It’s common knowledge that the U.S. healthcare system is complete chaos.
But the bottom line is Twitch streamers need health insurance.
Now that open enrollment time is among us, it’s the perfect time for streamers to find health insurance.
For many streamers, and self-employed folks in general, this is a gigantic headache.
Are you paying too much, or do you need more coverage? How do you even know??
There are a ton of questions like these that don’t have an easy, one-size-fits-all answer.
But one question is fairly straightforward at least –
“Why do I need health insurance? Can’t I just get by and pay out of pocket until I make enough to afford the best insurance?”
In the short term, yes, not paying for insurance can be less expensive.
But thinking critically about this, if you’re uninsured you’re just one small medical issue away from catastrophe.
For example, say you have to spend ONE night in the hospital…you may come out of that owing upwards of $10k. Even a simple trip to urgent care could cost you a pretty penny while uninsured.
And if you’re paying this out of pocket, it could very well lead to medical debt.
Not to mention the mental wellness impacts –
If you’re uninsured you have the incentive to make health decisions based on financial impact and not on your wellbeing.
Streamers and content creators may not have that hazardous of a work environment, but unfortunately everyone is subject to life’s whims.
So how do you figure out which health insurance policy is the best for you?
Insurance works by “pooling risk”. This means that a pool of insured people (i.e. population) are gathered together and analyzed by an actuary.
This actuary calculates the risk of how often & how much the insurance company will pay in claims by looking at the people it’s covering. The riskier the actuary considers you, the higher your theoretical costs to be in the pool – like if you smoke, don’t exercise regularly, etc. you’re higher risk for health issues.
The resulting calculations determine the various costs you pay for insurance. These are some terms to help you understand your health insurance policy a little better –
- Premium – what you pay to have an insurance policy. This is typically a monthly payment. If cost is the most important factor to you when choosing insurance, this is where you want to focus most.
- Deductible – If you ever have to file a claim, you pay the deductible before your insurance benefits kick in. For example, if you have a $1,000 health insurance deductible, say you accidentally fall and break something and rack up $2,000 of health bills – you would have to pay the first $1,000, and your insurance would cover the remaining $1,000.
- Copayment– a flat dollar amount you’ll pay your primary care provider for a service. Generally, copays won’t count toward your deductible (but this depends on your plan). For example, you could have a $20 copay for visits to primary care physicians (PCP), so if you were to go for a regular checkup you’d owe $20. Copays can also accompany things like ER visits and prescription costs.
- Out-of-Pocket Maximum – the max you’ll pay for covered services during your policy period. This is what helps you avoid some of the catastrophic financial consequences of being uninsured in years where you need a lot of treatment, because you know your set out-of-pocket limit ahead of time. This limit can vary, and has its own limitations of what counts towards it, but typically it’s a factor of the previous 3 things (premiums, deductibles, and copays).
- Coinsurance – percentage of costs you pay each year toward covered health services. For example, if your plan has a 20% coinsurance payment, and you’re charged $1,000 for services, the insurance company will cover 80% ($800) of the total. This means you’re responsible for 20% ($200) of it, at least until you meet your deductible.
Types of Health Insurance Plans
The various parts of a policy also differ by which type of plan you have. The most common types are either HMO or PPO:
- Health Maintenance Organization (HMO) – get access to providers at a reduced rate. However, you only get access to those providers. So if you go out of network for some reason, you get no coverage. HMOs also generally require you to have a designated PCP who is responsible for dictating most of your care. This means if you want to go to a specialist you need a referral from your PCP. These restrictions make them less expensive than PPOs.
- Preferred Provider Organization (PPO) – similar network of preferred providers, but you’ll still have some coverage if you go out of network. These tend to be more costly because of the greater flexibility.
You have to weigh the trade-offs between flexibility of coverage vs. cost. If you really like your doctor, you may want to spend a little more to have access to them.
Where can streamers find health insurance policies to start comparing them?
