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.
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.
But it's also worth noting that if they keep the employer-sponsored plan for the whole family, the premiums will almost certainly be payroll deducted on the pre-tax basis. On the other hand, if they opt to buy an individual market plan, the premiums would only be tax deductible to the extent that they (along with other medical expenses) exceed 10 percent of the family's household income, and assuming that the family opts to itemize their tax deductions (increasingly rare now that the Tax Cuts and Jobs Act has greatly increased the standard deduction).
Custom Health Plans is a full-service Texas health Insurance broker providing affordable Texas health insurance quotes to individuals, families, small businesses and the self-employed. Based in Dallas, TX, our team of professionals has more than 30 years of experience in the health insurance and financial services fields. Our integrated suite of online services and partnerships with top health insurance carriers positions us to offer the highest level of service and guarantees the best health insurance quotes in Texas.
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.