Jose-Andres Alegria Why are there so many things in adulthood I feel so ill-prepared for when they blindside me? It makes you question why I had to learn the Pythagorean theorem in high school instead of learning to pay my taxes or buying health insurance for the first time. It might just be the zillennial in me that feels entitled to all of life’s answers, but someone dropped the ball when it came to preparing our generation for adulthood. There I go sounding like a whiny baby blaming others when I have all the information I could need on my phone, but it does feel a bit overwhelming at times, having to know all of these essential life tasks that you can’t mess up or something terrible will happen. (Again, I’m talking about taxes. Stupid IRS)
What to know when buying health insurance for the first time
1. Where are you getting your insurance?
No, I don’t mean what company is providing your health insurance, but you have to figure out which of the three main avenues you will be looking through to find your insurance. Think of it as three separate marketplaces that all sell the same thing but are slightly different.
- Employer – Most companies offer health insurance to full-time employees. Ask HR for any information they have on options to set up your health insurance through them.
- Government – Check out your state’s public marketplace if available, or the federal government offers insurance as well. (Here’s the link, so you don’t have to go hunting for it.)
- Private – This option doesn’t offer income-based discounts on your monthly premium, so it is the priciest option out of the three, but if you don’t have any luck with the other options, it won’t hurt to check this one out.
2. Different Types of Insurance Plans
Just like everything else in adulthood, people made basic healthcare more complicated than it has to be. There are different types of health care plans out there, all with their pros and cons. I’ll try my best to simplify it. There are two things to keep in mind when choosing an insurance plan. Do you need to stay in your insurance company’s network to get coverage? And do procedures and specialists require a referral?
| Plan type | Stay In-Network | Referral | Basic Breakdown |
| PPO: Preferred Provider Organization | No, but staying in-network costs less. | No | You get more options in who is providing your care but your out-of pocket costs are higher |
| EPO: Exclusive Provider Organization | Yes, except for emergencies. | No | You don’t have much say in who is providing your care but your out-of-pocket costs are lower with the added benefit of no referrals needed. |
| POS: Point of Service Plan | No, but staying in-network costs less. | Yes | You have more options in who is providing your care but you will have a primary doctor who is in charge of your care. |
| HMO: Health Maintenance Organization | Yes, except for emergencies. | Yes | You pay less for services out-of-pocket, but you have a primary doctor who is in charge of your care. |
When it comes to choosing an insurance plan, it’s all about figuring out what suits you best. I hate having to get referrals. I get injured so often that I know what is usually wrong and would prefer to skip that step entirely. Maybe you would rather let your primary doctor handle all the nonsense and tell you what is probably best for you so that they can come up with a game plan to help you. But, again, it’s all about knowing your needs and picking the plan that fits them best.
3. Benefits
Different insurance providers offer various benefits. It seems obvious enough, but it’s something really important to watch out for first-time buyers. For example, I am currently still on my mom’s health insurance. (Thank you, Obama!) But when the time comes and I need to get my insurance, I need to keep in mind a few things. For example, what will they charge me for my Adderall prescription? How much will physical therapy cost me out-of-pocket? (As I said, I get injured a lot.) There are few other things, but I don’t think you want to hear about my extensive medical history.
Don’t Get Overwhelmed.
Being an adult is overwhelming at times, but I prefer this over being back in high school. Some days are hard, and some are easy, but as long as you do your best to stay informed, it can be a little less overwhelming. Buying health insurance for the first time is a big milestone in adulthood, or that’s what I tell myself. So take a deep breath, relax, and take the milestones one step at a time. If you have any more questions about health insurance, feel free to drop a comment down below.
And if you have questions on renter’s insurance, then we got you covered.
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