You have a lot of expenses as a professional musician. One that’s easy to forget is health care, but health insurance for musicians is vital.
Keep reading to learn why it matters and what your options are. That way, you can get the care you need for you and your family.
Disclosure: I’m not an insurance professional. This is for informational purposes only. Please contact an insurance agent near you for more.
Overview of Health Insurance for Musicians
If you live in the United States, it’s up to you to find health insurance coverage. And sadly, you have to repeat this process every year.
Obtaining health insurance can help you pay for any expected or unexpected medical costs. Health insurance can help cover preventive visits, prescriptions, hospital stays, and more.
You’ve probably had health insurance for most of your life. As a child, your parents should have added you to their policy.
But as an adult, you have to figure out which health insurance plan to choose and where to get it. There are many things to consider, which will explore in this post.
Health Insurance for Musicians: Your Options
You can find health insurance for musicians from a few different places. Consider the following options during this enrollment period.
Employer-Sponsored Health Insurance
One of the most popular options for getting health insurance is through an employer. Until I was 26, I had this type of coverage through my mom.
This year, I’ll be getting this type of coverage again but through my own job. You can also obtain employer-sponsored coverage through a spouse’s job.
Health insurance through an employer can be much more affordable than other options. Depending on your company, you may have pretty good coverage as well as multiple plan options.
The employer may cover anywhere from half to almost all of the cost of the health insurance. That can be a nice option if you have access to it, but not all musicians do.
ACA Marketplace
The Affordable Care Act (ACA) set up a health insurance marketplace. This is one of the best places to shop for coverage if you’re self-employed.
Some states have their own marketplaces, but people in most states can enroll through the general marketplace.
You can enter things like your expected income to see if you qualify for subsidies. Now, if you’re eligible for health insurance through a job, you won’t qualify for subsidies.
However, if you do qualify, you can save a decent amount on your health insurance premium. That can make health insurance for musicians more affordable.
University Alumni Association
Both the university I attended for undergrad as well as the one for grad school offer health insurance for alumni. I could apply through a page on the university website to potentially get a lower rate.
Be sure to look at the websites of any colleges you’ve attended. Consider if you’d qualify for their group discounts on health insurance.
You may not have as many options as you would on the general ACA marketplace. But the options available could be closer to your price range.
Musicians Union or Professional Association
Another way you could get health insurance is through a musicians union or professional association. Some groups offer group health insurance coverage for their members.
Be sure to consider where you live and join the local union for their options. You can also look into other organizations that help local musicians, such as the Health Alliance for Austin Musicians.
Depending on the instrument you play or the type of music-related work you do, you may also qualify for a group plan. There may be more options for some musicians than others, but it’s worth considering either way.
Health Ministry
A less traditional option you can look into is joining a health ministry. This options tends to be best for healthy individuals as it’s not true health insurance.
You and the other members pool your money into one large account. If a member gets sick or needs help paying for medical care, they can take money from the larger pool.
For that reason, I would recommend this as a last resort. You won’t get the same benefits of cost-sharing that you would with a typical health insurance plan, but it may work for you if you have no health concerns.
Medicaid
Another last-ditch option you may need at some point is to go on Medicaid. The income limits are quite low, so this option is only available to people who are either unemployed or not making very much.
Still, the coverage can be more affordable than other plans. If you do qualify, you may be able to get the care you need without using up what little income you have.
Of course, the goal is to make enough to not qualify for Medicaid. But it’s good to know it’s there if you should ever need it.
How to Choose Health Insurance
Now that you know your options, you need to narrow them down to what works for you. Here are some of my tips for choosing a health insurance plan.
Understand the Terminology
First, it’s important to know what different things mean in relation to health insurance. You’ll come across the following terms:
- Premium: the monthly cost for your health insurance payment
- Deductible: the amount of money you have to spend before your health insurance kicks in
- Out-of-pocket maximum: the maximum amount of money you’ll spend on health care in a given year
- Copayment (copay): the amount of money you spend on covered services before meeting your deductible
- In-network: a doctor or facility that contracts with your health plan to save you money
- Out-of-network: a doctor or facility that doesn’t contract with your health plan, thus costing you more
With that, we can get into more tips for choosing between your options.
