According to the Centers for Medicare, health insurance protects you from high medical costs in three ways:
After you’ve met your deductible, your costs will be lower. Marketplace plans cover between 60% and 90% of your covered expenses once you’ve met your deductible, depending on your coverage. The rest is paid in coinsurance or copayments, which typically range from $5 to $50 per service
Maximum out-of-pocket. No matter how much covered care you need, the total amount you’ll have to pay each year is limited. If your plan has a $3,000 out-of-pocket maximum, for example, once you’ve paid your $3,000 in deductibles, coinsurance, and copayments, the plan will cover all covered care for the rest of the year. The peace of mind that comes with knowing you’ll never have to pay more than your maximum is invaluable.
There are no yearly or lifetime restrictions. Once you meet your yearly deductible, all health plans in the Affordable Care Act marketplace are required by law to spend as much as they can each year or over your lifetime to cover these essential benefits. It bears repeating that cancer treatment can cost several hundred thousand dollars over several years. Everything must be covered in your strategy.
So it sounds good, but health insurance is still expensive, especially for those who don’t have health insurance through their employer and must purchase it on their own, right?
Certainly not. Most people are unaware that ACA plans are much less expensive than they think. Even for high-earners – a single person earning around $50,000, a family of four earning more than $100,000 – tax breaks are available that can significantly reduce premium costs. Greenfield says, “Famous last words: I can’t afford it.” “The Affordable Care Act and the exchanges it created are a fantastic way for people to get subsidies that make premiums much more affordable.” Those who have lost their jobs and income may be eligible for Medicaid, which will cover their health-care needs if they qualify.