hit your deductiblefor the year. With coinsurance, you’re splitting the costof medical services with your health insurance until you reach your out-of-pocket maximum.

What are out-of-pocket maximums?

An out-of-pocket maximum is the most you’ll have to spend on health care costs in a year. If your health expenses go over this amount, then your insurance company will pay 100% of your costs for the rest of the year. (Yay!)

What’s private health insurance?

Private health insurance is any health insurance plan that doesn’t come from the government. You can buy private health insurance through your employer, directly from an insurance company, or through an independent insurance agent.

We recommend working with Health Trust to explore this option. Their network of independent insurance agents can show you the most options from different insurance companies—and they’ll help you pick the one that’s right for you.

What types of private health insurance plans are there?

Some of the most popular private health plans are:

• Health Maintenance Organizations (HMOs) – HMOshelp healthy people stay healthy. And they only pay for doctors listed in your plan.
  
• Preferred Provider Organizations (PPOs) – PPOssave you money when you go to doctors in your network. If you go outside the network, your insurance still payssomeof the costs—just not as many. PPOs charge high premiums, but they can be good for people who need a lot of doctors’ visits.
  
• High-Deductible Health Plans (HDHPs) – With these plans, you have to pay more out of pocket before your insurance kicks in. But you’ll paywaylower premiums. SomeHDHPsalso qualify you to open a Health Savings Account (HSA) where you can save money for health care costs.
  
• Short-Term Health Insurance – This coverage lasts up to 12 months. It’s meant to cover the gap from the time you stop using one health plan until your next plan starts. The downside? Some states don't allow short-term health insurance.
  
• Faith-Based Health Care – Religious nonprofits use these plans to share health care costs among plan members. Everyone pays a monthly fee, and when someone needs health care, everyone helps pay the bill.
  
• Special Needs Coverage – These planshelp cover the extra medical costs that come with certain chronic illnesses or disabilities. (Some government programs, like Medicare and Medicaid, also offer special needs coverage).

What is a high-deductible health plan (HDHP)?

As you probably guessed from the name, a high-deductible health plan has a higherdeductiblethan other health insurance plans. But there’s a significant payoff in the form of lower monthly premiums. HDHPs are a relatively new approach to health coverage, but they’re becoming more popular every year, both as an employee benefit and for the self-employed.

Wait . . . What is an HSA? Is it a type of health insurance?

No. HSA stands forHealth Savings Account, and it’s where you can save money to pay for health expenses. You can't open an HSA unless you a high-deductible health plan (HDHP).

What’s the difference between an HSA and an FSA?

The short answer is, HSAs are better.

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Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs)both let you save money for health care expenses. But even though the F stands forflexible, FSAs are actually way harder to use.

You can only get an FSA from your employer’s health insurance plan . . . so you can’t get one on your own if you’re self-employed or if your workplace doesn’t offer this option. You also can’t invest with your FSA. And if you don’t spend the money you saved before the end of the year, you lose it all.

With an HSA, your savings roll over to the next year, and you can invest them to make them grow. The best part is, you can get an HSA through your employer or on your own, as long as you buy a qualified high-deductible health plan (HDHP) first.

What does private health insurance cover?

It depends. Private health insuranceshouldcover the 10 essential health benefits listed in the Affordable Care Act, like emergency services, prescription drugs and newborn care.²Some states make insurance companies cover additional services. And some companies add their own coverage benefits and limits.

It's important to understand what your plan covers. Our RamseyTrusted partner Health Trust will walk you through your health insurance options so you can feel confident you’re getting the right coverage. And the best part?

Should I get private insurance or Medicare?

Typically, private insurance is better because it gives you the most freedom to choose the best coverage for you. If you qualify for Medicare due to your age, health or income, that may be your most affordable option—just remember that it also comes with lots of limits.

A good independent insurance agent can help you find a plan that gives you the best value on the coverage you need.

What types of government health insurance are there?

There are actually quite a few government health insurance plans. Some of the most common federal plans are Medicare andCOBRA insurance. There are also state-run programs like Medicaid and the Children’s Health Insurance Program (CHIP).