Start With the Listed Costs
When comparing health insurance plans, consider the listed costs of each plan. This will include things like the premium, deductible, and out-of-pocket maximum.
At the least, you’ll spend the value of the premium on health care each month. And at most, you’ll spend 12 months of premium payments plus the out-of-pocket maximum in a year.
Calculating these values can give you a range of what you can expect to spend on health care. If you don’t have a lot of money, you may want to go with a cheaper plan.
Calculate the Overall Cost
Another thing I’d recommend is calculating how much you can expect to spend based on your specific situation. I did this when searching for health insurance on the marketplace a couple of years ago.
Take a look at the premium and out-of-pocket maximum. Then, think about how many prescriptions you take and about how much those cost.
Consider how many times you visit a doctor or specialist in a given year, especially if any of them don’t accept your insurance. This can give you a better estimate of which plan is the most affordable for you.
Note: the plan with the cheapest premium may not cost the least for everyone.
Check the Network
Next, you’ll want to look at the plan’s network of doctors and facilities. When I was shopping for my own health insurance, I wanted a plan that my primary care provider would accept.
For better or worse, neither of the two specialists I was seeing accepted the plan I chose. However, I only visited them once or twice a year, and paying out of pocket wasn’t too expensive.
But if you’re tight on cash, you may want to choose a plan that your doctors will take. Or you may need to look for new doctors that take your new plan.
Compare Plan Types
You may also want to look into different types of health insurance plans. First, you have plans based on different metals, such as bronze, silver, and gold.
Gold plans cover more of your health care, but their premiums are higher than bronze and silver plans. If you have more health issues, though, paying for a gold plan can be worth it.
Other plan types include:
- Exclusive provider organizations (EPOs)
- Preferred provider organizations (PPOs)
- Health maintenance organiations (HMOs)
With an EPO, you have to stay in the network to get things covered by your plan. The only thing covered outside of the network is emergency care.
A PPO has a larger network and will cover some costs of your care out of network. But it also comes with a higher premium than an EPO.
Meanwhile, an HMO requires you to choose a primary care provider (PCP). Then, you’ll need a referral from your PCP to see any type of specialist.
Don’t Forget Your Dependents
If you’re married or have kids under 26 years old, you can add them to your health insurance. Now, this can add to the cost of the plan you choose.
You can add dependents to almost any plan, be it through your employer or the marketplace. Of course, if you have dependents, you need to consider their health needs.
If you’re married with kids, you and your spouse should decide which plan to add your kids to. Assuming you both have job-based insurance, one of you may have a plan that will suit your kids better.
Consider an HSA
A health savings account (HSA) is an account you can contribute money to before taxes. To contribute to one, you need to have a high-deductible health plan (HDHP).
You’ll be able to put money into the account each month to put towards your health expenses. As long as you use them for that, you won’t owe taxes on what you withdraw.
You can even start to invest your money once your balance reaches a certain amount. That can make it work like a secondary retirement account.
Unfortunately, plans have strict requirements to qualify for HSA contributions. Luckily, you can keep your account open if you ever switch plans; you just can’t add money to it.
How Much Does Health Insurance Cost?
Health insurance could cost as little as $0, such as if you have a job that covers everything. However, your plan could also cost upwards of $1,000 a month.
This scenario is most likely if you’re self-employed and have a spouse and kids. Most of the time, you’ll pay somewhere in the middle for your health insurance.
Can You Go Without Health Insurance?
Health insurance is expensive, so you may not want to pay for it. While the ACA did put in place a mandate, that fee was dropped to $0, so there’s no penalty for not having it.
However, I wouldn’t recommend foregoing health insurance. Even if you’re healthy, you never know what can happen or when you may need it in an emergency.
Health Insurance for Musicians: In Review
Health insurance for musicians can seem scary. But it’s one of the most important things you can spend your money on.
Be sure to consider your options so that you can choose the best possible plan to meet your needs this year!
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