Your health insurance questions answered with PolicyGenius and Fiverr

Colin Lalley 1600


Colin Lalley

Colin Lalley

Insurance Expert

Colin Lalley is the Associate Director of SEO Content at Policygenius in New York City. His writing on insurance and personal finance has appeared on Betterment, Inc, Credit Sesame, and the Council for Disability Awareness.

Published January 20, 2017|7 min read

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Update: We’ve got good news and bad news. The good news is that our #HealthcareHustle Twitter chat with Fiverr was a hit, and we answered a lot of health insurance questions not just for freelancers but for anyone who is shopping for health insurance on their own.

The bad news is that the Twitter chat is over.

But more good news! Here are the questions asked during the chat, along with our answers. We cleaned up the Twitter grammar a bit, but don’t worry – we kept the gifs.

How important is it that my doctors are in my network?

If you like your doctor, look for a plan where he/she is included. This is especially important if you have a must-see specialist. But keep in mind that doctors drop insurers (and vice versa) often, so if you’re banking on a specific doctor being covered, you might be disappointed six months down the line. Be careful making doctor coverage one of your must-have health insurance considerations.

Also keep in mind that your doctor’s coverage can vary not just by insurer but by individual plan. Check to make sure they accept your specific plan before you commit if it’s high on your list.

Finally, make sure you know what kind of plan you have. An HMO will require you to get permission to see specialists, while EPOs and PPOs are more flexible as to which doctors and specialists (in and outside of your network) you can see.

How much should I be paying for health insurance?

The average person spends 5% of their income on health insurance premiums. This puts you in the range of a silver plan but still allows some flexibility in your budget for out-of-pocket expenses like deductibles and copays.

Your deductible and premium work like a seesaw. When one goes up, the other goes down. If you’re looking to play with how much you’ll pay each month, pull the lever on one of these and see what it does to your monthly costs.

If you have a high-deductible plan, you can also offset some of your costs with a health savings plan (HSA). This allows you to put money aside pre-tax and use it on healthcare costs – meaning you save on your tax bill while paying for the things you would’ve paid for anyway.

Didn’t understand things like "deductible" or "copay"? You’re not alone. A survey we ran late last year saw that only 4% of Americans could correctly define deductible, copay, coinsurance, and out-of-pocket maximum. Those are all terms that directly affect how much you pay for health insurance – so they’re all terms you should know.

Can I really get a subsidy?

There are two subsidy types: An advance premium tax credit, which you can receive as part of your tax return or have it applied monthly to help pay for your premiums, and cost-sharing reductions that help you cover out-of-pocket costs. According to, 81% of Open Enrollment shoppers will receive an advance premium tax credit.

You’re eligible for a subsidy if you make between 100-400% of the federal poverty line – but the subsidy isn’t automatically applied. You have to note on your application that you’re eligible, so don’t overlook that important step!

What should I look for in a health insurance plan?

First consider your in-network doctors, the premium and deductible amounts, and your prescription drug coverage. Create a "must-haves" and "nice-to-haves" list so you can compare plans based on what you know you need, and what you’re willing to compromise on. This will also allow you to compare similar plans and avoid paying less but unknowingly get less coverage, too.

Every health insurance plan comes with ten essential benefits. Those are things you can know you’ll have coverage for, so choose your plan with that in mind.

If you’re under 30 years old, look into catastrophic plans. They’re high-deductible plans, so you’ll pay less each month in premiums; if you’re healthy and don’t (and don’t plan to) go to the doctor frequently, it can help save you money.

Why do I need to buy health insurance?

Medical bills are linked to 60% of personal bankruptcies. Paying for health insurance now can save you from financial hardship in the long run. Especially if you’re a freelancer and aren’t an LLC, you need health insurance to protect your personal and business assets.

Then, of course, there’s just general wellness. Regular preventative care now means that potential health issues are spotted sooner before they worsen (and treatment gets even more expensive). You’ll be setting yourself up for a health future.

What’s the difference between between my premium and my deductible?

Your premium is the up-front cost - what you pay monthly to have health insurance. Your deductible is what you pay to use your insurance until your coverage kicks in. So you might pay $75 a month to have health insurance, but you’ll still have to cover, say, $5,000 of expenses before your insurer starts paying. That $5,000 is your deductible. If you’re self-employed, you may be able to deduct your premiums.

If you go to the doctor often, it may be worth having a low-deductible plan. You’ll pay more each month, but you’ll hit your deductible faster and your insurance will kick in sooner, which could end up saving you money in the long run.

Will I have coverage throughout the year regardless of a potential Trump ACA repeal?

Yes. There are a lot of Obamacare replacement plans floating around. No one knows what’s going to happen with it.

But you still need to shop this year. If you don’t, you’re subject to the individual mandate penalty. And regardless of what happens with the Trump administration, if you buy now you’re set for 2017. Your coverage won’t be taken away, and you, your family, and your assets will be protected.

What do I need to know about non-coverage penalties?

Your last day to get covered for 2017 is January 31, unless you qualify for a special enrollment period. You may also qualify for a special enrollment period if your coverage changes mid-year (like you quit your job and lose your employer-provided coverage.

If you aren’t covered, you’ll pay a fine of $695 ($347.50 for minors) or 2.5% of your household income, whichever is higher. That means regardless of whether or not you have coverage, you’re paying – but only one of those will actually protect you from medical bills.

Remember, the deadline to buy health insurance is right around the corner! Still have questions? Feel free to reach out and ask any of our experts.

The original call for questions is below.What’s that, super Doer? You haven’t bought health insurance for 2017 yet?

I get it. You’re busy collecting invoices and finding new clients and, oh yeah, actually doing the work you’re getting paid for. In other words, you’ve got things to do.

But getting health insurance is important. Really important – and not just for freelancers, but for everyone. Is it because medical bills have been cited as the leading cause of personal bankruptcies? Is it because you’ll be paying the higher of $695 or 2.5% of your annual household income thanks to the legally-mandated tax penalty if you don’t have health insurance? Is it because, if you’re sick or hospitalized, you shouldn’t have to worry about how you’re going to pay for medical care? Is it because the deadline for Open Enrollment is coming up fast, and after January 31, unless you have any special enrollment period authorizations, you’ll be locked out of health insurance options for the rest of the year?

Yes. Yes, it’s because of all of those things.

Whether you’re your own boss or punch the clock at an office, you need health insurance. You just might not know how to get it. That’s where Fiverr and PolicyGenius come in. Join us Wednesday January 25th at 2pm EST/11am PST as we take your questions live on Twitter and help you navigate the ins and outs of health insurance.

Ask your health insurance questions

So how does this work? It’s pretty straightforward.

Your job: Ask whatever health insurance questions are on your mind!

Follow the PolicyGenius and Fiverr Twitter accounts, use the hashtag #HealthcareHustle, and let us know what’s got you tripped up when it comes to shopping for health insurance.

If you need to spark some ideas for questions to ask, we’ve already got resources ready for you. Dig into our Open Enrollment guide, learn the basics of freelancer health insurance, or find out what popular personal finance bloggers think about the health insurance shopping experience.

That way, when Wednesday rolls around (or start asking today! We’re not your mom, do what you want!) you’ll be prepared with better questions than, "But what really is health insurance?"

Our job: The insurance experts at PolicyGenius, led by CEO and co-founder Jennifer Fitzgerald, will tackle your questions so you get the advice you need in a way that makes sense to you.

We’ve built a health insurance marketplace from the ground up, so we know the pain points of shoppers like you. We’ve made health insurance as easy to understand as is scientifically possible, and we’re bringing that expertise to Twitter.