This is the first article of an ongoing series.
The Affordable Care Act requires most Americans to buy health insurance, and the exchanges created under the healthcare law are just one place to find it. There are many ways purchase a health insurance plan that qualifies as “minimum essential coverage” as designated by the federal government. Which option is right for you depends on personal preference and the need for financial assistance. All major medical health insurance plans available today must meet ACA requirements, whether they are sold in the private marketplace or on a state-based or federally facilitated health insurance exchange. Plan and carrier options will vary based on region and whether you shop on or away from the exchanges. Key differences will be in plan details such as premium, deductible, copay, coinsurance, drug formulary and network.
The four main places to buy individual and family health insurance coverage that fulfills the ACA requirement include:
1. Your state’s health insurance exchange or the federal marketplace
On Oct. 1, 2013, the Affordable Care Act’s health insurance exchanges opened for business. Some states opted to run their own, some partnered with the federal government, and others decided to become part of the federal marketplace. Americans may shop and apply for health insurance coverage through these exchanges online—or visit their websites to learn more about over-the-phone and in-person application options.
One key advantage of purchasing health insurance through these exchanges is that you may apply for income-based financial assistance. This financial assistance may include advanced premium tax credits can reduce your monthly premium payment and cost-sharing subsidies that help lower out-of-pocket spending. This financial assistance is not available in the private marketplace.
Learn more your state’s state or federal health insurance exchange, as well as how to apply for Medicaid where you live, at HealthCare.com.
2. Health insurance company websites
You may also shop for health insurance in the private marketplace and buy directly from a carrier’s website. Perhaps you already know you want to buy coverage from a specific health insurance company and do not qualify for financial assistance or do not wish to purchase exchange-based coverage. Make sure you at least investigate other plan options and compare them to ensure this carrier and health insurance plan are the best fit for your healthcare and financial needs.
If you have questions and need assistance, you may contact the carrier’s customer service department. As with all plans purchased away from your state or federal exchange, these plans will not be eligible for financial assistance.
3. Licensed agents or brokers
These individuals may help you shop on and away from the state and federal exchanges. You can locate licensed agents and brokers in your area through local directories, online search engines, and through a state or federal exchange website. They can help you through the plan selection, application and enrollment processes. Be aware that some agents and brokers are contracted with specific health insurance companies in the private marketplace, which means the may only have access to select plans.
4. Websites such as HealthCare.com
Websites such as HealthCare.com provide a way to shop the private marketplace and get a broad view of available plans and carriers. You may find plan and carrier options that are not available through the state and federal exchanges. If you do not qualify for
Simply enter your ZIP code, birthdate, gender, tobacco use and household income to get a list of plan options and price quote. A subsidized price estimate will also be included, if you qualify; however, you must shop and enroll through a state or federal exchange to apply for and receive such subsidies. Filter criteria to narrow your options, and compare plan benefits side by side. You may also estimate your premium tax credit using the HealthCare.com subsidy calculator—again, if you qualify for such assistance and want to take advantage of it you must shop and buy coverage through a state or federal exchange.
If you need help selecting a health insurance plan or have questions, call 877-275-0485 to speak with a licensed agent from one of our trusted insurance partners.