Edward Harris

Mental Health Insurance Coverage And Information

Mental health treatment is now covered under most conventional health insurance plans, and is also considered an "essential benefit" (ESB) on any policy purchased through a Federal or State Exchange. This means that a typical Marketplace plan must include comprehensive coverage for the diagnosis, treatment and rehabilitation of behavioral  expenses. This includes mental and substance abuse costs. As one of the 10 ESB mandated benefits, all newly-issued policies must contain these provisions.

The Affordable Care Act (ACA)

The ACA (Obamacare) was the signature legislation that greatly improved and enhanced many healthcare benefits. One of the most important changes was eliminating any extra charges, delays or higher deductibles for pre-existing conditions. And of course, the new federal tax subsidy was created to reduce rates for many qualified Americans.

Pre-existing conditions can not be excluded on any newly-issued plan that is Affordable Care Act-compliant. This feature also applies for any person that purchases a policy that was not previously covered, or had a lapse in coverage. There is no waiting period, surcharge or limitation of benefits for any of your expenses.

However, policies must be purchased through designated Open Enrollment periods. For example, for 2015 plans, the period between November 15th and February 15th (2015) is the official OE time frame. You can also qualify for a special exception (SEP) if you lose your benefits at work, move to a different location, get divorced and several other situations.

Required Benefits

Among the specific provisions that must be included in newly-issued policies are substance abuse (and accompanying disorders), behavioral treatment, counseling, psychotherapy, and some other inpatient-related expenses. Each state will have different levels of coverage although annual and lifetime caps can not be placed on benefits.

Any restrictions listed on the general policy can not single out a specific type of illness. This includes copays, coinsurance and deductibles. For instance, if the copay for a non-preventive office visit is $25, a mental-illness visit can not be singled out with a copay of $35 or $50. Also, the number of covered visits can not vary from one type of illness to another.

Parity And Addiction Equity Act Of 2008 (MHPAEA)

Obamacare Mental Illness Coverage Available

The Affordable Care Act Provides Comprehensive Mental Illness Benefits


The Mental Health (MH) Parity And Addiction Equity Act Of 2008 has now become fully implemented. It states that there should be no difference in copays, coinsurance and deductibles between medical and surgical benefits and other "mh" and substance abuse and use disorder (SUD)benefits. The level of treatment including the quality, scope and its duration must also not differ from other types of treatment.

The legislation also mandates that if out-of-network benefits are offered for hospital and surgery expenses, the same must be provided for MH and SUD coverage. If treatment (or payment for treatment that was performed) is denied, then the reason for that action must be made available to the beneficiary or participant.

The law applies to both private and public sector companies. Both state and federal authorities have enforcement capabilities to ensure parity of coverage. There was also a similar law passed in 1996 which is simply amended by the more recent legislation.

The IRS, Department of Labor and Department of Health and Human Resources are all involved in compliance. Each state insurance commission also has jurisdiction in many circumstances. These regulations apply to plans provided by employers with more than 50 employees.

It does not apply to smaller employers or policies that are privately purchased.  This MHPAEA fact sheet provides additional more detailed information. Also, the impact on Medicaid and Medicare is a bit murky, since additional rulings and regulations are expected to provide more specific guidelines.

Denied Claim

If you submit a claim that is denied, or you feel that your current coverage is unfairly imposing restrictions on benefits you feel should be covered, you do have recourse. In many instances, decisions are reversed and/or restitution is paid.

The Parity Implementation Coalition (their website is found here) specializes in legal compliance in the mental health field. They handle complaints from both providers and patients, and assist in mediating or solving your concerns. For more than 15 years, they have helped fight  mental illness and substance abuse discrimination against families and individuals.

If your coverage is self-administered by your employer, then the federal government may have to handle your complaint or appeal. However, the Coalition may still be able to offer guidance regarding which resources will be the most helpful and how to initiate the appeal process.

Provider Network Availability

Perhaps one of the most critical components of your coverage is the availability of network providers from your individual or group plan. Although most large carriers have a significant number of physicians, specialists and medical facilities within a short radius of most customers, finding mental health professionals may be a bit trickier.

It's imperative that you check the number of providers that are within a reasonable driving distance. If the closest provider is an hour away, you may not want to drive that distance. Or, you can compare multiple companies and their provider networks, and select the one that is able to provide the closest MH or SUD provider. Even the cheapest available HSA plans will allow you to utilize large networks of specialists and benefit by the negotiated discounts.

Pay cash for mental illness coverage

Always Check Provider Network Before Getting Treatment


You may also find that many psychologists, psychiatrists and other related specialists do not accept insurance. Therefore, unless you pay in cash, check, or debit,credit card, immediate service may not be available. This practice is an effort to reduce cost (including administrative staff salaries) and the time and labor hours often needed when attempting to recover patient reimbursement.

