If you live in the United States, you probably know you need to figure out your health insurance each year. It’s November, and that means it’s open enrollment season.
Whether you’re keeping your same plan or making a change, now’s the time to do so. In this post, I’m going to share a little bit about health insurance and what musicians need to know.
Please note that I am not an insurance agent nor a health professional. This is for educational purposes only and should not be used for advice; contact an agent if you need specific help.
Why You Need Health Insurance
You may not think you need health insurance if you’re perfectly healthy. “I can just pay out of pocket for my annual checkup; it’s not that big of a deal,” you say to yourself.
However, you never know when that could change. You could get really sick and need to go to the hospital, or you could develop a condition that requires expensive prescriptions to manage.
What’s more, when healthy people drop their coverage, it makes it even more expensive for those of us who need it. And if you’re self-employed, you’re on your own for insurance, making the cost even higher.
Open enrollment runs from November 1 to December 15 for January 1 coverage. If you go through an employer, their period may vary slightly.
What to Look for in a Health Insurance Plan
A lot goes into choosing a health insurance plan, including:
Individual vs. Family
The first thing to consider is who all will be on your health plan. As a single person, I just need to cover myself, but maybe you have a spouse or kids and need family coverage.
Family plans almost always cost more than those for an individual. After all, you’re covering more people, which generally means higher healthcare costs.
If you or your spouse has a job that offers them health insurance, that might be your best best. But if you’re both self-employed, you may want to visit the ACA Marketplace to select a plan.
Premium
One of the most important considerations is your insurance premium. This is the amount you’ll pay each month to maintain your coverage.
Since I have a day job, I’m fortunate that my employer covers a decent part of the premium. But when I was working fully for myself, I had to cover the entire cost.
In recent years, the ACA Marketplace offered expanded subsidies for people under a certain income level. Those subsidies aren’t going away entirely, but they are set to decrease in 2026.
That means your monthly cost could go up.
Deductible
If you’re fairly healthy, your premium may be all that matters to you. But if you need to use your health insurance at all, you’ll want to know what your deductible is.
That’s the amount of money you have to pay before your insurance kicks in. So with a $5,000 deductible, you have to spend $5,000 on healthcare (excluding premiums) before your plans will help pay.
If you’re chronically ill, it might seem better to go for a lower deductible plan. But that comes with higher premiums, so you should run the numbers to see what would be cheaper for you.
Out of Pocket Maximum
Another number to look at is your out of pocket maximum. For some health plans, this is the same amount as your deductible, so once you hit it, your healthcare is essentially free for the rest of the year.
But other plans, usually those with lower deductibles, have an out of pocket max that’s higher. These plans usually have a coinsurance amount.
So once you hit your deductible, your plan will pay part of your health bills, and you’ll pay the other half.
HSA Eligibility
I’m the first to sing the praises of a health savings account (HSA). It’s an account that allows you to save money for health expenses tax-free.
You can then use those funds to pay for prescriptions, doctors visits, and more. The money will continue to be tax-free as long as you spend it on qualified expenses.
Finally, any money you don’t spend rolls over. And once you hit retirement age, you can use the money for anything. If it’s for non-healthcare expenses, you’ll just pay income tax on those funds.
If you want these benefits, look for a qualified high deductible health plan (QHDHP).
In-Network Providers and Medications
Assuming you already have a doctor you like and/or you take prescriptions, you’ll want to make sure those providers and medications are covered by your health plan.
In theory, most doctors will accept most insurance plans, and most plans will cover common medications. But that’s not always the case.
When I aged out of my parents’ health insurance and went on my own plan, it didn’t cover one of my specialists. I still continued to see that provider, but I had to pay out of pocket, and that money didn’t go towards meeting my deductible.
How to Get Health Insurance
You can obtain health insurance in a few ways, depending on your situation.
The easiest way to get coverage is through a day job, and that’s how I have coverage now. Many employers cover a good chunk of the premiums, which can help you save money.
If you’re married, you might be able to get coverage through your spouse’s employer. Covering both of you will cost more than one person, but it can be still be relatively cheap.
Until you turn 26, you can also stay on your parents’ health plan. Depending on the plan, you may age out on your 26th birthday, at the end of that month, or the end of that year.
When all other options fail, you should look at the ACA marketplace. This is where you can get health insurance if you’re self-employed and don’t qualify for coverage elsewhere.
It’s the most expensive, but it can still be a good choice.
Open Enrollment and Qualifying Life Events
Open enrollment season begins in November for most companies along with the ACA marketplace. This is the annual period where you can enroll or make changes to your health coverage.
However, you may be able to make changes outside of that window if something in your life changes. For example, there was a period of two months between leaving my old job and qualifying for coverage at my current job.
Those months fell outside of open enrollment, but I was able to get temporary coverage on the marketplace.
Other things that might qualify for changes include:
- Getting married or divorced
- Having a child
- Moving
Final Thoughts
Health insurance can be tricky to navigate, especially if you’re on your own for getting coverage. But that doesn’t mean you should ignore it and go without.
You never know when you might get sick or have an accident. I HIGHLY suggest you make room for health coverage in your monthly budget.
As mentioned, though, I’m not an insurance professional. Be sure to speak with an agent if you need help getting the right coverage for you.
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