4 ways to buy a health plan in 2014

What if my income is too high to get lower costs on monthly premiums?

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If you’re not eligible for lower costs, you can buy health coverage through an insurance company, an agent or broker, an online insurance seller, or the Marketplace.

Find information about these different ways to apply below. (Getting lower costs based on your income is sometimes referred to as getting “subsidies” or “tax credits.”)

First: Find out if you’re eligible for lower costs

You could be eligible for lower costs on health coverage based on your income and household size. However, you generally won’t qualify if your estimated 2014 income is above:

• $45,960 for an individual
• $94,200 for a family of 4

(These are 2013 figures, and likely will be slightly higher in 2014.)

The lower your income, the lower your costs. If your income is close to these limits your savings will be less.

To figure out if you may qualify for lower costs:

• Use our chart to quickly see income eligibility levels for different household sizes.
• Use the Kaiser Family Foundation subsidy calculator to see what your savings might be.
• Learn how to count your income and household size when figuring out if you qualify for lower costs.

Four ways you can buy a health plan

If you don’t qualify for lower costs based on your income, you can get coverage 4 ways:

• Directly from an insurance company. You can contact any health insurance company and see plans available in your area. Many have websites that let you compare all plans available from that company.
• With the help of an insurance agent or broker. Agents generally work for a single health insurance company. Brokers generally sell plans from a number of companies. They can help you compare plans based on features and price and complete your enrollment. You don’t pay more by using an agent or broker. They’re generally paid by the insurance company whose plans they sell.
• From an online health insurance seller. These online services offer health plans from a number of insurance companies. They let you compare prices and features and then enroll with the insurance company.
• Through the Health Insurance Marketplace. You can apply and enroll through the Marketplace whether or not you qualify for lower costs based on your income.

Health plans inside and outside the Marketplace are similar

No matter how you buy your health insurance, health insurance plans generally offer the same set of essential health benefits, free preventive services, coverage for pre-existing conditions, and other rights and protections under the health care law.

Most plans available outside the Marketplace meet the requirement for providing sufficient coverage under the health care law. This means you won’t have to pay the penalty that some people must pay if they don’t have coverage in 2014. But not all plans you buy outside the Marketplace meet the requirement. Most insurers must tell you if the plan you’re buying qualifies as coverage under the health care law. Be sure to ask.

There’s one very important difference between plans sold inside and outside the Marketplace: The only way to get lower costs on your monthly premiums based on your income is through the Marketplace.

Even outside the Marketplace, open enrollment ends March 31, 2014

After open enrollment ends, generally the only way you can buy a health insurance plan is if you have a qualifying life event that gives you a special enrollment period.

This is true whether you buy your health insurance through the Marketplace or other ways.

www.healthcare.gov/whats-the-difference/