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.
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.
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.
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.
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.
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.
Losing your doctor? Missing your nationwide health plan? Sick of your HMO and looking for the Nationwide PPO network plans? A short term Texas health insurance plan may be the solution for you. Without reliable short term medical insurance to keep you covered (or in lieu of COBRA health insurance, which can be expensive), one unexpected illness or injury could bring bills and debt for years to come. For about half the price of COBRA insurance, Short Term Medical insurance will safeguard your health and assets during any gaps in medical coverage. Enjoy next-day coverage, plus you can lock your rates in for the next 12 months.