If you’re a full-time streamer, you’re likely self-employed and don’t have an employer-sponsored insurance plan to fall back on. But if you’re married and your spouse works, you might be in luck!
If you’re a part-time streamer and still have a full-time gig, you might also be able to take advantage of an employer-sponsored health plan.
This will be the easiest and likely the least expensive route.
If you don’t have this option available, consider these options:
Federal or State Marketplace
The federal government’s Health Insurance Marketplace was created by the Affordable Care Act in 2010, and is a central hub for non-employer-sponsored insurance plans.
This can be found at healthcare.gov.
Each state features one official health insurance exchange for its residents – and in most states, the healthcare.gov site fills this role. But if your state operates on a separate platform, you can also find the list on the federal website too.
Open enrollment begins each year on November 1, and goes through January 15, 2023 for most of the country.
There are other federal programs for more specific applicants like:
- Medicaid – needs-based assistance through the government. This can be a good option for qualifying new full-time streamers seeking health insurance, because participation is based largely on income. You can explore eligibility through healthcare.gov here as well.
- Medicare – primarily for U.S. adults ages 65 and older. There aren’t many streamers in this bucket, but they are out there! Check out medicare.gov for more info and qualifications.
- Military Programs – TRICARE is the healthcare program for military service member and their families offered by the government. If you’re a current or former military member, you can go to the milConnect website to check eligibility and plan options. Veterans can also apply to enroll in VA coverage programs year-round.
Additional Sources
If you want to explore all the possibilities, there are other ways you can source health insurance plans:
- Membership organizations – group plans through professional or trade organizations offer group plans. Other membership organizations like AARP, colleges & universities.
- COBRA – if you left a job with health insurance to stream full-time, COBRA may help. You might be eligible to continue that coverage for up to 18 months after it would have lapsed. It’s definitely expensive, but can help in these situations where you’re transitioning to self-employment.
- Talk to an agent or broker – these are professional insurance agents & brokers who can find plans for you. This is definitely a helpful option, but do your due diligence beforehand. There’s an old saying – “Don’t ask an insurance salesman how much insurance you need.” They tend to work on commissions, which means the more they sell you the more they earn.
Final Considerations
Company reputation
If you’re debating between two similar-priced plans, you may want to consider some of the qualitative factors:
Are customers reviews good, bad, or meh?
Do they answer the phone to help you, or will you be on hold all day?
Is the claims payment process quick?
Health Savings Account (HSA)
If you go with a high deductible health plan (HDHP), you can also open an HSA.
Hint: This is one of the best tax benefits the government has created.
A high deductible is considered to be $1,400 for one person or $2,800 for a family in 2022.
And cool note: HSAs are the only place where you can get a triple tax break.
This means that the money you put in is pre-tax, you can invest it like you would a 401(k), and the growth & money you take out also isn’t taxed (as long as you use it for healthcare expenses, are over 65, or are disabled).
Pretty incredible, and a great way to save for potential future medical costs.
How 1Up Can Help You
This process is severely overwhelming to most people, if not everyone.
I personally don’t know anyone who is 100% satisfied with their insurance coverage, but there are a select few who can get pretty close.
If you feel uneasy going through this whole thing alone, I’m here to help streamers find the best health insurance policies.
Let me clarify, neither me nor the 1Up Financial Advisors sells insurance. But we do help you source the right plans and analyze them based on your needs to determine…
- Which types of insurance are right for you (health, life, disability, etc.)
- How much coverage you need, and
- Weigh all these trade-offs we talked about to find the right price for you.
We can also help you explore the taxes & benefits you get from paying for your own insurance.
1Up is a fee-only financial planning firm, so we don’t make commissions off of any service we provide to you or by any professionals we work with.
So you can rest assured that we work with a fiduciary responsibility to you and always put your best interests first.
If you have any questions on getting started finding the right health insurance policy for you as a streamer, grab a time to chat here for a free consultation call!