JAMA Reports

The Journal Of The American Medical Association (JAMA) also recently revealed that only about 50% of practicing psychiatrists accepted individual or group health insurance coverage. If you need this type of treatment and you do not want to pay out-of-pocket for your services, it's critical to find a professional in your area. There are reputable rating websites (such as YELP) that will help you find professionals that have been recommended by other consumers.

"Cash only" providers often charge less (up to 50%) than a typical provider-affiliated physician. However, you will have to pay for your treatment either before or just after your appointment, and typically balances must be paid in full. Billing statements are not mailed since they are collected in person.

However, if you build up a long-term relationship with a physician, alternative billing arrangements may be able to be arranged. There are also provider service locators that can help you find a list of specialists in your area that may be willing to accept new patients.

Non-Compliant Plans

Not every plan that is available is ACA-compliant. In fact, many "short-term" policies are very popular, and issued by major reputable companies, such as UnitedHealthcare and Blue Cross Blue Shield (BCBS). However, these are considered "off-Exchange" policies and do not have to conform to specific legislative mandates. Typically, temporary contracts have very limited mental-illness coverage, since coverage is kept for less than 12 months, and often less than six months.

However, these types of policies will help you maintain major medical benefits until you become eligible for an SEP (mentioned earlier) or the next Open Enrollment. Once your Marketplace policy is effective, you may resume coverage for your specific needs. Naturally, you should still continue treatment, if possible, for any conditions you have, despite your existing healthcare plan not covering them.

After Age 65 Mental Expenses Covered

Many Behavioral Medical Expenses Are Covered Under Medicare


Mental Health Benefits Through Medicare

Once you reach age 65, your medical benefits will be covered through Medicare. Your prior or employer-sponsored retiree plan will be canceled since you can not carry primary and Medicare benefits together. Of course, if you are still working, you can  keep an existing group coverage, if available.

Part A covers your inpatient expenses including nurses, room charges, meals and other related expenses. Benefits would be payed for stays in a conventional hospital as well as a psychiatric hospital. However, there is a 190-day limit (lifetime) for psychiatric  hospital expenses. Phones, televisions and a private room are not covered.  A deductible applies to inpatient care and after the first 60 days, out-of-pocket coinsurance will apply.

Part B includes coverage for visits to the following professionals: (Assignment must be accepted and these services may not be covered at 100% as copays and/or coinsurance may apply). Usually, there is a 20% coinsurance for specific treatment.

Nurse practitioner

Clinical social worker

Physician assistant

Drug and alcohol counselor



Many outpatient services are also covered that don't take place in the traditional hospital setting. Examples include  offices used by doctors, clinics and therapists. Also, many hospitals have outpatient services that treat  alcohol and drug use. A depression screening (one per year) is also allowed.

Additional Part B benefits include single and group psychotherapy  with physicians and other approved licensed specialists. If family counseling is part of the recommended treatment, it also is covered. Occasionally,  mediation services or management will be required along with diagnostic tests and injection drugs (that you can not give to yourself).

Part D  is the prescription portion of your Medicare coverage.  Prior to enrolling in a Part D plan, it is important to determine if your medications are part of the "formulary" listing. This list is always available from the company that issues the policy. There's no guarantee that all of your prescriptions will be covered, although most are likely to be on the list.

However, some of the types of drugs that are normally required to be included in benefits are anticonvulsant, antidepressant, and antipsychotic medications. A "cover determination" can be requested if a specific prescription is not on the formulary list and you feel it is needed or it's too expensive for you to afford to pay.

Treatment for mental illnesses including depression have become much more comprehensive and affordable in recent years. There are many available health insurance plans that include these benefits at a cost you can afford.

How To Get The Cheapest Health Insurance Rates

Save money on your Obamacare health insurance coverage. The combination of the new federal tax subsidy and properly enrolling in the right plan, will provide quality medical benefits at the cheapest available price. You no longer have to meet underwriting guidelines to qualify, and affordable healthcare enrollment is easier than ever to obtain.

Free Subsidy Money

Understanding the Federal  Government Marketplace subsidy and how to use it, is a great place to start. To qualify, your household income must be between 100% and 400% of the Federal Poverty Level. OK. So What are the  magic numbers?

The graphic below (courtesy of CAHBA) shows the different income levels that will earn financial aid. For example,  a household with four family members and an income above $95,000 will not qualify. However, a five-member household can earn about $110,000.

