Marketplace health insurance plans might be the best medical policy for your situation. Marketplace plans, also known as The Affordable Care Act, ACA, or Obamacare; cover pre-existing conditions, pregnancy, and mental health. Even if you don’t need coverage for pre-existing conditions, a marketplace policy might be the most affordable health insurance plan depending on your income.
The Health Insurance Marketplace
The health insurance marketplace is a government funded centralized system to purchase health insurance. You can still use a trusted advisor, like a health insurance agent who is licensed and certified with the marketplace, to help you choose the right plan at no extra cost. Most States still use the official federal marketplace, which is healthcare.gov; however, there is a much easier way to shop for affordable health care plans.
Free Health Insurance
Depending your taxable income, you might qualify for free health insurance through the Affordable Care Act. Technically the plan isn’t free, but you might qualify for enough of a “tax credit” which lowers the monthly price to $0/month. Your income and household size will determine how much of a savings you are eligible for and the plan you choose will determine how much you actually pay each month. You get the same plan as you would if you were paying full price, so you don’t have to sacrifice coverage when getting a lower price.
Coverage for Pre-Existing Conditions
Marketplace health insurance plans meet the ACA requirements for providing coverage for pre-existing conditions. The health insurance policies are “guaranteed issue”, which means you can’t be turned down for your health history. As soon as the plan takes effect, then coverage starts immediately, according to the terms of the plan.
Mental Health Coverage
The marketplace medical insurance plans provide many coverages including mental health. By law, all of the ACA Marketplace policies must cover mental and behavioral health. Even though each policy will cover mental health, each policy can cover it differently. While shopping for a policy, talk with you agent to make sure the level of coverage fits your needs.
Affordable Health Insurance
The Affordable Care Act (ACA, Obamacare, etc) helps make health insurance more affordable for some. If your household income falls within certain ranges, you might qualify for a lower monthly price. The savings is called a “tax credit” or “advanced premium tax credit”. If you qualify, you can take advantage of the savings off the full monthly price, without having to be reimbursed.
Marketplace Health Plans
The marketplace health plans are split into 5 categories. There are the four “metal” levels (bronze, silver, gold, platinum) and a catastrophic level.
Catastrophic Health Plan
Catastrophic health plans through the marketplace are a stripped down medical policy available to consumers under the age of 30. These plans were designed as a lower cost option for individuals who are young and healthy. These plans aren’t eligible for any savings based on income. If you choose a catastrophic health plan, then you will pay full price, regardless of your income level.
Bronze Health Plans
A bronze level plan is defined by its actuarial value of 60%. Each insurance company might structure the coverages on their bronze plans differently. Even though coverages might appear to be different, the overall average the plan covers for an average enrollee in an average population is 60%.
Silver Health Plans
Silver level health plans have an actuarial value of 70%. Coverages might be structured differently from one silver plan to the next, however; the overall average that the plan coverages for an average enrollee in an average population is 70%. The exception is when the household qualifies for a Cost Sharing Reduction (CSR), available to lower income households, which improves the coverage of a silver level health plan.
Gold Health Plans
Gold health plans through the marketplace have an actuarial value of 80%. There might be differences in coverages from one gold plan to the next, so you can pick the one that best fits your needs. Based on an average population and an average enrollee, a gold level health plan will cover 80% of medical costs.
Platinum Health Plans
Platinum marketplace health plans are the highest level offered but not available in all areas. Platinum plans have a actuarial value of 90%. Which means that a platinum plan will cover 90% of average costs for an average enrollee in an average population.