ACA health insurance or fixed indemnity plan? Co-pay? Premium? Co-insurance?

Health insurance is complex and confusing. Here are nine mistakes to avoid when you’re looking for a health insurance plan for yourself and your family.

Mistake 1: Not buying health insurance

Even though there is no longer a tax penalty for going without health insurance, don’t make the mistake of thinking that because you’re young and healthy, you don’t need health insurance.

For instance, a broken leg can cost up to $7,500, and the average cost of a three-day hospital stay is around $30,000, according to, the federal government’s website. We hate to even mention the “C” word, although comprehensive care for it can run into hundreds of thousands of dollars.

Unfortunately, none of us knows when we’ll get sick or have some kind of accident that will require expensive medical treatment. When that happens, it’s too late to start looking for health insurance.

Mistake 2: Not shopping around

You have choice when it comes to health care. There are ACA or Marketplace plans, also known as Obamacare plans. If you’re covered by Medicare, you can buy supplementary coverage for the things that Medicare does not pay.

You could also consider healthcare sharing plans that are offered by healthcare sharing ministries, rather than traditional insurance companies. Also known as faith-based health plans, they share the medical expenses among members who have common ethical or religious beliefs. Their monthly costs are generally lower than insurance premiums, but they may not cover all procedures.

If you only need health insurance coverage for a short time, you could look at short term health insurance. For example, this could be you when you’re starting a new job and the employer’s health insurance coverage does not start for the first three months, or students who are aging out of their parents’ coverage between open enrollment periods.

Mistake 3: Forgetting that your needs change over time

Your health care needs will change as you get older, and therefore, so will your health insurance needs.

Generally speaking, older people need more health care and prescription medication than younger people (although there are many young people with particular, extensive health care needs).

Major life events, such as having children, changing jobs, and just plain getting older, will also change your health insurance needs.

When you shop around, consider your needs and circumstances. With every life event, take some time to review your health care and insurance needs now and in the foreseeable future.

Mistake 4: Picking the lowest premiums

Insurance is similar to many other products and services: the cheapest option may not be the best for you. In fact, the lowest monthly premiums could cost you more.

The lower the monthly premium, the higher the deductible, co-pays and co-insurance, generally. Also, the coverage limits will be lower. In short, when you need health care, a plan with a lower monthly premium could leave you with thousands of dollars more in medical expenses that you will have to pay out of your own pocket.

When shopping around, look closely at the premium, coverage limit, co-pay and co-insurance rates. Consider what your bottom line will be for the medical services you will most likely need, but don’t forget about the things that you cannot predict.

Mistake 6: Missing the open enrollment period

The Affordable Care Act has a three-month open enrollment period. Usually lasting from early November through the end of January, this is the time during which you can buy health insurance from the government-run ACA marketplace. If you miss this period, you may have to wait, uninsured, for up to nine months.

Mistake 7: Confusing preventative and diagnostic care

While the ACA provides preventative care at affordable costs, diagnostic care is considered different, and the insurance plans treat it differently, too.

For example, a visit to the doctor’s office is conserved preventative care, and under some plans there is no co-payment or other charge. However, if your doctor sends you for tests and prescribes medication, that’s considered diagnostic care, and they may not all be covered.

Review plans carefully and make sure that you understand the coverage, limits, co-pays and co-insurance before you decide on the plan for you and your family.

Mistake 8: Ignoring the health care network

Your health plan may have a network, which is a list of preferred providers of health services. Going outside the network may mean that you will pay 100 percent of their fees out of your own pocket.

Before you go for specialized services or tests, review the providers that are “in-network” so that you get the maximum value from your health insurance plan.

Mistake 9: Not seeking advice

Health insurance is complicated. It can be confusing and difficult to find the insurance plan that fits your needs, state of health, financial circumstances and life stage. That’s why we’re here: to help you choose the plan that’s best for you.

Give us a call at any time for a no-obligation quote: 1-888-987-6593.