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Answers for Comparing Employer Offered Insurance vs. the Current Healthcare Marketplace

As part of the Affordable Care Act, an 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 healthcare marketplace. It really isn’t a question of which one is better because the 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

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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. You have a much better chance of getting a lower price if you use your current company to get health insurance. They are paying a portion of your premium, and that brings your costs down a lot. The company knows that you are with a preferred partner, and they might work with you on a plan that best suits your needs. This is not common, but it is possible because large carriers have many options for you to choose from. The marketplace firms that you find are not willing to give you a discount because you are not a preferred customer. They expect to write up a policy so that they can get you on the rolls. Because of this, you tend to have less flexibility.

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.

How Long Does Coverage Last?

The coverage that you get should last for a year, and it should renew automatically. You will find that you could get coverage that lasts longer, and you will notice that the coverage is cheaper because you took a longer contract. You could change your insurance if you want, but it might be better to get something that has a longer contract if you want to save money.

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. You must look into the insurance carriers that work with your company. Small companies might only have one provider, and you must have several if your employer is a large corporation. Look at all the different healthcare options that you have,  you could contact all these companies to learn about what they can offer to you. They help you with comparing the policies that they offer, and they have several styles that you might not have even heard of before.

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.

How Do You Compare Employer-Offered Insurance With Policies In The Marketplace?

Comparing employer insurance to the healthcare marketplace is an important task for you. You know that you must take a look at both policies, but you have many options if you are willing to ask questions of your current employer. They have an insurance program and coordinator who might work with you, and they give you an idea of how much you could save if you choose from different policies through their carriers. Have a look at what you can do if you are truly researching all the different options that you have. You should go online to compare the coverage networks for all these insurance companies. You need to be certain that your current doctors and dentists are on the network. You might need to know if your specialists are in their network, and you might find therapists you know on the network. These little things are important because not all doctors are on all panels. You cannot get in with the right people unless you have compared coverage first.

Which Policy Do You Want? 

Healthcare policies with your current insurance firm could include a PPO, HMO, HSA, and combinations of all three. You might get some policies with the HSA attached, or you could ask for nothing but an HSA. You have to decide what you are most comfortable with, and you will find that these insurance companies like to work with you because they understand that you need more options. The same cannot be said for a random company that you picked off the marketplace.  Large insurance firms will offer you many choices such as indemnity policies and solo HSA plans. You must understand how these programs work because you need to know if an indemnity policy with a high lifetime maximum is right for you or not. You could get an HSA or Health spending account that will pay for all your healthcare needs during the year. You must be careful to budget the HSA, but it might be a better option if the policy is cheaper overall. Someone who wants to use an HMO might prefer the wide coverage area, and people who want a cheaper PPO will appreciate that their premium is so low.

National Vs. Regional Insurance

National insurance coverage is offered through the marketplace because it was designed to reach everyone in America. Regional health coverage is usually offered through your business because they can get better prices with companies that are in the area. You must ask them if they have special discounts for you because of where you live, and you must ask national corporations through the marketplace if they have any regional options. Regional options tend to be cheaper, and they have a better coverage area. Choosing your insurance provider is very simple if you are willing to compare all the companies that are available. These companies do a very good job of working with you on the policies that they offer, and you will save a lot of money once you have chosen between your employer and the national marketplace. Your employer’s insurance might be the best thing for you because they offer better service, or you could get a very low price from the marketplace because you know that it will help you get insured without all the pretense.

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