There are premium subsidies available in the exchange, but you're not eligible for them if the plan offered by your employer is considered affordable and provides minimum value (this is true for your family members as well, if they have access to your employer-sponsored plan, even if the employer-sponsored plan is only affordable for the employee's portion of the coverage; this is known as the family glitch). Most employer-sponsored plans are affordable and do provide minimum value. So if you're shopping for an individual market plan instead, chances are high that you'll have to pay full price for it, without any subsidies.


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.
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.

There are premium subsidies available in the exchange, but you're not eligible for them if the plan offered by your employer is considered affordable and provides minimum value (this is true for your family members as well, if they have access to your employer-sponsored plan, even if the employer-sponsored plan is only affordable for the employee's portion of the coverage; this is known as the family glitch). Most employer-sponsored plans are affordable and do provide minimum value. So if you're shopping for an individual market plan instead, chances are high that you'll have to pay full price for it, without any subsidies.

These plans meet all the requirements of the health care law, including covering pre-existing conditions, providing free preventive care, and not capping annual benefits. If you have one of these plans, you won’t have to pay the fee that people without coverage must pay through the 2018 plan year. (Note: Starting with the 2019 plan year (for which you’ll file taxes in April 2020), the fee no longer applies.)


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.
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.

But the ACA changed all that. Medical underwriting is no longer used, although applicants can now only enroll during open enrollment or a special enrollment period triggered by a qualifying event (similar to how enrollment works for employer-sponsored plans). Essential health benefits are now covered on all new individual major medical plans in every state. And millions of people are receiving premium subsidies that cover the majority of their premiums for plans purchased in each state’s health insurance exchange (the ACA’s consumer protection reforms apply to plans sold outside the exchanges as well, but the subsidies are only available in the exchange). The ACA also limits the percentage of premiums that insurers can use for administrative costs, including profits and executives’ salaries; insurers have refunded billions of dollars to consumers as a result of the new rules.
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.
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.
​​​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. ​​​​​
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.
YP - The Real Yellow PagesSM - helps you find the right local businesses to meet your specific needs. Search results are sorted by a combination of factors to give you a set of choices in response to your search criteria. These factors are similar to those you might use to determine which business to select from a local Yellow Pages directory, including proximity to where you are searching, expertise in the specific services or products you need, and comprehensive business information to help evaluate a business's suitability for you. “Preferred” listings, or those with featured website buttons, indicate YP advertisers who directly provide information about their businesses to help consumers make more informed buying decisions. YP advertisers receive higher placement in the default ordering of search results and may appear in sponsored listings on the top, side, or bottom of the search results page.
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