Do I have to get a health insurance plan through healthcare.gov?

Implementing the Affordable Care Action (ACA) back in 2010 rocked both the medical and the insurance communities. There has been much confusion as rules have changed over the years and especially as administrations changed.

However, the one thing you need to know is you have many options to get health insurance coverage without going through the government website of healthcare.gov.

The Benefits of a Broker

The passage of ACA created a new job as a health insurance broker. Where people used to go to a local insurance company to learn their options, they can now call an individual broker who has all the information on various government and private plans. A broker can also sign you up either through the marketplace, the state program or directly with a private insurance company.

Be aware that some brokers work specifically with certain health insurance companies. While they can still sign you up through the exchange, they can't file paperwork if you choose a different insurance company than the one they represent.

State-Sponsored Healthcare Exchanges

States have the option of having their own healthcare exchanges rather than relying solely on the federal exchange. Each state is different and has different options. Some include expanded Medicaid while others incorporate private healthcare insurance into the state plan.

There are currently 13 state marketplaces operating. There are also six state-managed marketplaces that function off the federal exchange platform and six states that are in a partnership with the federal government to offer health insurance.

Three states, New Mexico, Oregon, and Main, plan on developing their own exchanges in the immediate future.

Private Healthcare Exchanges

There are a number of private plans and exchanges outside the federal healthcare marketplace that will offer you insurance even beyond the fall/winter open enrollment period. This will satisfy federal requirements. As of the 2019 tax year, the federal fee for remaining uninsured doesn't apply.

These health insurance exchanges meet all the requirements of the federal health care law. That includes allowing only plans that cover pre-existing conditions and provide preventive care for free. They also don't cap annual benefits.

Buying Directly from the Insurance Company

It is possible to buy directly from a private insurer. While that can sound complicated, it doesn't need to be difficult. There are a number of qualified plans that aren't listed on the various marketplace exchanges.

Just like those listed on the exchanges, private healthcare insurers must meet federal requirements. You can find these plans in several ways:

• Insurance companies

• Agents

• Brokers

• Online health insurance sellers

What is the price difference?

The price of these types of insurance policies will vary from company to company, but will also vary from one access point to another access point. For instance, an online health insurance seller may have substantial discounts because they deal in volume, so the insurance company works with them to offer great deals.

However, a local agent in your hometown may have a good deal but their value is in personally knowing the agent. An agent you build a relationship with can be helpful in resolving a problem and answering questions quickly.

Insurance companies themselves tend to price their policies higher than other access points, especially for individuals, but it could be good to know the cost. This is where a broker is helpful.

A broker can tell you which plan best meets your specific needs and budget. They can compare the healthcare insurance plan you are considering with other plans and also compare all plans with the federal and state exchanges and give you an honest assessment of which plan is best for you.

How to Choose

All health insurance companies don't do business in every state. Since each state can craft its own health insurance option, the best place to start is to do some internet research to find out what is offered in your state.

For instance, Illinois health insurance options include a partnership exchange that uses the federal website for enrollments and private healthcare exchanges along with insurance agencies and companies where you can buy health insurance directly.

Once you do your research, you can develop a plan to obtain health insurance that works best for you and your family. That will give you peace of mind.

This article does not necessarily reflect the opinions of the editors or management of EconoTimes