How Much is Health Insurance through the Marketplace?

As you may know, the Affordable Care Act has opened up several new options to help people get health insurance coverage if they don’t have it through their employer or other means.

One of these options is called the Health Insurance Marketplace and it helps individuals who are not offered insurance through their employer, or who can’t afford their existing plan, to select an affordable health plan that meets their needs and budget.

But how much will this cost you? And how do you know if you qualify?

What Is The Affordable Care Act (ACA)?

The Affordable Care Act (ACA) of 2010, also known as Obamacare, was created to help make health insurance more affordable and accessible.

In many states, subsidies are available for low- and middle-income families who need to purchase health insurance in order to comply with government requirements or simply get covered.

The ACA has four main components: individual mandates, exchanges or marketplaces, premium tax credits, and Medicaid expansion.

It’s important to know what these parts of Obamacare mean for you before determining whether it makes sense for you and your family.

At a high level, here’s how it works: Each state has its own exchange (also called a marketplace) where people can buy private insurance plans approved by each state’s department of insurance.

Who Qualifies For Marketplace Coverage?

Those who are self-employed, unemployed, or work for a small business that doesn’t offer health insurance may be eligible for coverage under Obamacare.

If you can’t get coverage from your employer, you’ll need to purchase it from a marketplace (exchange) like Covered California.

If you earn between 100 and 400 percent of FPL, depending on your state and situation (for example, if you’re older or in good health), then affordable health insurance may be available to you.

Some people will pay premiums only; others will qualify for subsidies to help with premium costs or out-of-pocket expenses.

Some people will qualify for free coverage when they apply at Healthcare.gov.

What Does It Cost To Get ACA Coverage?

If you don’t have insurance, or if your plan isn’t providing you with coverage that meets ACA standards, you may want to consider getting a new policy through one of the healthcare exchanges.

But how much will these plans cost and how do they work? We break down what it costs to get ACA coverage.

If nothing else, we hope our answer sheds some light on exactly what health insurance is going to cost for you and why.

Understanding Deductibles, Coinsurance, And Copays

The Affordable Care Act requires most Americans to buy health insurance and opens new opportunities for individuals, families, and small businesses to receive financial assistance in paying for their coverage.

New state and federal exchanges (also called marketplaces) offer a selection of private health plans that meet different needs and budgets.

Consumers can apply for premium tax credits that lower their monthly premiums or reduce what they have to pay out-of-pocket for care.

If you currently have an individual plan—whether it’s provided by your employer or purchased directly from an insurance company—it will be replaced by a marketplace plan on January 1, 2014. So whether you’re eligible for subsidies or not, it’s likely that marketplace plans will be less expensive than what you’re currently paying.

The Bottom Line On ACA Premiums

To sum it up, with health insurance you get what you pay for. Under Obamacare, many Americans will soon have coverage for pre-existing conditions and be able to remain on their parents’ health plans until age 26.

You may also receive additional benefits such as maternity care, domestic violence screenings and wellness visits—features that are not currently common in all insurance plans.

However, your costs for coverage will likely increase because of these added benefits (though not enough to fully fund them).

This can cause some sticker shock if you’re used to paying $100 a month in premiums without much in the way of coverage options or restrictions.

State And Federal Exchanges

Healthcare exchanges were created to make it easier for people to purchase insurance.

State-based marketplaces and exchanges are run by each state and federally based marketplaces are run by a branch of the federal government.

In order to see if you qualify for subsidies, you must go to your state’s marketplace or exchange.

The uninsured can also go directly to healthcare.gov, although they will still have to find their way back to their state’s marketplace eventually in order to choose a plan and enroll in coverage.

Medicaid/CHIP Coverage: Another Important Option

As we’ve said, health insurance exchanges offer plans in different metal tiers: bronze, silver, gold and platinum.

Premiums are set at each level based on actuarial value; bronze plans have a lower actuarial value and thus have lower premiums than platinum plans.

If you’re eligible for Medicaid or CHIP (Children’s Health Insurance Program), however, you might be covered by these programs before premium subsidies kick in—your eligibility depends on your state’s program rules and household income.

Since Medicaid/CHIP coverage offers 100% of projected medical costs with no deductible or copay requirements beyond nominal office visit co-pays, it can be more cost-effective than private insurance.

Marketplace insurance plans

The health insurance marketplace allows people without health insurance to purchase healthcare plans.

Those who are looking for a plan must consider monthly premiums, deductibles, and coinsurance in addition to coverage options.

Depending on your income level, you may qualify for subsidies or tax credits to offset some of these costs.

To find out how much a plan would cost you in your state, enter your age, zip code and income level into our search tool and we will provide you with a list of available plans from which you can choose.

For additional information on individual market plans check out our complete listing of Affordable Care Act health insurance plans by state.

Best individual health insurance

Rather than buying health insurance through an employer, you can buy it directly on your own by purchasing coverage on your state’s health insurance marketplace.

The marketplace makes it easy to compare plans side-by-side and choose one that meets your specific needs and budget.

You may be eligible for subsidies if you have a lower income, although premium costs vary based on age and whether or not you smoke.

The process is relatively simple, but it’s important to know what to expect when shopping for individual health insurance before beginning your search.

Health insurance cost calculator

Find Out How Much You’ll Pay Next Year.Health-insurance premiums have skyrocketed in recent years, eating up bigger chunks of household budgets year after year.

One way to combat those rising costs is to shop around and compare prices on health-insurance plans at state and federal exchanges.

Check out some of these key features to make sure you get enough coverage without overspending.

The Cheat Sheet below will tell you how much you should be looking to spend for a plan on your own or with help from an employer.

It’ll also list additional considerations like whether you’re eligible for subsidies and what medical services are covered by your state exchange.

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