Personal Health Insurance

Even though the Affordable Care Act (ACA) requires insurance companies to offer minimum essential coverage in all health programs, the competition between insurance carriers remains fierce which is considered a good thing for the consumer. Individual health insurance policies can be accessed through the state or federal health insurance exchange or appointed agents in the marketplace, and many carriers have even started selling directly to consumers.

The ACA requires that insurance plans provide minimum essential coverage, but not every plan is the same. On the contrary, every insurance company offers several different types of major medical plans with a large selection of additional coverages. At first glance, the choices may appear overwhelming, but there are online comparative raters available that will allow the consumer to make side by side comparisons. Never before has there been so much information available at your fingertips and so easy to access.

For individual health plans to be ACA compliant, the insurance carrier must use the metal designation that makes it clear to the consumer the percentage of healthcare costs the company will pay. Currently, Bronze plans pay 60%, Silver Plans pay 70%, Gold will pay 80% and Platinum plans will pay 90%. There are, however, very affordable Catastrophic Plans available to consumers who are under age 30 or qualify with income-based hardship qualifications.

Included in the ACA is the availability of subsidies for qualified applicants. There are two types of subsidies available to help qualified applicants offset their cost of insurance and health care :

• The Advanced Premium Tax Credit – This tax credit is used to pay all or a portion of your monthly health insurance premium. It is not a loan; it is a tax credit.
• Cost Sharing – The Cost-Sharing Reduction reduces out of pocket costs for the insured that are paid during the policy period. Typically this cost sharing reduces the deductible, copays and coinsurance costs of the plan. It also is not a loan.

Qualifying for a health insurance subsidy depends on your family size and the amount of annual income earned as compared to the Federal Poverty Level. The Marketplace, Health Insurance Companies and most all brokers have a Subsidy Estimator available for health insurance applicants that will allow the consumer to find out if and how much of a subsidy may be available.

The Health Insurance market place can still be confusing to most consumers, so it’s highly recommended that you contact us and speak with a qualified and reputable agent. We are available to offer expert advice and help you navigate the plethora of plans available for purchase.