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Which type of plan or health insurance should I get?

For individuals, families and business owners, there are 3 types of health insurance. As always, our licensed agents are here to help you find the right health insurance plan to suit your individual needs.

You may know Affordable Care Act (ACA) plans as major medical, comprehensive coverage, or even “Obamacare,” but whatever you call them, these plans meet all the requirements of the ACA and are typically the most comprehensive on the market. If you have a chronic illness or face a medical emergency, these plans can help prevent staggering expenses.

ACA plans provide benefits for a broad range of health care services, both inpatient and outpatient, and can save you money on routine doctor visits, prescription drugs, preventative care, hospital stays, and more. These plans are available to almost everyone, and you can’t be denied based on preexisting conditions.

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If you can't afford an Affordable Care Act (ACA) plan or have missed the cutoff to apply, you may want to consider a short-term plan. Compared to ACA plans, short-term health insurance typically provides much less coverage and does not help you avoid any state tax penalties. But short-term plans do accept applications year-round, and they can help offset costs if you have a medical emergency unrelated to a preexisting condition.

Short-term plans do not meet the requirements of the ACA and may not cover all — or any — of your medical needs, so you’ll want to read the plan details carefully before applying. Also worth noting that purchasing short-term health insurance may make you ineligible for other health insurance including ACA plans and COBRA.

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Also known as fee-for-service plans, medical indemnity health insurance pays you a fixed amount for services such as $50 for a doctor visit. In this example, if you visit the doctor, the plan will give you $50, regardless of the bill for the actual visit.

When combined with other insurance, medical indemnity plans can help cover out-of-pocket medical expenses like copays and coinsurance. You can also purchase a medical indemnity plan as your only insurance or as part of an insurance package, but as with short-term health insurance, medical indemnity plans do not meet the requirements of the Affordable Care Act (ACA) and will not help you avoid any state tax penalties. Indemnity plans also typically do not cover preexisting conditions and may include per-incident, yearly, and/or lifetime benefit limits.

Medical indemnity plans are not right for everyone, but if you want help covering medical costs and expenses, they may be worth a second look.

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Decision Guide
ACA vs. Short-Term Plans in Florida

For most Florida residents, eHealth recommends ACA plans. Why?
ACA plans go by several names — Affordable Care Act or Marketplace plans, major medical coverage, and even “Obamacare” — but however you know them, the important takeaway with that, by law, these plans are required to meet a long list of requirements designed to ensure that your major medical needs will be covered and that you won’t experience crippling medical debt in the event that you do need care.

In the state of Florida, the best alternative to an ACA plan is short-term health insurance. Short-term plans offer attractively low prices, but if you qualify for a subsidy — which eHealth can help you determine — an ACA plan may be equally affordable. (And it’s worth noting that subsidies can’t be used to pay for a short-term plan.) Value aside, short-term plans fall short of ACA plans in a variety of other ways including that they typically do not cover many basics like preexisting conditions, ambulance services, and prescription drugs. And they have coverage period Maximums, which means if your medical bills reach a certain amount, your insurance will stop paying.

When should you choose short-term health insurance?
Even though we recommend ACA plans for most Florida residents, short-term plans are worth considering if you live in Florida and cannot sign up for an ACA plan. Specifically, if you’ve missed the ACA open enrollment deadline (usually mid-October to mid-December) and don’t qualify for a special enrollment period, then short-term insurance is almost certainly worth exploring.

Alternatively if you’re generally healthy and only need transitional coverage for a few months, such as when you’re between jobs, then short-term coverage may be a good option. It’ll still be a financial risk, but you may decide the risk is worth it to save money on monthly costs.

Ultimately it’s your choice which plan is right for you.
While ACA plans are often the best option, it depends on your unique situation. If you would like additional help deciding which type of plan is right for you, our licensed insurance agents are standing by to help.

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