For an individual who has a relatively solid income but lacks coverage through their employer, the obvious source of health insurance is the federally regulated Affordable Care Act marketplace.
Assessing your options can be a little challenging when you sign on to the government website and browse various plans. First of all, there might be only a few coverage providers in your state. Many individuals find that there is only one or two real options that serve their unique needs while remaining affordable.
Assessing your options can also be very confusing, especially if you’re not familiar with complex insurance terms like deductibles, annual expected costs, premiums, and so on. Even if you are familiar with these terms, it’s often challenging to do the math and figure out which provider offers the cheapest coverage.
It’s also worth mentioning that all Affordable Care Act plans must provide coverage for the same things. These are known as the “10 essential health benefits.” These benefits include:
- Emergency services
- Out-patient services
- Maternity and newborn care
- Mental health and substance abuse care
- Prescription drugs
- Rehabilitative and habilitative care
- Laboratory services
- Pediatric services (including oral and vision)
- Preventative care and chronic disease management
No matter which Affordable Care Act plan you choose, you will always enjoy coverage for the above treatments and services.
With that being said, there are a few things to consider when choosing an ACA-compliant plan.
Firstly, determine whether you need to wait for an open enrollment period before you sign up with a new insurance provider. If you’re going to experience a long wait, you might want to explore other, short-term options in order to fill your coverage gap.
You also need to consider the fact that certain premium subsidies are only available if you choose a “silver” ACA-compliant plan.
Another solid choice is to use online tools to get subsidy estimates while you search for plans on the marketplace, which gives you a more accurate sense of how much you’ll actually be paying for coverage.
Next, consider your state’s stance on health insurance mandates. If you will encounter a significant tax penalty for not choosing Obamacare, it might make more sense to stick with the Affordable Care Act marketplace instead of searching for alternative coverage.
That being said, you should always do the math and determine whether certain alternatives are more effective even after tax penalties are taken into account.