Health Insurance
Individual & family health insurance: simplified
Health insurance is a form of risk management that provides financial protection against medical expenses. It is essential to have the right type of health insurance to ensure you are covered adequately in case of unexpected health issues. There are two primary types of health insurance for individuals and families – ACA health insurance and private health coverage. Let’s explore the differences between these two types of coverage and help you decide which one is best for you.
What is ACA Health insurance?
ACA health insurance, also known as Obamacare, is a type of health insurance that adheres to government mandates. This type of health insurance is available to individuals and families who cannot afford private health coverage. ACA health insurance is designed to provide affordable coverage for essential health benefits, such as doctor visits, hospitalization, mental health, drug rehab, and preventive care.
What is private health coverage?
Private health coverage, as the name suggests, is health coverage that does not adhere to government mandates. It is typically favored by small business owners and those who may not qualify for lower rates based on income. Private health coverage can vary significantly, with different levels of coverage, term lengths, deductibles, copays, and out-of-pocket expenses.
Benefits & limitations of ACA Health insurance
Benefits
- Wellness/Preventative Visits are fully covered
- Discounted rates may be available based on income
- Coverage for mental health, maternity, and substance abuse treatment
- Rates cannot be increased, and coverage cannot be denied due to preexisting conditions
Limitations
- Depending on your state, network options may be limited
- Expensive if you do not qualify for a lower rate based on your income
- Higher deductibles and plan maximums
- Only available during open enrollment (November 1st through December 15th) unless you qualify for a SEP (special enrollment period)
Benefits & limitations of private health coverage
Benefits
- Access to nationwide networks
- Access to more doctors, specialists, and facilities
- Lower deductibles and plan maximums
- Lower deductibles specifically for accidents/injuries
Limitations
- Approval is subject to medical underwriting
- Does not cover maternity, mental health, or substance abuse treatment
- Depending on the plan, performance may vary significantly for larger claims
- Consulting with a licensed health insurance professional is required to enroll
Which one should you choose?
The choice between ACA health insurance and private health coverage ultimately depends on your personal circumstances and needs. If you cannot afford private health coverage, ACA health insurance can be a good option. It provides affordable coverage for essential health benefits, and you may qualify for financial assistance to help pay for the premiums.
On the other hand, if you can afford private health coverage and want more flexibility and choice in terms of coverage and benefits, private health coverage may be the better option for you.