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Navigating the Health Insurance Market on Your Own

Healthcare coverage in the US has come a long way over the last ten years. While previously confined to those with conventional full-time employment, their children, seniors, and those under the federal poverty limit, health insurance is now available to everyone.

However available, many still wonder how to access health insurance in their region. Luckily, finding and getting coverage is often easier and cheaper than people think. Read on to learn more.

Can You Buy Your Own Health Insurance?

In the United States, people traditionally rely on employer-sponsored health insurance, which is a benefit of their job. Unfortunately, not everyone has an employment situation that includes benefits. People are increasingly choosing to work part-time or in freelance roles. Therefore, these people do not qualify for health insurance through an employer. Others eligible for health insurance through their employer may not be able to realize those benefits if they live far from their plan’s providers.

If an employer-sponsored health insurance plan isn’t an option for you, or you don’t want your health insurance tied to your job, you can buy your own health insurance. In 2010 the Affordable Care Act (ACA) made affordable healthcare more accessible.

In 2014 the Health Insurance Marketplace was created. The Health Insurance Marketplace website features a collection of insurance programs and information to help you find insurance and apply for it. This website also allows you to sign up for qualifying subsidies to make your insurance more affordable.

What Are the Advantages of Employer-Sponsored Health Insurance?

Employer-sponsored health plans have some benefits that make them an excellent option for many. The biggest positive is probably the cost factor, with most employers paying a significant part of the premiums, reducing your overall costs.

Another benefit for some people is that employer-sponsored plans are pre-determined. Often shopping for healthcare can seem like a complicated and time-consuming process. Having an employer who does all or most of the legwork for you can be a great benefit.

The downside of employer-sponsored health insurance is if you lose your job, you also lose your insurance. The Consolidated Omnibus Budget Reconciliation Act, often called COBRA, was created to continue health insurance for people who lost their jobs. Unfortunately, employer contributions disappear when you’re on COBRA, and the insured is responsible for all the expenses, which can be cost-prohibitive.

What Are the Advantages of Individual Insurance?

Individual health insurance cuts your employer out of the equation. These plans are available to individuals through private health insurance companies. The type of plans and variety of their offerings is vast, which plays into the wide differences in monthly premium costs, coverage, providers, and out-of-pocket expenses. Many people appreciate this aspect of individual insurance as it allows them to customize their plan and costs.

Additionally, some discounts are available in the individual health insurance marketplace. If you enroll through the marketplace, you may qualify for a Cost-Sharing Reduction subsidy and Advanced Premium Tax Credits, which can dramatically affect the cost of your overall health insurance coverage.

Another factor that can play into your health insurance costs is your income level. The ACA subsidizes monthly premiums for people with a household income below 400% of the federal poverty line.

Where Do I Shop for Individual Health Insurance?

The federal or state health insurance marketplace is a great starting point for finding health insurance coverage. But these aren’t your only options. You can search online for health insurance, or you can find an agent and have them walk you through their options.

Regardless of where you go to find information on health insurance plans, your first step should be to compare available options. You’ll want to look at deductibles, out-of-pocket costs, copayments, and specific coverage benefits related to your healthcare concerns. Evaluate the available insurance options with your unique health situation in mind.

Once you’ve selected a plan or two that interest you, it’s time to start the paperwork. If you purchase your plan through an agent, they help you through the process. Likewise, if you purchase your plan through the open marketplace, you can find the necessary documentation online.

Can I Buy Health Insurance Without an Agent?

Purchasing an individual health insurance plan through an agent carries some benefits. Specifically, insurance agents understand industry jargon and operations. However, agents are by no means necessary in purchasing a health plan. You can do the research and comparison shopping through the healthcare marketplace. Then, once you choose a plan, you can enroll too.

However, if you prefer to forego both an agent and the marketplace, you can still perform the same steps in the other avenues. The main difference is that instead of going through an online platform or an agent, you would independently contact insurers and perform your research that way. Regardless of your chosen method, remember you’ll still face an application process and medical underwriting.

Can I Buy Private Health Insurance at Any Time?

Most health insurance plans typically have an Open Enrollment Period from November 1 to December 15, when you can apply for health insurance. Some qualifying life events, like losing your job or getting married, trigger a special enrollment period (SEP). An SEP allows you to get insurance in between open enrollments. You often have 60 days before or 60 days after the event to enroll.

Is Individual or Employer-Sponsored Health Insurance Cheaper?

Employer-sponsored health insurance plans are considered group health insurance. Your co-workers or the other employees usually comprise the group. Traditionally, your employer pays less, providing lower premiums to employees.

Today, it’s possible to not only find an individual plan that’s as cheap as a group plan, but you might qualify for subsidies that make individual coverage less expensive. To see how much an individual health plan costs for your situation, visit the healthcare marketplace website in your area.

You’re just a few steps away from a personalized health insurance quote.

Learn More

You’re just a few steps away from a personalized health insurance quote.

Learn More