Health Care on Your Own

Josh Jackson learned firsthand why it's important to have insurance and a trusted doctor—even when you're young and the picture of good health.

At the age of 25, Mr. Jackson battled a bad stomach ache for two days before going to the hospital. He was diagnosed with appendicitis and later suffered a near-fatal infection.

Mr. Jackson says he regrets not having a family physician to guide him through the crisis. But he's grateful he had a catastrophic health-insurance policy that covered tens of thousands of dollars in charges. He paid about $2,000 out of pocket.

"I was in a pretty healthy state of denial like most people my age" that I would ever get that sick, the labor and employee-relations specialist says. But "just having coverage, even basic coverage, pays dividends."

Like Mr. Jackson, many healthy 20-somethings don't expect to get seriously ill. Starting new jobs and handling their own health care for the first time, many fail to establish relationships with doctors or carefully research health plans. For those just starting out, here are some basic tips on how to take charge of your health care:

Everyone will have to have health insurance by 2014 or pay a penalty under the Affordable Care Act recently upheld by the Supreme Court.

If your employer offers a health plan, find out what it covers and what you will pay for office visits and prescriptions, says Susan Heathfield, a management consultant in Williamston, Mich. If your employer doesn't supply this information, get it from the insurer.

Under the new health-care law, young adults generally can stay on a parent's health plan until they are 26 years old—and that may be cheaper than taking what is offered by an employer. Compare premiums and copays to determine which plan makes the most sense. Be aware, however, that until 2014, some group plans don't have to offer dependent coverage up to age 26 if a young adult can get insurance through work.

Copays and medication costs can vary widely, and many insurers now charge 20% of the total bill instead of a set copay.

To cover out-of-pocket medical costs, some people set aside pretax dollars in flexible-spending accounts through work. But be careful how much you set aside: You can't carry unused funds over from year to year.

Those on a budget who can't get coverage through a parent or employer can buy low-cost, high-deductible, or catastrophic, policies that cover things like hospitalizations and offer access to doctors at discounted rates. Some employers offer this option, as well. A website like can help you find policies, or go to to learn more. A high-deductible policy can be paired with a health savings account, or HSA, which allows individuals to set aside money, tax-free, to pay for medical expenses. Unused funds can be carried over from year to year and job to job.

Schedule preventive-care visits with physicians and dentists, so you have a doctor when a medical problem arises. Women in their 20s with no previous problems should visit a gynecologist at least once every three years, according to the American College of Obstetricians and Gynecologists.

To find a doctor, ask for recommendations from friends and family or go to your insurer's website. Some insurers have smartphone apps that allow you to search for doctors, or you can tap websites like to find nearby doctors who take your insurance. Some plans require a referral or preapproved doctor, so check with your plan provider.

Before going to the doctor, gather your immunization records and family health history, says Jeffrey J. Cain, president-elect of the American Academy of Family Physicians. And be prepared to discuss your tobacco and alcohol use, he says.


Custom Search

A News Center Of Health News By Information Center