March 04, 2021
The federal government has changed the rules for enrolling in a health insurance policy if you’re not covered through work. Typically, the Affordable Care Act (ACA) allows enrollment each Fall, for the coming calendar year. But right now through May 15th, the Biden administration has swung the health insurance door wide open and anyone can enroll and get immediate coverage.
If you don’t have health insurance, please don’t pass up this opportunity. Worried you can’t afford it? I hear you. But don’t talk yourself out of it before you do the research. For many people, coverage is subsidized by the federal government.
And for those of you who lost a job last year but kept your health insurance by agreeing to pay for 100% of the coverage, I want you to comparison shop too: I think you may find an ACA policy is more affordable.
You may qualify for a reduced premium
The ACA program, regardless of what state you live in, offers help paying the premium if your modified annual gross income is within the program’s limits. This year, individuals with modified adjusted gross income below $51,040 may qualify for a premium subsidy (that means you don’t pay the full premium). A family of four with income below $104,800 may also be eligible for subsidies.
The subsidy can cut your monthly cost by more than half what it would be without the subsidy.
Everyone can start shopping at the federal government’s ACA marketplace: healthcare.gov. There are 13 states that run their own ACA marketplace, but if you start at healthcare.gov and are a resident of one of those 13 states, you will be shown a link to get to that site.
Still on COBRA?
If you were laid off last year and decided to keep your health insurance policy, you have been paying plenty for that option, right? While some employers are required to offer continued health insurance coverage to laid off workers—through a federal regulation known as COBRA—they are allowed to require you to pay 100% of the premium cost, whereas when you were employed you likely paid no more than 20% to 35% of the premium cost. And on top of that there can be a 2% COBRA charge for administrative costs. So you’re now paying 102% of your premium cost. And COBRA coverage only lasts for 18 months.
Please spend some time exploring switching to ACA health insurance.
The great thing with the ACA is that you can purchase a policy regardless of any pre-existing conditions. And don’t worry, you won’t be charged more.
That said, if you have an illness or condition that requires ongoing care, you will want to investigate whether your current care providers will accept an ACA policy. If not, you have to decide if you are willing to work with a new doctor. Ask your current doctor for referrals (don’t worry, they understand the insurance insanity and will not be offended if you need to change) and then call up those doctors and ask if they accept the ACA policy you are considering.
And please pay attention to more than the premium. You want to choose a policy where you can afford the copays. And be sure to consider the maximum annual out-of-pocket cost. Do you have that much tucked into an emergency savings account?