The price of insurance depends on a number of things; the zip code you live in, your age/gender (ages/gender & number of family members on the plan), as well as the level of coverage you desire!
The public market (aka ACA or Obamacare) is based on your income; Higher the income, higher the premiums. It is also more beneficial for major medical conditions as there are no pre existing condition clauses. Great for mental health, pregnancy, & drug/alcohol abuse. IMPORTANT: If you report a low income and qualify for savings, but at the end of the year you make more... you can be penalized and owe money back at the end of the year. The employer coverage is typically amazing for yourself as the employee, because your employer is legally obligated to pay at least 50%. Most employers pay more if not all of it for you as an employee. Now when it comes to adding family on... that is where your premiums can get quite high! It is at the employers discretion to pay anything towards your family, and at times leaves you paying a full hefty price for them. The private market is based on your health; By being relatively healthy, you will qualify for preferred rates with excellent benefits. It does not take income into consideration. The plans are 100% customizable. All of them are PPO nationwide coverage. SELF EMPLOYED 1099: You can write off your premiums at the end of the year as tax write offs! (I've been self-employed for over 20 years, and am always looking for write offs;-)
Yes!
Example 1~ If one family member has major medical conditions, they can go on the public market while getting the rest of your family savings based on their health through the private market.
Example 2~ Employer is covering your portion at 100%, but nothing towards your family leaving you paying full price for them. You can get your family qualified for savings based on health through the private sector, or income through the public market.
Yes and no. Some pre-existing conditions (depending on the severity) may disqualify you for the medically underwritten plans on the private market; but you can still secure coverage through the ACA or guaranteed PPO plans through the private market.
A deductible is a dollar amount that you must spend on medical expenses in order for your insurance to kick in. These can range anywhere from $0 – $16,000 depending on your plan.
This is an amount of money that you will need to pay in a worst case scenario (exp. hospitalization/catastrophic event) and the insurance will then cover the rest 100%.
An entrance fee.
This means that your health insurance has a limit. During the course of your policy, your insurance will cover up to a certain amount and then you are responsible for paying the rest.
HMO plans are local plans that only cover you within your zip code area; you also need to see a primary doctor before being referred to a specialist. PPO plans are a wider network, they cover you nationwide and you can go straight to a specialist without being referred first.
This is the period of time from November to December when the public marketplace (ACA) is open for enrollment. If you miss this window; you will need to wait a year to sign up for insurance on the public market or unless you have a life qualifying event.
YES... ALL YEAR LONG! The private market is open all year long, because you have to qualify for the medically underwritten plans. PERK: Once you get approved on a plan, you do not have to renew every year... It will automatically renew for you!
No worries! There are guaranteed plans to give you coverage right away till the next open enrollment.
Yes, because you are not ever contracted onto a plan through the public or private market. I help clients switch all the time, if they find something that suits them better than what they have. Now employers are different, and you'd have to ask your HR.
Generally, plans can take a couple hours up to weeks to start from the date of application. Best thing to do is apply for the coverage you desire. You can always push your start date out to exactly when you want it to begin to avoid gaps in your insurance!
