Individual Health Insurance and the Affordable Care Act

Individual Health Insurance and the Affordable Care Act

The Affordable Care Act (ACA) ushered in many individual health insurance market changes. Under ACA, individual health insurance plans have become more comprehensive, benefit-rich, and mandatory by law. They are also guaranteed issues, meaning applicants can no longer be turned down based on medical history. In addition, there is no longer any waiting period for enrollment and no more fear of higher premiums or rejection due to pre-existing conditions.

Affordable Care Act

In October 2013, the Affordable Care Act launched individual health insurance exchanges. Though the rollout was slow and some websites were not functional, many previously uninsured Americans found coverage during the first and second open enrollment periods. According to survey data, 22.8 million new Americans gained health insurance, while 5.9 million dropped out. That left 16.9 million newly insured, and the total number of uninsured Americans decreased from 42 million to 25.8 million.

Individual health insurance under the ACA comes with various requirements and benefits. For instance, you cannot receive subsidies if you purchase a private health plan outside the health insurance marketplace. However, there are special enrollment periods that let you purchase a healthcare plan without waiting until open enrollment. This is especially useful if your circumstances change, including marriage, having a baby or adopting a child, moving or losing health insurance. Moreover, if you have a disability, you may also qualify for special enrollment periods.

Costs of individual health insurance plans

One of the most significant concerns in personal finances is the high cost of medical care. This has led many people to work outside their chosen professions and accept low-paying jobs to afford health insurance. While this makes economic sense, it's not the most desirable personal choice. The type of coverage primarily determines the cost of health insurance and the number of people covered.

Health insurance premiums have increased dramatically over the last decade. Until the Affordable Care Act, insurers priced plans using various factors. However, with the passage of the Affordable Care Act, the number of factors decreased, and today, premiums are based primarily on location.

Availability of individual health insurance plans

There are many options when it comes to getting individual health insurance. These plans can vary significantly in their cost and coverage. Bronze plans have the lowest premiums, copays, and deductibles, while the Platinum plans offer the highest premiums and coverage. The subsidies are the same for each plan, and most offer preventive care for free.

These plans are available from several carriers. Most are managed care plans and are network-based. Some are available through Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs).

Disadvantages of individual health insurance plans

The primary purpose of health insurance is to protect a person from high medical costs in the future. These plans typically cover pre-hospitalisation, daycare procedures, ambulance charges, and medicinal expenses. These plans help protect policyholders from high medical costs and help avert a financial crisis. However, they do have disadvantages. For example, you may not be eligible for coverage if you have a pre-existing medical condition.

Premiums are another disadvantage. Premiums for different plans can vary widely, depending on your age, health status, and lifestyle. This means you should consider all of your options and choose the plan that's best for you. To determine the best plan for you, learn more about the benefits and drawbacks of individual health insurance plans.