Four alternatives to traditional health insurance
While there are many advantages to choosing a traditional health insurance plan in the US, there are also disadvantages. These are primarily costs that only some have the means to cover. Luckily, there are also some alternatives that might be better suited to your needs and finances. Here’s a guide to the four best traditional health insurance alternatives.
Traditional healthcare options in the US
When choosing the right health insurance, there are many things to consider.
One of the most pressing worries is usually affordability – America’s healthcare system is expensive, and private plans are still the primary way of covering healthcare bills.
Private healthcare options like HMOs (Health Maintenance Organizations) and PPOs (Preferred Provider Organizations) offer more choice and coverage than non-private plans, including shorter waiting times and more specialized treatment options, but these things come at a cost.
HMOs and PPOs are therefore not viable options for people on lower incomes.
Instead, state-funded options like Medicaid and Medicare exist to provide aid for some services and health plans.
Medicare covers costs for people 65 and over and younger people with disabilities or illnesses like ALS (Amyotrophic Lateral Sclerosis).
It helps a lot but can be challenging to budget for, because you’re charged based on the amount of medical care you end up needing.
Medicaid is probably the best of the sponsored state and federal options, especially now that 39 states have expanded the parameters regarding who is eligible for Medicaid.
It guarantees financial protection for a wide range of care costs, although not all emergencies or surgeries are covered.
There’s also the Children’s Health Insurance Program (CHIP), which provides medical coverage to children whose families earn too much to be eligible for Medicaid but not enough to pay for private health insurance.
CHIP covers doctor visits, dental care, vision care, prescriptions, and more.
Each of these healthcare options is fully explored in our complete guide to US healthcare.
Although these options cover most bases, they don’t suit everyone’s needs.
Certain alternatives to health insurance might be better placed to help you cut down on your expenses while still getting adequate care.
Alternatives to traditional health insurance
One in every ten Americans doesn’t have any health insurance coverage, despite how essential it is to be covered if you want proper medical care.
When surveyed, most say that their reasons for not having health insurance are financial, which is understandable when the average monthly cost of health insurance, as of 2022, is $541 per month (a 1 per cent increase from 2021).
For higher earners, $541 a month might be manageable. But it becomes more difficult to manage when it’s a massive chunk of a person’s total salary.
If you fall into this category and want to explore your other options, here are four alternative medical insurance plans to consider:
Primary care membership
A primary care membership is like any other subscription service. You pay a monthly fee to an independent physician, and they agree to provide you with specific medical services.
Those medical services are basic but necessary, given how expensive the average doctor’s appointment is.
You also have a choice of your primary care physician and have access to almost an unlimited number of visits. And procedures like blood tests are covered.
On the downside, a primary care membership doesn’t cover costs for any surgeries you might need or any hospitalizations you might experience. (If, for example, you frequently need to visit the hospital, this might not be the best plan for you.)
Plus, memberships differ quite widely – just because certain expenses are covered under one plan doesn’t mean they are under another.
Cost-sharing programs are a great initiative in which a group of individuals pays into a fund that then pays for the medical bills of all the group’s members.
When a medical problem arises, you can get your bills reimbursed through the fund. The monthly premiums in a cost-sharing program are much lower than in a traditional plan, and these programs frequently agree on discounts with hospitals and doctors.
That said, families can still end up paying as much as $1,000 monthly, and there is also an unshared portion that all members must pay.
Plus, many cost-sharing plans are religious or faith-based, so if you’re not open to this, you may prefer to steer clear.
Discount cards offer reductions on medical treatments and prescriptions that are larger than they would be in other plans.
They frequently enable you to save up to 80 per cent on healthcare, which can be used towards costs not covered by whatever healthcare plan you have. Generally, they only cost $10–20 per month.
Discount cards don’t cover primary care costs, so you ideally still need a primary health plan in place.
Plus, you can only get discounts from a care provider if they’re within your specific plan’s network.
If you decide to look into getting a discount card, watch out for scams and make sure the card is legitimate before committing to a purchase.
Health Savings Account (HSA)
If you’re enrolled in a High-Deductible Health Plan (HDHP), you have access to a Health Savings Account (HSA).
The HSA is a personal savings account that you can use to cover medical costs. If you pay in cash or with a credit card, you can reimburse yourself from your HSA funds, tax-free.
This means that if you make contributions with after-tax dollars, you can deduct the money from your income on your tax return. Therefore, your yearly tax bill will be lessened.
However, because the tax deductibles are expensive and need to be paid before they can be reimbursed, it can be tough to meet the financial requirements for a costly medical procedure.
An HSA is the closest option to a traditional health insurance plan – definitely not cheap – but it’s still more affordable, comparatively, month-on-month.
Kate has written for leading publications and blue chip companies over the last 20 years.