Health insurance is a contract between an insurer and an individual or family that provides payment for part of the costs of some or all medical services. Having health insurance usually means that you pay a monthly premium in exchange for being covered by the insurance company in the event of medical need. Most people purchase health insurance through their employer, a state or federal marketplace, an association or community organization, or through a private company. The ultimate goal of health insurance is improved individual and population health, but the contribution of health insurance to this end remains a subject of debate.
The most common way to get health insurance is through an employer’s group plan. About seven out of ten Americans* with employment-based coverage get their health insurance this way. Employers typically pay half or more of the premium, so it’s often cheaper than buying individual health insurance. *Note: Those who have pre-existing conditions can’t be turned down or charged more by health insurance providers when they shop for their own coverage on the national Health Insurance Marketplace or in a state marketplace, although local market competition and cost of living differences impact premiums.
There are also options for people who want to buy individual health insurance outside of the marketplace, but they may be subject to higher premiums because of their age or other factors. Also, some insurers offer supplemental policies that can help cover costs not paid by primary health insurance plans, such as dental and vision care, prescription drug coverage, medical management programs like weight loss or smoking cessation, and travel insurance.
When shopping for health insurance, it’s important to understand the basics of how the industry works. Then you can compare plans, deductibles, copayments and out-of-pocket costs to find the right fit for your specific needs. You should also make sure that your preferred clinicians are in network for any plan you consider.
When choosing a health insurance plan, it’s important to look for an insurer that offers multiple plan types and metal levels, as well as one with a low complaint ratio. Oscar is one of the few insurers that offer all three plan types and metal levels, plus it has a lower complaint rate than most other insurers in our best health insurance rating.