How to buy health insurance

Health insurance plans and pricing

For many, purchasing a health insurance plan may be the most confusing form of insurance you’ll ever have to buy. With so many unknowns and new plans and providers, common questions our customers ask us are, “What is the health insurance marketplace?” “What is the difference between bronze, silver, and gold plans?” And, “How do I get health insurance quotes?” If you’re not electing health insurance through your employer, then you are on your own to find the right policy for you or your family and review all your options. It can be daunting.

Individual health insurance plans and family health insurance plans are available in the marketplace and are also available privately through licensed health insurance agents. You probably wonder, “What is the difference between marketplace and private health insurance?” and “Which health insurance is right for me?”

What are marketplace health insurance plans?

Any health insurance plans through a state, federal, or private health insurance marketplace like healthcare.gov or a Marketplace/Exchange, also known as “Obamacare”, then you are purchasing a marketplace health plan. If you buy a plan from the Marketplace, you may qualify for a premium tax credit or savings, based on your income.

For most state(38 states in total), people enroll through the federal exchange, healthcare.gov. The other remaining 12 states have a state specific exchange and can be found through healthcare.gov. All of these plans are considered marketplace health plans.

You don’t need to search around for your own state specific exchange if you live in one of the 12 states, you will automatically be redirected through healthcare.gov

Marketplace plans and their subsidies can only be enrolled in through the marketplace exchange. These plans are not available through private health insurance agents.

Can I buy private health insurance plans?

Private health insurance plans are not available through the marketplace exchange and do not offer subsidies. Health insurance plans on the private market are not usually what is called “Minimum Essential Coverage”. That does not mean that they do not cover all of your medical needs, but they may not include coverage for pregnancy or substance use services. If you don’t require medical coverage for these circumstances, then you may save money on a health plan by not paying for types of coverage you don’t need.

What is the minimum essential coverage?

  1. Ambulatory services (outpatient care)
  2. Emergency services
  3. Hospital stays
  4. Laboratory services
  5. Mental health services
  6. Substance use services
  7. Pediatric services (medical, dental and vision)
  8. Preventative care
  9. Pregnancy care
  10. Maternity care
  11. Newborn care
  12. Birth control coverage
  13. Coverage for pre-existing conditions
  14. Plan offerings in bronze, silver, gold, and platinum

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