How Do I Get Health Insurance Quotes?

Fran
Fran Majidi
November 20, 2019

A health insurance plan may just be the most confusing form of insurance you’ll ever buy. Common questions are, “What is the health insurance marketplace?” “What is the tier system?” And, “How do I get health insurance quotes -- and where?” To make things even more confusing, if you’re not electing health insurance through your employer, you have options on where to buy your plan. Individual health insurance plans and health insurance plans for the family are available in the marketplace and are also sold privately through agents. Now you’re asking, “Well, which one should I buy?”

We try to clarify some points so you can shop for health insurance quotes in a way that works for you and your family.

What’s a Marketplace Health Insurance Plan?

If you purchase your health insurance through a state, federal or private health insurance marketplace like healthcare.gov or a Marketplace/Exchange then you have a marketplace plan. These plans are often called Obamacare. If you buy a plan from the Marketplace, you may get premium tax credits or savings, depending on your income.

In 38 states, people enroll through the federal exchange, healthcare.gov. The remaining 13 states have their own state exchange and can be found on healthcare.gov. These plans are also considered marketplace health plans.

If you try to buy insurance from healthcare.gov but your state has its own marketplace, healthcare.gov will redirect you to the appropriate website for your state.

Healthcare.gov is also where you can find out if you qualify for public health insurance programs that are subsidized by the state. You can only enroll in public health programs like Medicaid or the Children’s Health Insurance Program (CHIP) by using the marketplace. You cannot do it on the private health exchange.

The premium tax credit, a government subsidy, can only be applied to health insurance plans available on the marketplace. However, you can buy those plans on the private health exchange. Just make sure the plan is also offered on the marketplace exchange.

Do I Have to Be Low Income to Apply Through the Marketplace?

No, but if you are low income, you may qualify for a lower-cost health plan if you apply through the Marketplace.

Which States Have Their Own Marketplace?

California, Colorado, Connecticut, District of Columbia, Idaho, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Vermont, and Washington.

What’s the Difference Between State and Federal Marketplaces?

The two are almost identical, but states with the local exchange are states that have more control over health insurance plans on their exchange. Often states set quality standards and pricing limits. They may also have other, or additional, qualifying events for people enrolling outside of the open enrollment period.

What is a Private Health Exchange?

Private exchanges are very similar to the marketplace except they show you plans that are not sold through the exchange as well. By law, these plans meet the same requirements as marketplace health plans, but these health insurance companies are not obligated to offer plans across all four tiers (bronze, silver, gold, and platinum). For instance, a health insurance carrier selling privately can offer just bronze or just gold plans. This is the main difference between private health exchange plans and the marketplace health plans, which need to offer all tiers according to the law. You can shop and compare health insurance quotes from the private health exchange. Note that you have more options on the private health exchange.

What Do Marketplace and Private Health Exchanges Have in Common?

You can check which medications are covered, which doctors are in the network, premium prices, copay breakdowns, and deductibles for each on both types of exchanges.

What’s Required for Marketplace Health Plans but Not Private Health Exchanges:

  • Ambulatory services (outpatient care)
  • Emergency services
  • Hospital stays
  • Laboratory services
  • Mental health services
  • Substance use services
  • Pediatric services (medical, dental and vision)
  • Preventative care
  • Pregnancy care
  • Maternity care
  • Newborn care
  • Birth control coverage
  • Coverage for pre-existing conditions
  • Plan offerings in bronze, silver, gold, and platinum

Private health plans may also offer some or all of these, but they are not required to do so. Check to see what’s offered by each company after you get several health insurance quotes.

Should I Buy Private Health Insurance or Should I Buy from the Marketplace?

Both types of exchanges are easy to use. However, keep in mind that even though shopping from a private health insurance exchange, like SmartFinancial, offers more options, you’ll need to make sure you’re comparing apples-to-apples because not all health plans offer the same tiers. Also, you’ll want to make sure the plan you choose from a private exchange offers services you require. For instance, if you know you’ll be wanting to start a family within the year, you’ll want to make sure to only compare plans with pregnancy and maternity care.

Do I Pay More for Health Insurance if I Buy from an Agent?

No, you do not pay more for health insurance if you use an agent or broker. In fact, they often work with several carriers and can shop rates for you with your requirements in mind. If you find the process of comparing different plans confusing you may want to tell your agent what you require and then compare the options he/she gives you. SmartFinancial’s health insurance partner-agents are highly qualified to help you find the right health insurance plan for 2020. To start comparing health insurance rates, visit here and fill out a simple form.

When Is Open Enrollment?

Open Enrollment is from November 1, 2019, through December 15, 2019.

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