There are other plans available year-round that are not individual major medical coverage. Most of these plans are not recommended as stand-alone coverage (with the exception of short-term plans, which can be adequate stand-alone coverage if you're healthy and you know that you need the coverage for only a short time; they are usually not at all adequate for longer-term coverage). These plans are not regulated by the Affordable Care Act, which means they can exclude pre-existing conditions, impose dollar caps on your coverage, and don't have to cover the ACA's essential health benefits. In most cases, these plans cannot really be compared with an employer-sponsored plan, since the coverage will be so much lower quality. If an insurance offer sounds too good to be true, read the fine print carefully. It may end up being a poor substitute for real health insurance, and you don't want to learn those details after you have a major claim.
However, they might still be able to find a less expensive plan in the individual/family market, even paying full price for the premiums. It would almost certainly have a higher deductible and out-of-pocket exposure than the plan Doug's employer offers, but that might be a trade-off that the family considers worthwhile. Doug might find that his employer-sponsored coverage for just himself is very affordable, since employers often pay more towards the employee's premiums than they pay towards additional family members' premiums. So Doug's family might opt to keep Doug on the employer-sponsored plan and get an individual market plan for his wife and kids.
How do the benefits differ? What would you owe in out-of-pocket costs if you were to be injured or get seriously ill? How does that compare with your out-of-pocket exposure on the employer-sponsored plan? Are your doctors in the network of the individual plan? You'll want to carefully consider all of these things before switching, and keep in mind that you won't be able to rejoin your employer's plan until the next open enrollment window offered by your employer.
How do the benefits differ? What would you owe in out-of-pocket costs if you were to be injured or get seriously ill? How does that compare with your out-of-pocket exposure on the employer-sponsored plan? Are your doctors in the network of the individual plan? You'll want to carefully consider all of these things before switching, and keep in mind that you won't be able to rejoin your employer's plan until the next open enrollment window offered by your employer.
Humana health products are underwritten and issued by Humana Insurance Company which is financially responsible for these products. No member of the State Farm family of companies is financially responsible for these products. Humana, Inc, Humana MarketPOINT Inc, and Humana Insurance Company are not affiliates of State Farm. Please call a State Farm agent for more detailed information.
Anthem Blue Cross is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.
There are other online brokerages, both large and small, that can help you sort out the individual market health insurance options available in your area. Most of them can show you plans that are available in the exchange as well as options that are only available outside the exchange (no subsidies are available outside the exchange, but as noted above, you're probably not eligible for subsidies anyway, if you have access to an employer-sponsored plan).
​​​Medi-Cal is California's Medicaid program. This is a public health insurance program which provides needed health care services for low-income individuals including families with children, seniors, persons with disabilities, foster care, pregnant women, and low income people with specific diseases such as tuberculosis, breast cancer, or HIV/AIDS.  Medi-Cal is financed equally by the state and federal government. ​​​​​
Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, Humana Health Benefit Plan of Louisiana, The Dental Concern, Inc., Humana Medical Plan of Utah, CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits).
As mentioned above, the majority of Americans who have insurance obtain it through employer-sponsored, or group health insurance plans. The coverage has numerous advantages – among them cost (including the government income tax exemption for health benefits), ease of enrollment, and a wide range of plan options. (In addition to a health insurance plan, employees may have the option to purchase insurance for dental, life, short- and long-term disability.) Read here for more details about group health insurance plans.
A good place to start is HealthCare.gov. This is the health insurance exchange created by the The Patient Protection and Affordable Care Act, and is a one-stop shop for private individual market health insurance plans (note that the exchange itself is run by the government, but the health plans for sale in the exchange are all private, from the health insurance companies with which you're already familiar). People in 39 states use HealthCare.gov to enroll in individual market plans. The other 11 states and the District of Columbia have state-run exchanges, and you'll be directed to their sites from HealthCare.gov when you select your state.
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call: 1-800-MEDICARE (800-633-4227). TTY or TDD users should call 877-486-2048, 24 hours a day/7 days a week; The Social Security Office at 800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY or TDD users should call, 800-325-0778; or Your State Medical Assistance (Medicaid) Office.
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