FPL Guidelines Obamacare

Federal Poverty Guidelines For Subsidy (Click For Full View)


Even though this aid is classified as a tax credit, the actual money is deducted directly from your health insurance premium. Therefore, you do not have to wait to file your taxes in order to receive reimbursement. If you over-estimate your income when calculating the subsidy,  the following year, an adjustment will be made. Likewise, if you underestimate the subsidy, a credit will be given.

Since all household members are considered, regardless if they are applying for coverage, obviously the larger the family, the bigger the subsidy will be. So if one spouse is retired and already receiving social security benefits (and Medicare), or they are covered under a group plan, it still benefits you when determining how much money you will receive.

Also, if you declare children as dependents on your tax return, even if they are over the age of 18 and not  a full-time student, it will increase the amount of your "free money." However, income that your children earn may have to be counted in the subsidy calculation. Of course, typically, the amount of money they make is easily offset by your tax credit reimbursement.

The Hidden Silver Plan Gem

The Silver plan is one of four "Metal" policies available when you choose coverage. The others are Platinum, Gold and Bronze. A special "Catastrophic" option is available for persons under age 30. Any company that wants to participate in the Marketplace must offer consumers at least one Silver and Gold plan.

From an actuarial standpoint, Silver plans are expected to pay about 70% of your anticipated medical expenses. The remaining 30% consists of the deductible, copays, and coinsurance. Often the deductible is in the $3,500-$4,500 range and maximum family out-of-pocket expenses can be as much as $12,600 for a family.

But here's the "hidden gem." The Silver option is the only Metal policy with "cost-sharing." If your household income is below 250% of the Federal Poverty Level, than you can drastically reduce the deductible and copays. Here's an example:

Suppose you lived in Indianapolis and your family consisted of two adults in their late 40s and two teenagers. The household income was $47,000 and pre-existing conditions prevented you from qualifying for coverage prior to 2014. And you could not afford to pay a large deductible (such as $5,000) if you had a major claim.

Cost-Sharing Exchange Plan Options

The "Silver" Metal Plan Features Cost-Sharing


The Anthem Silver Direct Access cbaa plan usually costs approximately $1,300 per month with a $3,500 deductible. But the subsidy  "cost sharing" reduces the deductible down to $800 and the premium to only $344 per month. That's a savings of more than $11,000 per year and the deductible drops by more than 70%. If the income increases to $57,000, the subsidy is still more than $10,000 and the deductible also reduces.

Bronze Metal Plan Options

Bronze Exchange policies are often the least expensive policy you can purchase, unless your low income can qualify for a "catastrophic" plan. Why are Bronze options the cheapest? Because, actuarially, it is calculated that you will have to pay approximately 40% of your medical expenses out of your own pocket. Thus, as opposed to the 30% (Silver), 20% (Gold) or 10% (Platinum) contracts, your risk is higher.

But what if you had no serious medical issues and you were unlikely to incur enough expenses to even meet a smaller deductible such as $1,500 or $2,500. Of course, you would select a higher deductible (perhaps $3,500, $5,000 or higher), and pocket the savings. If a serious medical condition developed, each Open Enrollment you can choose to switch to a different policy, that may be more cost-effective in covering your new expenses.

That's the concept of the Bronze Metal plans. Your worst-case scenario is $6,350 of medical expenses (that's the law) that you are unlikely to incur. Therefore, why pay for benefits that you probably will not utilize? And since this type of plan is likely thousands of dollars less in premiums (family plans), you can pocket the difference as a reward for your good health.

Medicaid Expansion

In many states, the expansion of Medicaid has created many opportunities for low-income families to qualify for free healthcare benefits. The threshold for determining who qualifies (and who is denied) has changed, and Medicaid enrollments have increased in every state. Actual expansion and liberalization of eligibility guidelines has taken place in about 30 states.

How To Reduce Healthcare Prices

Where Do Your Healthcare Dollars Go?


The states that have not expanded (yet) would like to transfer the matching Medicaid funds so their state residents can purchase coverage through the Exchanges. It's not a bad idea, assuming the benefits provided equal or exceed coverage that would have normally been furnished. And since more doctors, specialists and hospitals would be made available, network coverage would increase.

Often, individuals or couples in their 50s and 60s will surprisingly qualify. It's also possible that the following year, your income may change, and you will  be able to buy subsidized coverage through Exchanges. Since it's a fluid process, it's important to review choices before Open Enrollment each year.

Short-Term Options

Temporary medical plans are the least expensive type of coverage offered by the large reputable companies. They are typically used when there is a short-term gap in benefits. Often, these gaps are a result of  job loss, graduating college and waiting for employment to begin, seasonal layoff from work, job termination or waiting for Medicare coverage to start.

Although extremely cheap, these policies are not Affordable Care Act-compliant, and therefore do not include all 10 required "essential health benefits." You can keep your policy for up to 12 months, but the benefits-paid cap is often between $250,000 and $1 million, and a deductible applies to all claims Pre-existing conditions are not covered. Young adults often use  temporary coverage (details here), because of the low premiums.

