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Answers For When Comparing Employer Offered Insurance vs. The Current Healthcare Marketplace

As part of the Affordable Care Act, any employer must offer some form of medical coverage to their employees if they have more than 100 of them that work full-time. Just like individuals who don’t seek out insurance, there could be some heavy fines associated with this if they don’t do so.

If you work at such a company, you are not required to use the employer insurance they provide. The healthcare marketplace is still an option available to you for your coverage needs. Many people choose to forego their employer insurance and purchase coverage from the health care marketplace. It really isn’t a question of which one is better because employer provides a different level of insurance at a different cost to the employee. This weighed against the coverage you would get from the marketplace at the same price is what you should use to determine which version of health insurance is better for you both long and short-term.

The following factors should be the biggest factors in guiding your decision.

  • Price
  • Coverage
  • Subsidy Availability

The key is to have a complete understanding of your current employer insurance and the healthcare marketplace insurance you could get to make the correct decision for you and your family.

Comparing the Price of each Individual Plan

Price is an obvious factor, but don’t just choose the cheaper coverage because it is going to be easier on your pocketbook. Health insurance is not something to cut corners on. One of the biggest mistakes people make when they compare different plans is the deductible. A high deductible may not seem like a big deal right now, but it will make a big difference down the road when you need to use it. The slightly higher monthly premium that comes with a lower deductible sometimes outweighs the costs of the deductible down the road. Be sure to compare the deductibles of both your employer-provided insurance and your healthcare marketplace insurance before making a decision.

Being Aware of Your Coverage Options

It is also important to make sure that the two plans you are comparing have the same coverage. What is the point of paying a monthly premium if it covers fewer expenses? Find two plans that are similar as possible in their inpatient and outpatient services. On top of this, look into the prescription medicine coverage that is offered by each plan. This is something that can be very different from one health care plan to another and can be quite costly down the road.

Subsidies Plan Options That Benefit You

There are two forms of coverage typically offered through the ACA; comprehensive and supplemental. Supplemental insurance acts as a way for individuals to fill in the gaps in their current insurance plan in order to bolster their existing coverage. Before enrolling in your employee plan, make sure that you are still eligible for supplemental insurance through the marketplace. In some cases, you will not be allowed to have both while other employer-provided insurance allows you to do so. If you feel that you need supplemental insurance to help with the cost, then the marketplace might be the right place for you.

When You Should Choose Insurance Through Your Employer

While they can both be good options, there are some situations where it is advised that you use your workplace insurance. Most employers pay part of the premium for you, making it a good idea to use them in order to lower your overall costs. The more they cover, the more likely you should be to use that insurance. It is also a good idea to get employer based insurance if the coverage provider they use is particularly good and the coverage is very strong.

When You Should Use Marketplace Insurance

There are also some good reasons to use marketplace insurance. Here are some of the best reasons. Out-of-Network Doctor – If the doctor you like to use is not part of your employer’s insurance network, you may want to see if the marketplace insurance available to you includes them. Using an out-of-network doctor can be very expensive. You Have Specific Healthcare Needs – If you have specific needs or a condition that isn’t covered by your employer-provided insurance, it may be covered in the marketplace. There is no one health insurance option that is right for everybody. It is not a decision to be taken lightly, so be sure to weigh out all the facts before deciding on an employer or marketplace insurance.