Insurance Coverage for Our Family

Minimum Or Maximum Health Insurance: How To Decide

3 April 2018

Christian Byrd

Under the Affordable Care Act (ACA), the law requires that you have a minimum health insurance or face a penalty. The question is: what difference does it make whether you go for minimum or maximum coverage? What do you lose by going for minimum coverage and what do you stand to gain by opting for maximum coverage?

Minimum Insurance

Minimum insurance allows you to operate within the law. It offers the advantage of low premiums and a low out of pocket maximum.

Minimum coverage under the ACA also covers a wide range of benefits and admission is easy as it is not based on your health history. You also benefit from free preventative care and three primary care visits per year. On the downside, deductibles under ACA can be quite high.

Minimum insurance coverage, whether under ACA, your employer or a private insurer is ideal for people who have few medical issues. Under ACA, you have to be younger than 30 years of age, unless you are eligible for exemption.

Before you settle for minimum coverage, call your doctor in advance to find out if they are included in the plan's network. If you ever need to visit a doctor out of the network, you'll end up paying more, and it may not be worth it going for minimum coverage. If you are having financial difficulties and are on a tight budget, this is an option you want to consider; but only if you currently have no major health issues.

Maximum Coverage

Like most people, you may imagine that getting maximum coverage equals getting the best medical care. This is not necessarily so. Before you take this option, consider your health needs. Going for maximum coverage makes sense if at least one person on your plan is coping with a chronic condition. If you will need to visit a specialist often or take a lot of medications, definitely consider the more comprehensive plan.

Maximum insurance means high premiums. Unless you are chronically ill, you will be paying for what you don't need and subsidizing health care for other people with chronic health issues. Also, the premiums are likely to go up over time. The key to getting the right health insurance lies in focusing on your needs. Consider how much health care you'll require. If you are experiencing a chronic condition, maximum coverage may work for you.

If you are young and fairly healthy, you don't need maximum coverage but are welcome to get it anyway. Either way, make sure you choose a plan that includes your doctor in its network. Check out a website like http://continsurance.com/ for more information and assistance. 

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