Individual health insurance is one way to protect yourself against unexpected medical emergencies which can quickly drain funds and savings especially if long term care and therapy is required. Even more frightening is the idea of income suddenly being derailed because one can no longer go to work because of a medical condition. Under the Affordable Care Act (ACA), a person can buy individual health insurance through public exchanges rather than buy private exchanges dealing outside of the ACA marketplace.
Public exchanges were designed to address the growing number of uninsured or underinsured. More than 50% of the uninsured are expected to get free health insurance while some will get financial assistance on out-of-pocket costs. By 2016, around 20 million will no longer have to get public exchange although those exempted may still get coverage under a unique enlistment.
To a certain extent, public exchange has been successful in addressing the problem of uninsured and underinsured in spite of the many controversial and debates since 2013 – the year the enrollment started.
With Medicare, you still have to meet certain requirements to get adequate medical attention. Unfortunately, Medicare will not cover many long term care. In fact, less than 50% of nursing home costs and only 2% of nursing home accommodations are covered by Medicare.
Another significant change with today’s individual health insurance under ACA is that anything restorative must be deemed crucial. If you need something cosmetic, you will have to buy from the private exchange.
Under the public exchange, there is a minimum coverage that should be bought into during the open enlistment period. The only way to avoid this would be to fall under the exemption rule. Unfortunately, for many, the cost of health insurance under ACA is staggering with high deductibles. Under ACA individual health insurance, one is also pressured to buy well-being as well as pay for new fees when processing claims.
Those who did not buy the well-being insurance last January and those who did not buy into it because they did not meet the requirements of the Federal Poverty Level cutoff face additional problems.
On the other hand, individual health insurance through private exchange, which is not as popular, offers more flexibility and promise. Not only can it provide for all your possible emergency and preventive needs, it is considered by insurance experts as the road towards recovery for the insurance industry.
As you can see, the pros and cons of the ACA and private exchange is confusing and messy. It boils down to choice. With private exchange, you have more options and can customize your health insurance better but you could end up having to pay higher rates. In exchange, you can combine other insurance needs into a multiple benefit plan.
With ACA and its multiple carriers, you also have choices but the features are pre-set to follow certain criteria and price ranges. It is, however, designed to be user-friendlier than working on a private exchange individual health insurance plan.