But the rates are very affordable! Listed below are monthly rates  for a UnitedHealthcare short-term (Value option) policy for 45 year-old male living in Columbus, Ohio. Naturally, prices are  predominately based on age and zip code.

$56 -- $5,000 Deductible

$69 -- $2,500 Deductible

$91 -- $1,500 Deductible

$106 -- $1,000 Deductible

Short-term policies are often approved within 12-24 hours of the application submission and are quickly underwritten. Quite simply, there are about six medical questions (along with a few administrative questions). If you are able to answer all questions "no," you will be approved. Other major companies that offer competitive rates besides UnitedHealthcare include Blue Cross, Assurant, Companion Life, IHC Group, and HCC Life.

The cheapest Health Insurance Exchange rates will save you hundreds, or perhaps thousands of dollars, compared to more expensive plans you may currently have.Get your free quotes, compare quality plans and save!

North Carolina Health Insurance Exchange Rates – Online Quotes

The 2015 North Carolina Health Insurance Exchange allows consumers to purchase quality individual, family and small business medical coverage at affordable rates. Pre-existing conditions are covered without any waiting periods or surcharges, and applications for coverage can not be turned down for past or present medical conditions. There are many NC subsidized plans that allow you to obtain quality benefits.

The Obamacare federal subsidy provides savings of thousands of dollars every year to NC residents that qualify. The Affordable Care Act (ACA) has added 10 "essential benefits" that are included on all policies. However, it is possible to qualify for a "catastrophic" policy, that will eliminate some benefits, and thus, make available very basic cheap North Carolina healthcare. NOTE: Catastrophic plans are offered to applicants under age 30, or any person that can show "financial hardship."

In fact, hundreds of thousands of residents will currently qualify for "free" coverage either through meeting Medicaid income guidelines or qualifying for maximum subsidies that pay all of the premium. State workers and retirees can also expect some help, despite the recent delays in sending their ID cards. Since the financial aid is based on income, retired persons can often qualify for large amounts of assistance.

How To View Rates

We make it easy for you. Of course, the quotes we provide are always free with no obligation. We created a section in the top portion of every page that allows you to enter your current zip code. Instantly, you can view the best options in your area and request to view live prices. There are 16 "rating" areas in the state and you can view prices in all counties. If you move from one county to another, it's important to verify that your doctors, specialists or hospitals remain inside the provider network.

NC Companies Offering Marketplace Plans

The "Marketplace" is another name for the "Exchange." The participating carries for 2015 are  Coventry, BlueLocal, UnitedHealthcare and Blue Cross And Blue Shield of North Carolina. Yes...That's the complete list! First Carolina Health Care reversed its position in September (2013) and decided not to offer 2014 medical coverage last year. They would have provided plans in Lee, Richmond, Scotland, Montgomery, Hoke and Moore counties.

BCBS policies are available in all 100 counties in the state. Coventry was available in 39 counties, although that number has increased for 2015. A rate increase of 13.5% is expected. It is hoped that additional companies will also become available next year. Currently, there are four counties where only one insurer offers plans. The NC Dept. Of Insurance publishes the names of any new carriers that will enter the Marketplace next year.

Carolinas Healthcare System and BCBS are jointly offering 2015 coverage under the trade name Blue Local. UnitedHealthcare (UHC) is one of the largest companies in the US, and already has a large market share for plans issued outside of the Exchange. UHC also underwrites an extremely competitive short-term plan that provides cheap medical coverage for consumers needing temporary benefits that can be quickly implemented.

Can I Pay Monthly And Send Premiums In Mail?

Yes, you can. Although many policies had to be paid via electronic withdraw in 2013, starting in 2014, direct monthly billing became available. Checks, debit cards and EFT will also be accepted for the first payment and subsequent ongoing payments. You may change your billing mode with a simple request, although it's best to allow your broker or carrier to handle the paperwork.

Which Parts Of  The State Have The Least Expensive Prices?

NC BCBS Exchange Rates

BCBS Of North Carolina Offers Healthcare In All Counties


As earlier mentioned, there are 16 "rating areas" that include all 39 counties. Two territories with some of the cheapest prices are rating areas 11 and 13. They consist of the following counties: Alamance, Person, Orange, Lee Durham, Chatham, Caswell, Franklin, Johnston and Wake.

Rating areas 3 and 16 feature some of the highest  premiums. They consist of the following counties:Allegheny, Ashe, Watauga, Wilkes, Beaufort, Carteret, Craven, Dare, Hyde, Jones, Lenoir, Pamlico, Tyrell and Washington.

