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 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.
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).
If the coverage available through your employer feels unaffordable, you can shop around online to see what's available. You may be able to find an individual market policy that will provide you with the coverage you need but is less expensive than the premium you pay at work. This is unlikely to be the case if your plan only covers yourself, since your employer is likely subsidizing a good chunk of the total premiums for the plan offered through your job. But some employer-sponsored plans require the employee to cover the full cost of adding family members, so it's possible that your family members could get a better deal with a separate policy.
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).
Anthem Blue Cross Life and Health Insurance Company is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross Life and Health Insurance Company depends on contract renewal. Anthem Blue Cross Life and Health Insurance Company (Anthem) has contracted with the Centers for Medicare & Medicaid Services (CMS) to offer the Medicare Prescription Drug Plans (PDPs) noted above or herein. Anthem is the state-licensed, risk-bearing entity offering these plans. Anthem has retained the services of its related companies and authorized agents/brokers/producers to provide administrative services and/or to make the PDPs available in this region. Anthem Blue Cross Life and Health Insurance Company is an 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.
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).
The Texas health insurance market has turned shopping for affordable health insurance quotes in Texas into a maze. Although there is no single “best” plan, there are some Texas health plans that will be better than others for you and your family’s health care needs. Plans differ, both in price and in access to service. To ensure you make the right decision in choosing an affordable health insurance plan in Texas for you and your family, contact Custom Health Plans. A Texas health insurance agent will be able to provide personalized attention and a health insurance quote in Texas to find the perfect plan for you.