After separating from a company it used to be the only option for continuing healthcare was joining COBRA or looking for private coverage. Nowadays with the Affordable Care Act (ACA) there are more affordable options. That’s a good thing since you’re required to have coverage or pay a penalty.
In order to determine what options are available to you, I recommend starting at your state dedicated site or even the Healthcare Marketplace where eventually you’ll be directed to Healthcare.Gov to began the application process. I found the interface was set up so that even someone with limited computer experience could navigate the site pretty easily since it’s designed to walk the applicant through the process step-by-step.
After completing general info about yourself, and anyone in the household, there is a section on income. My biggest tip – don’t exaggerate your income one way or another since it affects how much you’re charged for the plans. Based on the info you provide, you’re given a pre-tax credit which is deducted from the cost of the health insurance and will determine your premiums. Your true credit will be realized at tax time, so if your actual income is different than reality, you will owe that money when you do your taxes. Therefore, be as accurate as you can as it will only help you in the long run.
After you complete all the information about yourself and those in your household a determination will be made on whether or not you qualify for the credit. If you do, you’ll receive a notification with the amount of the credit so you can start comparing policies. When going through the plan selection process, you have an option to use all, none or part of the credit you receive. If you opt to use part or none of the credit towards your health plan, the balance of the credit will be given at tax time.
The plans are broken down into four “metal” groups on the website: bronze, silver, gold, and platinum. Keep in mind there are minimum requirements for all plans found on the site regardless of which plan you choose. In addition, all the plans have a list of preventive health services which are covered 100% (no co-pay or co-insurance required even if the deductible hasn’t been met).
One of the things I found helpful was that Nicole and I could choose different plans, which is what we opted to do. I typically don’t have a need to visit the doctor, so a higher deductible/co-pay plan works well for me. I just want coverage for myself if something really bad happens while also keeping in mind the preventive health services that are covered. For Nicole, who has a tendency to see a doctor or specialist more often, we went with a lower deductible/co-pay plan.
Comparing plans on the site is a breeze. There are boxes for each plan you can click on to do a final comparison between the options you choose. If you need to select a primary care physician (PCP) you will do so during this step. We were able to view the doctors (and hospitals) in each plan so we could choose one which allowed us to keep seeing the PCP we’ve had for years. Once we selected the plan we had the option of going to the plan website, setting up the account, and paying for our first month.
Another benefit to the ACA is that dental and vision coverage are also available. We just had our vision exams and ordered new contact lenses so we didn’t need vision this year, but we did purchase dental. Just as with the health coverage, we were able to select a plan where we can keep our primary dentist. What’s interesting is that the plan we chose for dental is cheaper than what my company was offering for extending my coverage. And the plan covers quite a bit of dental work! Online payment made finishing up the dental side quick too.
The cost for COBRA would have set us back about $1k/month. Yikes! Yes, the insurance did cover quite a bit more than we’re getting with ACA coverage, but we are paying about a third of that cost.
Overall, I’m quite pleased with the options that were available to us. The website was easy to navigate and obtaining our cards in the mail was fast (plus you’re able to print them from the plan administrators site too).