Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
There are several exemptions from the fee that may apply to people who have no income or very low incomes. See the full list of exemptions for 2018. If you have an exemption, you don’t need to pay the fee for being uncovered when you file 2018 taxes in the spring. Note: Starting with the 2019 plan year (for which you’ll file taxes in April 2020), the fee no longer applies. You won't need an exemption for 2019 and beyond.
Insurers may have a greater range of policies available on their websites than they do on the state exchanges. Most will let you directly compare plan details, see more detailed information, and apply online. Of course, you won’t be able to see options from other providers, so this might not be your best bet for saving money unless you know which company you want to do business with.
One more tip: Consider opening a health savings account (HSA) if you go with a high-deductible plan, which are often called high deductible health plans (HDHP). You can sock away money in an HSA completely tax-free to help you pay for health care. Individuals can contribute up to $3,500 in 2019 as long as they are enrolled in a health care plan with a deductible of at least $1,350.
You can apply for coverage during the open enrollment period that runs from Nov. 1 through Dec. 15 in most states, including those using healthcare.gov. Coverage through a marketplace plan takes effect on Jan. 1, 2019. After Dec. 15, you may only sign up for a plan under special circumstances. Open enrollment in states that run their own marketplaces depends on the state. Seven states—California, Colorado, DC, Massachusetts, Minnesota, New York, and Rhode Island—have extended open enrollment beyond Dec. 15, 2018. Check with your state marketplace for details.
First-time purchasers should strongly consider consulting several independent agents before buying to compare their advice. To find an agent, ask friends or family members for recommendations. You can find agents who specialize in health insurance through the National Association of Health Underwriters. Online brokerages also typically have live agents available to answer questions by phone.
Incidentally, when the Affordable Care Act was originally passed, you had to pay a penalty tax for going without health coverage unless you met certain exemption criteria, including financial hardship. But going forward, in 2019, there will be no fee if you don’t have health insurance. (If you were uninsured in 2018, you will be penalized on your 2018 tax form for that.)
Prior to the ACA’s reforms in the individual health insurance market, medical history was a factor in eligibility for private plans in nearly every state, including California. Applicants with pre-existing conditions were often unable to buy individual plans in the private market, or if coverage was available it came with a higher premium or with exclusions on pre-existing conditions.
An agent should help guide you toward the insurer most likely to accept you. Keep in mind that if you are rejected by one carrier, you will probably have to disclose that in future applications. An agent also should help you fill out the application. But make sure that you know what’s in the application and that it is accurate. If you make mistakes, you may give the insurer an opening to rescind your policy later.
Another possibly cost-effective way to insure yourself is with a combo platter of sorts—but it could also become more complicated. You can try mixing traditional indemnity insurance, designed to pay a set daily benefit if you’re hospitalized or in an accident, with a short-term medical plan that can enable you to get to the doctor a few times a year for your more minor ailments.
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Health insurance premiums are filed with and regulated by your state's Department of Insurance. Whether you buy from eHealthInsurance, your local agent, or directly from the health insurance company, you'll pay the same monthly premium for the same plan. This means that you can enjoy the advantages and convenience of shopping and purchasing your health insurance plan through eHealthInsurance and rest assured that you're getting the best available price.