Perhaps the principal reason for higher prices in those areas is actual cost of medical care, including office visits, cost of hospital room and board, procedures, treatment and overall facility charges. The lack of competition may also be contributing to the rate disparity. Also, in areas where free preventive benefits are not highly utilized, often prices are higher. Whether it is being uninsured, or lack of knowledge that compliant plans cover routine physicals, mammograms and OBGYN visits, many rural parts of the state don't take advantage of many free services.


What Are The Four Categories Of Plans That Are Available?

Exchange policies are divided into four groups that are based on their "cost-sharing." This is the anticipated out-of-pocket expenses consumers will pay for their healthcare. The four categories are Platinum, Gold, Silver and Bronze. The expenses include deductibles, copays and coinsurance. "Catastrophic" policies are available to applicants under age 30 and anyone else that meets designated lower-income financial guidelines.

For example, Platinum plans are the most expensive, since their cost-sharing ratio is only 10%. However, the Bronze plans have a cost-sharing ratio of 40%, and thus, their premiums are typically the lowest of all available policies. There is also an additional "catastrophic" option for persons under age 30 and other applicants that meet specific low-income financial guidelines.

What Are The Least Expensive NC Policies That Can Be Purchased On The Exchange?

Although options vary, depending on your county of residence and other factors, some of the cheapest available plans are:

Catastrophic Tier

Coventry 100% HMO

Blue Value Catastrophic

Blue Advantage (Has bigger network that Blue Value)

UnitedHealthcare Compass 6600


Bronze Tier


Coventry Ded. Only HSA-Eligible

Blue Value 5500 (Also HSA-Eligible)

Blue Local 5500 (Uses Carolinas HealthCare System network)

Coventry $15 Copay

UnitedHealthcare Compass HSA 6275

Blue Value 2700 (Low $2,700 deductible but 50% coinsurance)

Blue Value B 5000


Silver Tier


UnitedHealthcare Compass HSA 3600

Coventry $10 Copay

Blue Value 3000

UnitedHealthcare Compass 5000

Blue Local 3000

UnitedHealthcare Compass 2000 (Low $2,000 deductible)

Blue Advantage 3000

Blue Select 3500

Blue Value S 5000

Blue Advantage S 5000 ($2,800 deductible with broad network)


HSA Rates NC

Save Money With An HSA


HSA Options

If you currently have an existing HSA (Health Savings Account), unless you have been notified otherwise, it is probably a "grandfathered" plan. Therefore, you can keep the policy along with the separate side account that you make qualified deposits into.

None of the provisions of the contract will be changed, although each year, new maximum deposit limits may be established. How to get the best HSA plans and other related topics are covered by us through a separate article. This type of plan helps you organize and take charge of your personal medical treatment.

Coventry's Bronze 100% HMO plan is an HMO-eligible plan that covers all expenses after the deductible has been met. However, since most consumers will not meet the deductible, preventive benefits are paid that cover all qualified expenses (not subject to deductible). And Coventry negotiates better prices from their network providers so you pay lower costs and fees.


June 29 2014: UnitedHealthcare is coming in 2015! UHC will offer subsidized plans on the NC Exchange. They will join Blue Cross Blue Shield and Coventry, who both were available to consumers in 2014. Although BCBS participated in every county, UHC has not indicated which counties it will offer individual and family plans.

We believe that UnitedHealthcare will capture a fairly significant market share. Typically, their prices are very attractive in most states, and they were able to effectively "sit out" and watch other companies before entering the Marketplace.

October 22 2014: North Carolina Blue Cross and Blue Shield 2015 health insurance rates will increase by about 13% for Marketplace plans for individuals and families. Naturally, not all plans will see double-digit increases. However, grandfathered plans that don't conform to Affordable Care Act mandates (generally issued in 2010 and earlier) will see prices go up as much as 15%-19%, depending on the issue date and type of policy.

Best Health Insurance Options For Self Employed

Affordable health insurance options for the self employed are available. Regardless whether you need coverage for just yourself and your family, or a small business, low-cost plans can be easily purchased. And with the passage of "The Affordable Care Act," pre-existing conditions are covered and a federal tax subsidy can substantially reduce your premium (if you meet eligibility requirements).

Sole Proprietorships  are very common (millions of persons in the US) and are required to buy healthcare starting. Whether you have no employees or 20 persons working for you, you still must buy coverage, although small business requirements have been temporarily postponed. Part of our expertise (more than 33 years of experience) is finding the new plans that will cost you the least, but still provide "essential" benefits.

Also, it's important to understand that any Obamacare subsidy you receive is not considered taxable income. There is no 1099 federal tax form that will be issued as a result of your premium reductions. These credits are best used to immediately offset healthcare premiums although you can wait until you file your federal return (which we don't recommend).

