I am confused about whether the Health Care Marketplace is right for me and my family. We have insurance through my work but it is not clear if I have to use the Marketplace to get coverage starting next year. Who is supposed to use the Marketplace?
The Marketplace is intended for people who are self-employed, employed by small businesses that do not offer health insurance, and who are otherwise under-insured or uninsured. This is not to say that people who have health insurance through their employer can’t use the Marketplace. It all depends on which option, Marketplace plan or employer provided plan, is the best and most cost-effective choice for you and your family. Most people who choose to sign-up with a Marketplace plan will get some help with costs. Other people may qualify for lower costs on their monthly premiums and out-of-pocket costs or get free or low-cost coverage from Medicaid or CHIP.
You will need to look at your current plan, its benefits, and out-of-pocket costs (premiums, deductible, copays, etc.), and compare it to plans available on the Marketplace. When making the comparison, some things to consider are whether you can keep your doctor on a Marketplace plan, if and how your medications are covered, and weigh monthly premiums verse deductible costs carefully. For a list of what to consider when comparing plans, see NHF’s Personal Health Insurance Toolkit. You can go online to learn more about Marketplace plans now and view plans starting October 1.
Word: Employer-Sponsored Insurance
This type of insurance is provided to employers through an employer. If you currently have this type of insurance and expect that to continue, you will fulfill the individual mandate in 2014.
HFA frequently receives questions from the bleeding disorders community related to advocacy issues. The questions often impact the entire community. In an effort to reach the largest audience possible with our responses to these widely applicable questions, HFA developed “Dear Addy.” Questions submitted to this column are edited in order to protect privacy and should be considered educational only, not individual guidance.