Key Takeaways
- Take care of your financial-self by looking at the whole picture. When choosing health insurance, be aware of all the costs—not just the monthly premium. Hardship exemptions through the Marketplace are available.
- Don’t leave self-care benefits on the table. If you have employer insurance, explore all of the additional benefits you might not realize are available to you—things like gym memberships, pet and disability insurance coverage, and even the new Student Loan Payment Match.
- For Solopreneurs, it’s worth exploring all of the tax benefits offered through HSA’s and Paid Family Medical Leave, and remember that you can likely deduct your health insurance premiums as a business expense.
Look Beyond Monthly Premiums
Whew! Health insurance is a doozy! We’re all aware that the system is rigged in order to send the profits to the top, and off the back of sick individuals and families, no less. But if we have to play this game, let’s ensure that we’re picking the best options for us! Think beyond premium prices.
Get reacquainted with all the health insurance lingo: Premiums, Deductibles, Co-Insurance, and Maximum Out of Pocket Costs. These are all the ways that insurance companies will take your money–and you want to make sure that you understand just how much that might be.
For example, an Annual Deductible will be what the insurance plan will require you pay beyond your monthly premium price, and then the co-insurance amount will kick in–usually something like requiring you to pay 20% of the cost. The Out-of-Pocket Maximum is the overall price you will be capped paying over the entire year, including Annual Deductible and Co-Insurance. This is usually several thousands of dollars beyond your deductible and will be in clear print when you’re reviewing your options.
In short, health insurance can get expensive, so sift through those details of what may be required of you, as well as any changes that may come up versus last year’s plan. Do not assume everything will stay the same. Identify where you’re going to go for care, and is your favorite provider in-network, and how much do your co-pays at appointments, prescriptions (both generic and brand) actually cost. With that info in hand, you can then weigh the balance of how much you actually attend the doctor, and decide which plan will give you optimum coverage.
Health Insurance Through Your Employer
If you receive health insurance through your employer, this is one of your benefits for working for them and you want to make the best of it by choosing wisely. You’re likely in open enrollment through the end of November!
Don’t sleep on any extra employee benefits! Several companies are offering perks beyond FSA’s & HSA’s (Flexible Spending Accounts & Health Savings Accounts). You may find additional insurance available for yourself such as Life Insurance, or the pets, or (should you get hurt) disability insurance, gym memberships, and additional benefits that make your work at home and/or commute easier and beyond! It’s absolutely worth reading all of the fine print in those boring onboarding manuals.
Be on the lookout for a new type of benefit that will hopefully gain steam in the future, the Student Loan Payment Match. Employers are now allowed to make a matching contribution into a Retirement Savings Account for you, that would match the payment you made on your student loans. This was the direct result of the Secure Act 2.0 in 2022.
Health Insurance through the Marketplace
If you don’t have insurance through work, or you want to search out your own plan, the “Marketplace” (also known as Obama Care) is where you shop for Individual & Family plans here in Washington State that are typically more-affordable than private company plans, since they are often based on income. Open enrollment extends through Jan 15, 2026. Coverage in other states may vary.
One terrible thing of note: if the existing health insurance tax credits go away that are set the expire at the end of this year, the premium costs here in Washington are estimated to increase by up to 65%. This is a sticking point for the current government shutdown and hopefully will be addressed and remedied (fingers crossed!). In the meantime, you can apply for a “hardship” through the Marketplace, if needed and found eligible.
For Solopreneurs in Washington looking for health insurance coverage, you are eligible for the both the Marketplace and Paid Family Medical Leave (if you meet the criteria and take the step to opt-in). You can also choose a High Deductible Plan that will qualify you to open your own HSA. All of these actions level-up your security should you need to take some time away from work. You work for you, and that means you’re responsible for setting up your own sick-time system. Furthermore, you can usually deduct your health insurance premiums as a qualified business expense.
FAQ’s
- Are there any resources to help guide me through finding insurance in The Marketplace?
“Navigators” by County still exist to walk you through your options. There might be a long wait for this service since budgets have been greatly reduced.
- I want to open an HSA but how do I know if my health insurance plan qualifies, and how much money can I put in?
2026 Qualifying High Deductible Health Insurance Plans are those with deductibles over $1700 and HSA contributions are capped at $4400 annually for individuals. HSA’s are another place you can sink money in order to a) lower your annual taxes due, b) invest and grow your money in a tax-free way, and c) save money on all types of medical and staying-healthy costs and facilities (gym’s/yoga studios included!).
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