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What is health insurance?

Health insurance is a type of coverage that helps pay for medical expenses, including doctor visits, hospital stays, prescription medications, and preventive care. It acts as a financial safety net, protecting you from high medical costs by covering a portion or all of your healthcare expenses, depending on the plan. With health insurance, you pay premiums (monthly payments) and may also have out-of-pocket costs like copays, deductibles, or coinsurance.

Health insurance is important for almost everyone, providing both financial protection and access to healthcare. Here are some key reasons why you may need health insurance:

  • Unexpected Medical Emergencies: Accidents or sudden illnesses can happen at any time, and without insurance, the cost of emergency care can be overwhelming.

  • Preventive Care: Health insurance often covers routine check-ups, vaccinations, and screenings to help detect and prevent health issues before they become serious.

  • Prescription Medications: Many health plans offer coverage for medications, helping you manage chronic conditions or illnesses without breaking the bank.

  • Financial Protection: Medical bills can pile up quickly, but health insurance helps cover those costs, reducing your out-of-pocket expenses and preventing potential debt.

  • Access to Specialists: Health insurance gives you access to a wide range of specialists and treatments, ensuring you get the care you need for specific conditions.

  • Legal Requirements: In some places, having health insurance is required by law, and not having it may result in penalties.

Having health insurance ensures you’re prepared for life's unexpected health challenges while giving you peace of mind.

Do I need health insurance?
Affordable Choice like major medical but different

The Manhattan Life Affordable Choice Plan and major medical insurance are two distinct types of health coverage with different levels of benefits and structures. Here’s a breakdown of the key differences between them:

Affordable Choice
As Low As $105.92/mo
  • Purpose: Designed as an alternative to traditional major medical insurance, providing a set of fixed benefits for specific medical services.

  • Coverage:

    • Pays a fixed dollar amount per service (e.g., doctor visits, hospital stays, surgeries) rather than covering a percentage of costs like major medical plans.

    • Includes limited benefits for doctor visits, hospitalization, surgical procedures, emergency care, and preventive services.

    • It is not designed to cover comprehensive healthcare needs but can help reduce out-of-pocket expenses for routine services.

  • No Deductibles: There are no deductibles to meet; the plan starts paying fixed amounts immediately when you access services.

  • Premiums: Typically has lower premiums than major medical insurance but also provides less coverage overall.

  • Ideal For: Individuals who are looking for more affordable coverage but are willing to accept limited benefits. It works best for people who may not qualify for major medical plans or want to supplement other insurance.

  • Exclusions: Does not cover certain extensive medical treatments, catastrophic care, or chronic illness management in the same way major medical plans do.

Major Medical
Price Varies Significantly
  • Purpose: Provides broad and comprehensive coverage for a wide range of medical services, protecting individuals from significant medical expenses.

  • Coverage:

    • Covers preventive care, doctor visits, hospitalizations, surgeries, prescription medications, emergency care, mental health services, and more.

    • Typically covers a percentage of costs (e.g., 80/20 plan) after meeting a deductible, which offers more extensive financial protection for both small and major medical events.

    • Includes protection for catastrophic care, ongoing treatments for chronic conditions, and larger expenses like surgeries or long-term hospital stays.

  • Deductibles: Most plans come with deductibles and coinsurance, meaning you must pay a certain amount out of pocket before the insurance covers costs.

  • Premiums: Higher premiums compared to limited-benefit plans like Affordable Choice, but with much broader coverage.

  • Ideal For: People who want comprehensive protection against unexpected medical expenses and require full coverage for both routine and major medical events.

What are the key differences?
  • Coverage Type: Manhattan Life’s Affordable Choice offers limited fixed-dollar payouts for services, while major medical insurance offers percentage-based coverage for a wide range of medical services.

  • Deductibles: Major medical insurance typically has deductibles and coinsurance, whereas Affordable Choice plans do not.

  • Premiums: Affordable Choice plans generally have lower premiums due to the more limited scope of coverage, while major medical insurance premiums are higher but provide much broader protection.

  • Ideal Use: The Affordable Choice Plan is designed for individuals who need basic coverage at a lower cost, while major medical insurance is meant to cover both routine healthcare needs and catastrophic health events.

  • How often do you visit doctors or need medical care?

  • Can you afford higher premiums for more comprehensive coverage?

  • Are you prepared for potential large out-of-pocket expenses with a limited benefit plan like Affordable Choice?

  • Do you want or need a plan that covers routine, preventive care, as well as major medical events?

  • What is your tolerance for risk in terms of unexpected medical costs?

How do you choose?
Key questions to ask:

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