Affordable Care Act
8 tips for buying your own health insurance
Published on December 09, 2014
As our “man-on-the-street” video reveals, what you don’t know about health coverage could cost you…
If you’re thinking about re-shopping for health coverage this year, here are 8 tips to help you get the coverage you need
What do the New York Times and Fox News agree on? The monthly price of health insurance is going up in 2015 for many consumers.
Silver lining? If you’re looking for one, be aware that in many areas around the country, the monthly price for some plans are going down.
What that means for you is that, if you’re looking to spend less on health insurance in 2015, you should take some time to re-shop your coverage before the end of the year.
If you decide to re-shop, here are 8 shopping tips from licensed eHealth agents aimed at helping you navigate the 2015 landscape:
The above chart shows general guidelines that may not always apply in your individual circumstances. Please visit our ACA resource center for more details.
ONE: Review ALL your coverage options (watch the video)
There are three types of individually purchased health insurance plans that meet the standards of the Affordable Care Act. They are major medical plans (sold off-exchange), qualified health plans (sold off and on-exchange), and catastrophic plans.
- Major medical plans: Major medical plans sold off-exchange are designed for people who do not qualify for or don’t want a subsidy. These plans do help you avoid the tax penalty, and meet all of the ACA coverage standards.
- Qualified health plans: Qualified health plans are sold on and off-exchange and are typically for people who qualify for and want to use a government subsidy to assist in paying for their health plan, though you can buy them without subsidies too. Depending on your state, you can purchase a subsidized Qualified Health Plan through either a private exchange like eHealth or your state’s government-run health insurance exchange or marketplace. You can also purchase an on-exchange qualified health plan even if you don’t qualify or apply for a subsidy.
- Catastrophic plans: Catastrophic health plans are only available to people under the age of 30, and these plans cannot be purchased with a government subsidy. Though catastrophic plans can help you avoid having to pay tax penalties for being uninsured (if you meet certain qualifications), they typically only carry the minimum level of benefits that are allowed under the law.
TWO: You’ll find all three at eHealth.com (watch the video)
As a federally licensed web-broker, eHealth has a wide selection of catastrophic health plans and both on-exchange and off-exchange health plans. And you can apply for subsidies through eHealth and use them to enroll in a qualified health plan, if you meet the requirements. But, eHealth also has off-exchange major medical health insurance plans available from brand-name insurance companies that are not available on any government exchange. And, these off-exchange major medical health insurance plans protect you from the uninsured tax penalty. If you want to compare on-exchange qualified health plans to off-exchange major medical health plans, you’ll find both at eHealth.com!
THREE: Know when your enrollment period starts and ends (Watch the video)
Open enrollment is a period of time when you can enroll or change their coverage without a qualifying life event. The open enrollment period for 2015 coverage runs from November 15, 2014 – February 15, 2015. Outside of open enrollment, you need a qualifying life event – like a marriage, permanent move, or loss of minimum essential coverage – to trigger a “special enrollment period” when you’ll be able to shop for major medical plans and qualified health plan with a subsidy.
FOUR: Understand your tax obligations if you go uninsured (Watch the video)
If you decided to go uninsured after losing your health coverage, you should be aware that you could face a tax penalty. In 2014 the tax penalty for going uninsured is the greater of $95 for individuals ($285 for families) or 1% of your taxable income, whichever is greater. In 2015 the penalties will be increased to $325 for individuals and $975 for families, or 2% of your taxable income, whichever is greater.
FIVE: Understand the true cost of any health plan you’re considering (Watch the video)
Your monthly premium is not the only cost of a health insurance plan you need to be aware of. Most plans require some level of cost-sharing that you’ll be responsible for when you receive medical care. Cost-sharing can take the form of co-payments, deductibles, or coinsurance. Be aware of all of your cost sharing requirements before you apply for a plan.
SIX: Pay attention to doctor and hospital networks (Watch the video)
Make sure you know which doctors and hospitals are accepted by your new insurance plan. Health plans often limit your coverage to networks of preferred doctors and hospitals or charge you more if you use out-of-network care. You can use eHealth’s physician finder tool, or doctor finder, at doctor.ehealthinsurance.com.
SEVEN: Know When Your Coverage Actually Starts (Watch the video)
It’s important to know that major medical health plans don’t typically start the day after you enroll. Typically, you’ll need to apply before the 15th of the month if you want your coverage to begin on the first day of the following month. If you apply after the 15th of the month, your coverage may not begin until the first day of the month after the following month.
EIGHT: Don’t be Afraid to Ask for Help (Watch the video)
Finding the right health insurance plan can be complicated, and a licensed agent can suggest the most appropriate options for you and your family. There is no additional cost to you, the consumer, to use an eHealth agent. And, if you ever have a problem filing claims or understanding the benefits of your plan, you can always give us a call. Our customer care team knows who to call and how to get things done, when our customers need guidance..
You can explore your options for health insurance plans by entering your zip code where indicated on the right side of this page. Or, you can sign up for our newsletter in the lower right side of this page, too.