These programs are designed to help people who truly need them and who may not be able to afford private insurance. That said, government programs come with tons of limits and rules . . . so you may not be able to choose the quality of care you get. That’s why we recommend private insurance whenever possible.

What is Obamacare? Is that government health insurance?

No. Obamacare isn't a health care program—it’s a nickname for a law called the Affordable Care Act (ACA). People started calling the law "Obamacare" because it was made during President Obama's administration.

The ACA set guidelines for how private health insurance companies have to cover people. Then, the federal government created the health insurance marketplace, or just marketplace for short. The marketplace is a website that you can use to shop for health insurance plans that meet ACA guidelines. The funny thing is—even though the government runs the website—all the plans being sold on the marketplace are actuallyprivatehealth insurance plans.

Some state governments have made their own marketplaces too—so you can shop for private insurance plans that follow ACA and state guidelines.

What health insurance does Ramsey recommend?

The Ramsey team and Dave Ramsey himself recommend high-deductible health plans (HDHPs) whenever possible. That way, you can enjoy lower monthly premiums, and you'll qualify to open a Health Savings Account (HSA). You can use those savings to cover health expenses and even invest.

That said, if you or your family have special health care needs, you may need to go with another type of plan likea PPOoran HMO. It's smart to work with our RamseyTrusted partner Health Trust so they can help you pick a plan that meets your unique needs.

How do I get health insurance if I’m self-employed?

There are both private and governmenthealth care options for self-employed people. If you need help finding the best option for you, reach out to our RamseyTrusted partner Health Trust. They'll help you actually understand your health insurance options so you can pick the right coverage for you and your family.

How do I get health insurance if I’m unemployed?

Losing a job ishard—especially if you lost your health insurance too. The good news is, you canget health insurance if you’re unemployed. You may qualify for government programs like COBRA or Medicaid, or you may be able to enroll in marketplace or short-term health insurance.

Is there a penalty for being uninsured?

Yes and no. The federal government no longer fines people for not having health insurance. But some states still require it, so you may owe a fee if you’re uninsured.

But the real penalty for being uninsured doesn't come from the government. Sometimes the “penalty” is getting stuck with a stack of medical bills after an unexpected accident or illness. And without insurance to help, it’ll be up to you to cover the costs. That’s why finding health care coverage that works for you is so important.

How do I get health insurance if I’m self-employed?

There are both private and governmenthealth care options for self-employed people. If you need help finding the best option for you, reach out to our RamseyTrusted partner Health Trust. They'll help you actually understand your health insurance options so you can pick the right coverage for you and your family.

How do I get health insurance if I’m unemployed?

Losing a job ishard—especially if you lost your health insurance too. The good news is, you canget health insurance if you’re unemployed. You may qualify for government programs like COBRA or Medicaid, or you may be able to enroll in marketplace or short-term health insurance.

Is there a penalty for being uninsured?

Yes and no. The federal government no longer fines people for not having health insurance. But some states still require it, so you may owe a fee if you’re uninsured.

But the real penalty for being uninsured doesn't come from the government. Sometimes the “penalty” is getting stuck with a stack of medical bills after an unexpected accident or illness. And without insurance to help, it’ll be up to you to cover the costs. That’s why finding health care coverage that works for you is so important.

What is Health Trust Financial?

Health Trust Financial is a network of licensed insurance agents who live and work all over the country. Health Trust is RamseyTrusted because they believe the same thing we do: that getting the right health insurance is an important part of protecting your future. That’s why we trust them to serve our customers!

Learn how Ramsey Solutions helps peopletake control of their finances. Or take a minute to meet our founder,Dave Ramsey.

Are Health Trust pros independent insurance agents or do they work for a specific company?

Independent! They don’t work for a specific insurer or for Ramsey Solutions. They’re independent insurance agents under Health Trust. That means they can compare health insurance quotes from multiple local and national insurers to find you the best coverage.

Why work with Health Trust?

They’re reliable, so they’ll be there when you need them—from shopping for quotes to helping you file claims. And they have the heart of a teacher, so they’ll actually help you understand your health insurance.

Does working with Health Trust cost money?

Nope! You just pay your insurance premium like normal—no catch, no extra costs.

Ready to Get Started?