Originally posted on November 4, 2019
November 1st, 2019 was the first day for people to sign up for health insurance through ACA marketplaces. The open enrollment period runs from November 1st, 2019 through to December 15th, 2019.
Do I need health insurance?
While everyone’s circumstances are different, the prevailing advice has been a resounding “yes” amongst financial experts. There are exceptions to the rule, of course, but the vast majority of people stand to benefit.
The benefits of having health insurance
40% of Americans are unable to cover a $400 emergency expense and the average emergency room cost exceeds $1233, and so having health insurance can prevent the number one cause of personal bankruptcy: medical debt.
Health insurance also often includes preventative care, such as free annual health exams, flu shots and other ways to catch problems before they require an expensive treatment or hospital visit. The benefit? Employees don’t have to take unexpected time off work, kids don’t have to miss as much school and the risk of medical debt is greatly reduced.
When shouldn’t you have health insurance?
Our general advice is to always have health insurance if it’s financially possible. However, if you have a high net worth, you may have the option of not taking it out. If paying for health insurance means that you can’t afford rent and groceries, that could also be a reason to avoid it. However, in that case, we’d encourage you to look into Medicaid or high deductible insurance plans.
In general, you should think of health insurance as being like an emergency savings fund for when something goes wrong.
Steps to follow when searching for insurance
There are plenty of great resources online that can help you to find and decide on health insurance policies, including healthcare.gov.
Does your employer offer health insurance?
Before signing up for any health insurance plan, check with your employer to find out if they offer health insurance as a benefit. If they do, learn about the costs and plan details. A plan that’s offered through your employer might be more affordable than going through the healthcare marketplace or using self-selected plans.
Note that you may not be eligible for the healthcare marketplace depending upon the out-of-pocket insurance costs offered by your employer.
Are you eligible for Medicare or Medicaid?
The healthcare marketplace can help you to determine this as you go through the sign-up process.
Go to Healthcare.gov or your state’s marketplace
Healhcare.gov is the official site for health insurance exchanges. Once there, you can use their calculator to determine your eligibility for discounted health insurance plans. Even if your income is too high for discounts, you can still use the marketplace to compare plans and to purchase one.
What are the differences in tiers?
For a quick overview of the differences between tiers, check out this chart.
If you’re unhappy with the plans that you find on the market, go directly to the source and check with individual insurance providers. Bear in mind, though, that marketplace plans must cover certain essentials.
Things to consider while shopping
- Monthly cost: Consider how the monthly cost of your health insurance affects your budget. Though deductibles are important, you need to ensure that you can afford the recurring monthly payments that are associated with your plan.
- Deductibles and co-insurance rates: How large is your emergency fund? Even if you have insurance, you’ll have to pay a fee for some services like doctor’s visits and prescriptions. Try to find plans with lower deductibles that you can afford with your monthly costs.
- Maximum yearly cost: Again, look at your emergency fund. Is the maximum yearly cost an amount you can pay out of pocket? After you reach this cap, you’re no longer responsible for your deductible.
- Provider network: Does the plan cover your preferred doctors and hospitals?
- Extra benefits: Some plans offer additional services, like life insurance policies, health savings accounts and medical management.
Open enrollment ends on December 15th, 2019, which means that you can’t afford to wait. We suggest making sure that you have coverage or a plan to enroll with your employer, Medicaid/Medicare or a private insurer before then.