Conversely, if you overestimate your income, you may be entitled to a refund. Rebate reimbursements from insurers (if they did not meet the requirements to limit expenses) may also generate a taxable event. That reimbursement may have to be reported as taxable income in the year you receive it.

What Is The Cheapest Plan?

Cheapest Self-Employed Healthcare

Affordable Business-Owner Healthcare Is Available


One of the newer components of recent legislation is the arrival of "Metal" plans. All policies will be lumped into four categories: Platinum, Gold, Silver and Bronze. Platinum plans will be the most costly policy since they are expected to cover 90% of projected medical expenses. The cheapest policy will be Bronze plans, which are expected to cover approximately 60% of projected medical expenses.

The maximum out-of-pocket expense for an individual is approximately $6,350 per year. Of course, your actual expenses could be substantially less if there are no major medical claims and/or a relatively low number of symptomatic claims such as colds, flus and viruses. If you or a family member develops a serious chronic illness, you can switch to a different plan with lower out-of-pocket expenses (Gold, for example) during Open Enrollment each year.

All preventive benefits for you or any other person named on the Bronze-type (and all others) policy will be covered at 100%. For example, annual physicals, mammograms, children's well check exams and adult PAP tests will have no out of pocket expense to you. For females, cervical cancer screening is covered along with contraception, well-woman visits and osteoporosis testing (if over age 60).

Many of the Exchange plans are HSA-eligible, which allows you to take advantage of  tax-deductions for qualified medical, dental and vision expenditures. We wrote about the best available HSA plans, and endorse this type of coverage if you are concerned with reducing your premium while maintaining prominent benefits.

Will The Government Help The Self-Employed?

Yes. For example, if your income is below 133% of the Federal Poverty Level (FPL), you may be eligible for Medicaid, which will pay for most/all of your healthcare expenses. Each state has the choice of expanding Medicaid eligibility (from the current 100% of FPL) and the map below (provided by advisory.com) provides a current status.

See States That Are Expanding Medicaid For Residents

Many States Are Expanding Medicaid








Even if you're not considered "low income," the government can still help. Although starting in 2014, you are taxed ($95 per year or 1% of your income, whichever is greater), tax credits (subsidies) will be directly applied to your health insurance premium to reduce the rate. Under the worst-case scenario, you would have to pay 9.5% of your income in premium dollars.

However, in the following scenarios, we have illustrated the significant reduction in premiums you may qualify for. We assumed a household with a husband, wife and two children.

Age        Income        Healthcare Cost   Federal Subsidy

35          $50,000       $11,209                $7,844

45          $45,000       $12,549                $9,899

45          $60,000       $12,549                $7,636

50          $60,000       $14,614                $9,700

50          $75,000       $14,614                $7,489


In all of the scenarios, a substantial amount of the health insurance premium is paid by the federal subsidy, including a whopping 79% for the 45 year-old (and family) with $45,000 of family income. Naturally, the older you are and the less money you make, the greater your subsidy.

It's also important to understand that we based these projections on the purchase of a "Silver" plan. This specific policy is designed to pay an estimated 70% of your anticipated medical expenses. Thus, if $3,000 is the average amount of  expected expenses,  your portion would be $900. Of course, your out-of-pocket cost could be substantially less if you have a healthy year.

Silver plans are also one of the most offered options, since companies must include this type of policy in their portfolio if they are participating in the Exchange. They are also considered "benchmark" plans since the amount of the initial federal subsidy is often calculated on on Silver options, regardless if you chose a Platinum, Gold or Bronze plan. However, benefits (other than deductibles/copays) are the same for the four Metal plans.

Young,  Healthy And Self-Employed

A special and envious situation is if you own your own successful business, you're young and healthy. Do you really need medical coverage? Although the likelihood of utilizing the coverage is fairly low, the risk still exists that a major illness or disease could cost thousands of dollars (or hundreds of thousands). This is not a risk that you should take lightly.

An affordable and popular solution is to consider purchasing an "off-Exchange" policy from one of the major companies. Although you will not receive a subsidy, it is not a concern since you are not eligible. Selecting a high-deductible plan will provide cheap catastrophic benefits from a reputable and reliable company, and preserve your estate and assets if you were to incur tens (or hundreds) of thousands of dollars of medical bills.

Cheap health insurance for the self-employed can still be found. We shop all of the available options so you can spend less time worrying about your medical benefits, and can concentrate on growing your business and enjoying your free time.

Affordable Medical Insurance In Utah Through The Exchange Marketplace

Affordable health insurance in Utah is available for individuals, families and small and large businesses. The most recent federal legislation has created Exchanges and Marketplaces that allow you to directly purchase quality medical coverage from the most reputable carriers. Our website will allow you to shop for the lowest prices, compare the best plans, and easily purchase coverage. The Utah Health Exchange is federally managed and we help you find the best fit for you or your family.


