Now that Obamacare open enrollment is here, we are seeing lots of questions as to whether someone should apply for a plan ON THE EXCHANGE (marketplace) as opposed to one that is OFF THE EXCHANGE (marketplace).
So here’s the difference: whether you buy a plan On-Exchange or Off-Exchange, what you’re buying is still a health insurance policy. On-Exchange simply refers to plans that are eligible for financial assistance. Off-Exchange no such considerations exist. But it’s still health insurance. So keep that tucked away for future reference!
Here’s what we see when it comes to helping our customers – It’ll work for you too!
Whether you choose an Obamacare plan On-Exchange or Off-Exchange depends on timing as well as income considerations – So, like most things in life, it all comes down to time and money.
When to consider an Obamacare plan On-Exchange
When you are eligible for and would like to receive financial assistance for paying premiums and/or reducing out of pocket amounts. The amount of financial assistance is determined by family size and income as a percentage of the Federal Poverty Level (FPL). If you’re at 100%-400% of the FPL for your income level and family size, you’ll get some sort of premium assistance. If you’re over 400%, you get nothing.
There is an exception – coverage in the exchange is available at other times if you have a qualifying event such as:
- Moving to a new state
- Certain changes in your income
- Changes in your family (such as marriage, divorce, birth or adoption of child)
- Loss of job-based coverage
- Existing insurance is being discontinued
When to consider and Obamacare plan Off-Exchange
The Application for Health Coverage & Help Paying Costs is 9 pages long. It requires a tremendous amount of financial information, most of which you would gather from your tax return and is estimated to take 30-90 minutes for completion. I’m confident the online application is probably an equal number of screens. So when you dig in, be prepared to spend some time and have access to all the information you think you could need.
Literally, if you qualify for help, you should take it, but understand that financial aid comes at a price for your time getting it set up.
On the other hand, if you aren’t going to qualify for aid, then going off-exchange provides some real value to you, as you are buying a policy much like you would have in years past.
Which one is right for you? Only you know, but you can always reach out to us at (615) 541-4257 or request a call online.