• Ryan P. Cleary

The Health Insurance Marketplace is Open: Time to Sign Up!


November 1st, 2019 was the first day to sign up for health insurance through ACA marketplaces. The Open Enrollment period runs from November 1st, 2019 through December 15th, 2019


Do I need health insurance?

While everyone’s circumstances are different, the prevailing advice has been a resounding “yes” among financial experts. Keep in mind, there are exceptions to the rule but many people do benefit.


The benefits of having health insurance

With 40% of Americans being unable to cover even a $400 emergency expense and the average emergency room cost exceeding $1233, having health insurance can prevent the number one cause of personal bankruptcy- medical debt.

Health insurance also often includes preventative care, such as free annual health exams, flu shots, and other ways to catch problems before they require an expensive treatment or hospital visit. The benefit? Employees don’t have to take off work unexpectedly, kids don’t have to miss as much school, and the risk of medical debt is greatly reduced.


When shouldn’t you have health insurance?

Our general advice is to always have health insurance if it is financially possible. However, if you have a high net worth, it may be an option not to. Alternatively, if paying for health insurance is the difference between having rent & groceries, this may be a factor (though in this case we encourage looking at Medicaid or a high deductible insurance plan). Think of health insurance as being like an emergency savings fund for when something goes very wrong.


Steps to follow when searching for insurance

There are a lot of great resources online to help with finding and deciding on Health insurance- including healthcare.gov


Does your employer offer health insurance?

Before signing up for any health insurance plan, check with your employer to learn if they offer health insurance as a benefit. If they do, learn about the costs and plan details. A plan offered through your employer may be more affordable than going through the healthcare marketplace or self-selected plans. [Note: Dependent on your out-of-pocket cost for insurance offered by your employer you may not be eligible for the healthcare marketplace]


Are you eligible for Medicare or Medicaid?

The healthcare marketplace can help you determine this when you go through the sign-up process.


Go to Healthcare.gov or your state’s marketplace

Healhcare.gov is the official site for the health insurance exchanges. Once there you can use their calculator to help determine eligibility for discounted health insurance plans. Even if your income is too high for discounts, you can still use the marketplace to compare plans and purchase one.


What are the differences in tiers?

For a quick overview, check this chart.


Compare prices

Check with individual insurance providers if you are unhappy with the plans you find through the marketplace. Keep in mind though, that marketplace plans must cover certain essentials


Things to consider while shopping

  1. Monthly cost: Consider how the monthly cost affects your budget. Though deductibles are important, you need to ensure you can afford the recurring monthly payments associated with your plan.

  2. Deductibles and co-insurance rates: How large is your emergency fund? Even if you have insurance, you will have to pay a fee for some services like doctor’s visits and prescriptions. Try and find plans with lower deductibles that you can afford with your monthly costs.

  3. Maximum yearly cost: Again, look at your emergency fund. Is the maximum yearly cost with the fund an amount you can pay out of pocket? After you reach this cap, you are no longer responsible for your deductible.

  4. Provider Network: Does the plan cover your preferred doctors and hospitals?

  5. Extra benefits: Some plans offer additional services, like small life insurance policies, health savings accounts, medical management


Don’t wait

Open enrollment ends on December 15, 2019. We suggest you make sure you have coverage or a plan to enroll with your employer, Medicaid/Medicare, or a private insurer before then.

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