What Are The Types Of Available Plans?


When the "Affordable Care Act" was enacted, four types of "Metal" policy options were created for consumers. They are "Platinum," "Gold," "Silver," and "Bronze." The Platinum contracts are the most expensive since they pay approximately 90% of your medical expenses. The Bronze contract costs the least of the Metal options, since up to 40% of projected medical costs have to be paid by you.


An additional type of policy that is offered is a "Catastrophic" contract. Available to persons under age 30, or anyone that can't afford other Metal plans, rates are very inexpensive, since deductibles and out-of-pocket expenses are higher. Some of the cheapest catastrophic plans are Altius POS, Bridge Span Catastrophic, Humana Connect Basic, and Select Med Millennial.


However, if you are over the age of 30, to qualify for these low-cost plans, you must not be able to find another plan that costs less than 8% of your income. It' also important to understand that catastrophic contracts are not eligible for the federal subsidy. Thus, in many situations, a Bronze or Silver plan may cost hundreds of dollars less per month because of the instant tax-credit.


How cheap are premiums on these high deductible plans? For example, The monthly rate for a 25 year-old in Salt Lake or Davis County is approximately $102. The rate for a 15 year-old would reduce to approximately $62.


Required Benefits


"Essential Health Benefits" are included on all policies. They consist of a wide variety of items including complete preventive care for adults and children, catastrophic hospital, office visit, prescription, maternity, mental health and many other coverages. Unlike policies prior to 2014, these plans have very few or no gaps. About 250,000 Utah residents were eligible  for these new plans when they were first offered in the beginning of 2014.


If any plans do not contain these 10 mandated benefits, then they can not be approved for enrollment through any Exchange in the US. For example, although temporary contracts are very affordable and provide major medical coverage, they do not contain each of the 10 required coverages, and therefore can only be purchased "off-Exchange."


About 100 different policies are offered through the Marketplace by six carriers. They are Arches Mutual, Humana, Altius Health Plans, BridgeSpan, SelectHealth and Molina. Some of the bigger carriers mentioned below (UnitedHealthcare, for example) are not participating in the individual Exchange. Although reasons vary, in 2015, additional companies may return to offer coverage to consumers.


Best Utah Health Exchange Rates Online

Get Affordable Utah Health Insurance Exchange Coverage

You can also buy policies independently from the Exchange. Since these options don't pay a federal subsidy, your individual income should be at least $45,000 and your family income at least $95,000 before you consider these plans. It is likely that the number of available physicians, specialists and other facilities will be much larger on policies bought "away from the Marketplace." The size of your family will impact the income guidelines just mentioned.


Which Utah Health Insurance Companies Offer The Lowest Rates?


There may not be a good answer for that question since there are so many variables. Of course our website allows you to easily compare the best options when you provide your zip code. However, listed below are the carriers that are likely to offer affordable options in your area. Not all of these companies offer Marketplace plans for 2015.


Humana is one of the biggest carriers in the US. They offer many types of plans including short-term, comprehensive, HSA and catastrophic high-deductible coverage. Their Value and Copay plans have been very popular and they feature of the largest provider networks in the state. Since they are a national company, out-of-the-area treatment is often treated as "in-network."


Regence Blue Cross Blue Shield  has it all. Medical plans, Medicare Supplements, Medicare Advantage, Part D and more. Typically, the BC and/or BCBS rates in most states are very competitive for both seniors and non-seniors. Utah is not an exception. The Evolve and Core Value policy portfolio has allowed customers to keep prices fairly low, but still get solid benefits including 100% preventive.


UnitedHealthcare  is larger than Humana. They often offer plans through their "Golden Rule" brand name and have an extensive portfolio consisting of HSAs, short-term, comprehensive and budget plans. Their provider list is very large and they also offer both group and individual policies. They have stated that they will not be participating in most State Marketplace Exchanges for 2013.


SelectHealth specializes in HMO-type of coverage along with high-deductible plans (HDHP) that work with HSA accounts. With their HMO coverage, a "primary-care physician" is selected that coordinates your treatment. For more than 25 years, SelectHealth has been providing integrated coverage, and they were voted Utah's "Top Plan" last year. J.D. Power & Associates gives them a high ranking in member satisfaction (four consecutive years) and we expect this tradition to continue.


Altius  is also known as Coventry and offers policies to both pre-Medicare and post-Medicare individuals and families. Coventry, is now part of Aetna, one of the largest companies in the US. Like UnitedHealthcare, they will be very selective about which states that will offer coverage in 2014. They offer many affordable options that feature lower deductibles between $500 and $1,250.


