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Why Get Health Insurance in the State Marketplaces?


Aug. 30, 2014 US News & World Report

The Affordable Care Act calls for everyone to be insured in 2014, and sets a financial penalty if you don’t get insured. Some healthy people may weigh buying insurance (with a monthly premium) versus taking this penalty. A range of options is available in your state’s official marketplace. Each state’s marketplace offers plans that come with different amounts of coverage and benefits. Also, if your income falls below a certain amount, you can qualify for a subsidy on monthly premiums, which can help you afford a more expensive plan.

Go to U.S. News’ state insurance guide for specific buying advice.

Consider these factors about whether signing up for health insurance via your state marketplace is right for you.

If you buy health insurance:

  • Any plan, even the cheapest on the market, is guaranteed to protect you to some degree against 10 kinds of medical costs, including hospitalizations, preventive care (like annual physicals and some vaccinations), emergency services, and prescription drugs.
  • The amount you pay for health insurance each month will no longer be based on your health status, or history of past medical claims.
  • You cannot be denied insurance for having a preexisting medical condition.
  • Plans cannot have a lifetime limit on coverage. Before the ACA, some insurers would stop covering you after paying for a certain amount of care.
  •  Even the least-expensive plan will cap your out of pocket maximum at $6,350 per year for an individual, or $12,700 for a family.
  •  Financial aid in the form of tax credits or subsidies may be available, depending on your income, and some consumers may qualify for coverage through Medicaid.
  •  Plans cannot cancel your coverage once you get sick, unless you commit fraud when you apply for coverage in the first place.
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