The year 2020 has been a year like none other and like many people, it is understandable if you might find yourself losing track of time. This year, the open enrollment period for the Affordable Care Act/Public Marketplace for 2021 begins Sunday, November 1 and runs through Tuesday, December 15, 2020. If you do not enroll in a plan by December 15, you will not be eligible for health insurance coverage through that option unless you qualify for a special enrollment period. The good news is that you do still have options, even if you have a moderate existing health condition. One or more of these options could be better for your unique needs than obtaining insurance from within the marketplace.
Private Health Insurance
According to the U.S. Census Bureau, most Americans are enrolled in a private health insurance plan. Private health insurance refers to coverage offered by a private company, such as an insurance company or insurance broker instead of the federal or state government. Some private plans are offered in the marketplace and meet the minimum essential benefits required under the ACA.
If you do not have access to health insurance through an employer or aren’t eligible for a public insurance option like Medicare, Medicaid, or CHIP, you could purchase a private plan. A private health plan is designed to split your medical costs between you and your insurer. This helps make medical care more affordable for you and your family. The advantage of working with a licensed broker is that he or she can help you find a plan in your cost range that fits your medical needs.
A Medi-Share plan is technically not a health insurance plan. Instead, it is a non-profit, medical expense sharing program where the members of the plan share the costs of each other’s eligible medical bills. The concept of this type of Christian program is based on the Biblical principle of bearing the burdens of others. A Medi-Share program is self-regulated by its organization’s Board of Directors.
A Medi-Share plan is not for everyone because it does not cover everything that you might expect in a health plan. There are limits on benefits and types of care that are covered. Not all preventative care is covered, along with mental health or substance abuse counseling. However, if you are in excellent health and can afford to pay out of pocket for your routine medical expenses, it could be the right plan for you.
Certain trades, including steelworkers, laborers, teachers, or utility workers may belong to unions in which they pay dues to. Membership in the Union often includes access to health and welfare funds that are paid for between the Union and its participating employers. The funds are usually managed by a Board of Trustees which consists of some members appointed by the Union and others appointed by participating employers.
The goal of this type of health plan is to provide its participants and their family members with high-quality and comprehensive health care coverage while keeping out-of-pocket costs low. The benefits included in a Union plan can vary. There is usually no general health plan for all members. The coverage generally depends on the Collective Bargaining Agreement between the worker’s Union and employer. When a CBA does not exist, the benefits may be determined with a Participation Agreement between the Union and employer.
Business Association Plan
One of the benefits of having insurance through a larger employer is that it is group insurance, which comes at a lower premium than purchasing an individual health plan. To provide more affordable health coverage options, the U.S. Department of Labor expanded access to Association Health Plans for American small businesses and their employees. Unlike Medi-Shares, AHPs come under the oversight of federal and state insurance authorities.
AHPs allow small businesses and self-employed workers whether grouped by industry or geographic area to obtain health insurance as if they were one large employer. These plans give participants stronger negotiating leverage with greater economies of scale and larger risk pools. Participants cannot be discriminated against based on prior or existing health conditions or be charged higher premiums than others in the plan.
Marketplace Options Might Not Be the Best Choice for You and Your Family
The options in the ACA/Public Marketplace are very limiting. You have very few company and plan options to choose from. You can see your own ACA options by simply visiting the website. However, it can be confusing to understand those options and the consequences of choosing what might seem like the least expensive option. If you are considering enrolling in the marketplace this year, you might one to consider one of the options above.
Too often people find themselves in financial trouble when they actually need to use their marketplace plan. They may quickly find out they have high deductibles, low coinsurance, no copay plan when they really need one, or have a plan that does not cover the medications they need or the doctors they want; all in the name of saving a little money.
When you work with Choice Health LLC, we work with you to find the health insurance that best suits your and your family’s personal needs. On top of that, we do not charge a fee for our services, either.