For those who don’t have access to employer-sponsored plans, coverage on the individual market is an option. This market has changed dramatically as a result of the Affordable Care Act. Prior to 2014, in most states, individual coverage was medically underwritten, which meant that coverage was only available for purchase if the applicant was at least fairly healthy, as the insurance companies would closely scrutinize your complete medical history when you applied. Coverage in the individual market was typically not as robust as employer-sponsored health insurance; maternity care, prescription drugs, and mental health care were often missing from the coverage. And people who purchased individual market coverage prior to 2014 had to pay the whole premium themselves.

Nearly a century later, private health insurance continues to dominate the U.S. health care landscape. Despite attempts by U.S. Presidents, including Harry S. Truman, John F. Kennedy and Bill Clinton, government-sponsored universal health care never materialized. And, although President Lyndon Johnson signed Medicare into law in the 1960s to provide a safety net for citizens over age 65, the majority of Americans under 65 continue to get their health care from private insurers.
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.
According to a Kaiser Family Foundation analysis, in 2018, the average American worker with employer-sponsored health insurance contributed $1,186 for a single employee health plan and $5,547 for a family health plan. Since this is an average, some employees may be paying much more (employers paid the bulk of the total premiums, which averaged $6,896 for single employees and $19,616 for family coverage).
Blue Cross Blue Shield Association is an association of independent Blue Cross and Blue Shield companies. Blue Cross Blue Shield Association is not a health insurance company and does not sell health insurance. Blue Cross Blue Shield health insurance is provided by your local, independent Blue Cross and Blue Shield companies and is marketed through authorized State Farm agents. Neither State Farm Mutual Automobile Insurance Company nor any of its subsidiaries or affiliates are financially responsible for these products.
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.
HealthMarkets can help you find options that meet your needs, whether it is for a private plan, a health plan on the new government exchange, or even a Medicare Advantage plan. We offer a broad portfolio of health plans from 180 recognized companies nationwide. From platinum level metal plans to catastrophic only, we’re ready to help you find a plan to fit your lifestyle.
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.
The Affordable Care Act (ACA) is intended to ensure that Americans have access to healthcare they can afford. To that end, it has created a public marketplace where people can buy health insurance. Depending on life circumstances and income, this public marketplace provides insurance plans with tax credits that lower premiums to make the plans more accessible to many Americans. If you’re interested in learning more information about the public marketplace, we can help you evaluate the options.
For some consumers, buying individual health insurance is the only health coverage option. However, even if you have health insurance from your employer, an individual/family health insurance policy may still be an option to save money. With health insurance premiums increasing every year and employers passing more of the costs onto their employees, your company's health insurance may not be the best deal, especially if you need to cover a family.
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.
Apply for Texas health insurance coverage at eHealthInsurance. We offer thousands of health plans underwritten by more than 180 of the nation’s health insurance companies. Compare Texas health plans side by side, get health insurance quotes, apply online and find affordable health insurance today. You can read more about the Affordable Care Act in our Obamacare Resource Center.
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