On October 1, Americans can start shopping for health insurance plans through the Affordable Care Act (aka Obamacare). Unfortunately, shopping is complicated, because each state manages their insurance plans differently. NerdWallet Health created this guide to lay out the basics every health insurance shopper will need to know.
Getting a quote
How to find your state marketplace
Find your state’s website here. States that opted to sponsor their own marketplaces have individual websites—those that chose federally run marketplaces are accessible through a single government website.
What to expect on the website
The term “marketplace”
- Obamacare establishes “healthcare marketplaces” or “health insurance exchanges”—essentially a fancy term for the place where you can buy new health insurance plans set up specifically for Obamacare.
- Buying health insurance at the marketplace isn’t exactly like going to Safeway. Your state’s “marketplace” isn’t necessarily a physical place—you can buy health insurance online, through a broker, or through a navigator (people paid by the government to present information on the different plans available).
- The websites have sections for individuals & families, employees, employers, and agents & brokers. If you just want to find insurance for yourself and/or your family, avoid confusion and find your way straight to the individuals & families section.
Gather this info before you start shopping:
- Household size
- Your age, and the ages of family members you’re also shopping for.
- Your zip code
- Your employer’s name
- Are you a smoker?
- Insurance premiums differ based on if you (or the other people in your household) are smokers.
- Get the discount you deserve! Most currently uninsured Americans will qualify for premium assistance – or a discount on the cost of insurance – but you’ll need to share your household income to calculate your discount.
- If you need to double-check your reported income, head to the Adjusted Gross Income line on last year’s taxes (find this on Line 37 on a Form 1040). You can calculate your premium assistance at any time using the Kaiser Family Foundation’s free Subsidy Calculator.
So now you have a quote…
How to think about metal tiers
All plans include the same standard benefits—free preventative care, no denial based on pre-existing conditions—odds are you’ve heard about a few of these added benefits of Obamacare.
So what is the difference between tiers?
- How much you pay per month
- How much you pay when you access health services
How to choose a company
At every tier level, most individuals will be offered a range of prices from a number of different insurance companies. Consumer Finance site NerdWallet has created an Easy Index to help you research these companies: use this guide to evaluate customer service, available technology support like on-line bill pay, as well as the size of the provider network (so you have more doctors to choose from).
Put a note in your calendar to pay by December 23, 2013
While you may start shopping on October 1st, coverage for all plans bought through marketplaces won’t begin until 2014. To make sure you are covered on January 1st, send in your first payment by December 23th, 2013. If you don’t sign up for insurance by March 31st, 2014 then you will have to pay a penalty on your annual taxes. Calculate your penalty here.
Vocabulary you’ll need to understand
- This is the price that the insurance company charges for a given plan. Many uninsured people won’t have to pay this full price.
Premium assistance (tax credit)
- The dollar amount that the government will pay to help lower your monthly payments.
- What you actually pay, after government assistance. This can be anywhere from free to the monthly premium (see above), depending on your income and location.
Tired of glitches on the government marketplace sites?
Try an established health insurance marketplace site such as eHealthInsurance.com to see your complete range of options. Be sure to select 2013 to see the plans available now: to see Obamacare plans, select 2014 in your search.
U.S. map photo courtesy of Shutterstock.