What Are Your Health Insurance Options If You Don't Qualify for an ACA Subsidy?
One of the biggest surprises people run into when shopping for health insurance is finding out that they don't qualify for much financial assistance.
You go to the Marketplace expecting an affordable monthly premium, enter your information, and suddenly you're looking at a much higher number.
If that's happened to you, you aren't necessarily stuck with that price.
You Can Still Buy an ACA Plan
The first option is still the ACA Marketplace.
You can compare the plans available in your area and look at the full premium, deductible, network, and out-of-pocket costs.
But if you're paying the full price, it makes sense to see what else you may qualify for.
Private Health Insurance Is Another Option to Compare
Depending on your state and circumstances, you may qualify for private health insurance outside of the ACA Marketplace.
Private plans can use different eligibility and underwriting requirements, and for people who qualify, the monthly premium may be more affordable than paying the full cost of an ACA plan.
This can be particularly relevant for people who:
- Are self-employed
- Have a higher household income
- Don't qualify for a meaningful ACA subsidy
- Are relatively healthy
- Don't use healthcare very often
Your individual situation determines what is available to you.
Why Compare Both?
You don't necessarily have to choose between “ACA” and “private” before looking at the numbers.
The better approach is to compare the options available to you and see how the premiums, deductibles, networks, and benefits stack up.
For one person, an ACA plan may make the most sense.
For someone else, a private plan may offer a much more attractive monthly premium.
It depends on what you qualify for.
What About Pre-Existing Conditions?
This is an important distinction when comparing coverage.
ACA Marketplace plans are required to cover pre-existing conditions without charging you more because of your health history.
Some private health insurance options use medical underwriting, so your health history can affect whether you qualify and what coverage is available.
That's one reason it's helpful to have someone walk through your individual situation rather than assuming a private plan is available to everyone.
See What You Actually Qualify For
If you aren't receiving much ACA financial assistance, don't automatically assume the Marketplace price is the best price available to you.
I can look at your situation and compare the available ACA and private options so you can see what your choices actually look like.
If you're paying the full price for health insurance, let's see if there's another option worth considering.
