QUESTION

I received a call/mailer selling me new coverage that is much cheaper than what is available on HealthCare.gov. How do I assess my options?

Individuals with no coverage | Coverage Outside the Marketplace |
ANSWER

Healthcare.gov, or the Marketplace website in your state, is the only place you can purchase coverage that is guaranteed to provide all the consumer protections of the Affordable Care Act. It is also the only place to buy coverage with premium tax credits. There is no income limit on eligibility for premium tax credits, which cap your premium contribution at a percentage of your annual household income, so most people will do better to buy coverage through the health insurance Marketplace. Be sure to find out what your cost would be to buy coverage in the health insurance Marketplace, taking into account any premium tax credits and cost-sharing reductions that may apply.

If you decide to forgo coverage in the health insurance Marketplace, proceed with caution when evaluating options outside of the Marketplace, as there have frequently been cases of fraudulent activity and deceptive practices. Note that using a general search engine to find health insurance online may lead you to sites and sales representatives that steer you towards non-ACA-compliant products. In order to evaluate your options outside of the Marketplace, contact your state’s department of insurance for a list of reliable brokers who can assist you in assessing your options. Always insist on getting plan documents to review prior to buying a plan, particularly when purchasing a plan outside of the Marketplace.

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