Cheapest 2015 Health Insurance Plans In Utah


Humana Bronze 6300 HMOX -- $6,300 deductible with 100% coverage thereafter (no coinsurance).
Altius Bronze HSA Eligible Peak Preference -- $5,500 deductible with 30% coinsurance.
Molina Marketplace Bronze HMO -- $4,500 deductible with $25 and $75 copays on office visits (after deductible).
Arches Personal Primary Access HMO -- Although the deductible is $5,000, $5 copays on primary care physician (PCP) visits and generic drugs are very attractive.
Select Value Preference Benchmark Bronze 5000 HMO -- $5,000 deductible with $6,600 maximum out-of-pocket maximum.
Humana Bronze 4850 HMOx -- Not available in all areas.$4,850 deductible.
Arches Secure WELLth Basic 100% AD -- 100% coverage after $6,000 deductible is met.

Is A Government Subsidy Available?


Yes. Actually, it is available in all states. Your modified adjusted gross income (MAGI) will determine your eligibility. If you are single and make under $45,000, you should be eligible. A family of three that earns less than $78,000 should also qualify (About $94,000 for a family of four). About 300,000 persons in the state may qualify for the subsidy and a higher number of persons are currently not covered on any type of medical plan.


Utah Health Marketplace Gives Tax Subsidy

Do You Qualify For A Federal Tax Subsidy?

It's paid in a form of a tax credit that is instantly deducted from the health insurance premium. Since the insurance company receives the credit directly, individuals and families don't have to wait to be reimbursed. However, if you underestimate your income, you may have to pay some of the subsidy money back.  And if you overestimate your income, you may receive a larger credit than anticipated.


If you don't qualify for a subsidy, then you can also buy a policy that is not listed on the Exchange. The major carriers offer these set of plans to persons that may want a larger network of providers or a higher-deductible option. Medical coverage for young adults can also be found. With children's benefits, often keeping your set of providers is the most important factor in deciding which policy to purchase.


Can I Keep My Existing Plan?


If your existing policy is not being terminated (you will be notified in writing), many companies are allowing you to keep your current plan through 2015 and perhaps 2016. These "grandfathered" policies were issued prior to April of 2010 and often contain higher out-of-pocket expenses for hospital-related claims. Also, maternity and prenatal benefits are typically missing or limited.


Regence BlueCross BlueShield and SelectHealth have both stated they will allow policyholders to keep older plans. Other companies have not officially announced their intentions. However, if your policy is discontinued, an additional 60 days is provided to select and enroll for new coverage.


What Is "Avenue  H"?


This is the separate Exchange (also called "SHOP")  for small business owners to shop for coverage on themselves and workers. More than 300 small businesses utilize this program to provide policies. Employers contribute a per-determined amount of funds for their worker's healthcare and those workers can then  contribute additional money to "upgrade" their coverage.


Governor Herbert was very instrumental in convincing the federal government to allow the state of Utah to run Avenue H. This means that the state will oversee certifications, compliance and much of the Medicaid program. The three participating carriers are expected to be UnitedHealthcare, Regence Blue Cross Blue Shield and SelectHealth.


Avenue H, however, is not designed to offer policies for the private sector that does not have group medical insurance. Utah has opted to allow its State Exchange (previously mentioned) to be federally run for 2014. This could change in 2015, depending on the projected expenses and how much taxpayers in the state will have to pay.




December 3 2013 -- Online enrollment for 2014 coverage is taking less time with far fewer delays and glitches. Although scattered issues are being reported, we are seeing a process that is much smoother compared to the initial rollout in October.

However, applicants that are eligible for Medicaid should automatically be transferred to the State Agency that handles the program. Currently, that is not occurring and the Department of Workforce Services is unable to determine eligibility. Temporarily, any Utah resident who believes they should qualify for Medicaid, should directly contact the Department.


August 19 2014 -- Medicaid expansion in Utah may become a reality shortly. Governor Herbert and the federal government (HHS) are attempting to jointly approve a plan that would satisfy all parties. If approved, the new legislation would provide low-cost coverage to thousands of residents that currently are not Medicaid-eligible because of their household income. "Healthy Utah" could become law by the end of 2014.

How To Get The Best Health Insurance For A Newborn

Health insurance coverage for a newborn is easily available and is quite affordable, since rates are typically based on the age of the applicant. Many of the largest companies offer 2015 policies that can be applied for in minutes and often approved the same day. We'll help you find quality medical benefits for your baby at the lowest possible price.

It's also important to know and understand many of the rights and privileges you have. For example, typically, you can expect either an approved two or four day stay in the hospital, depending on the type of delivery (we will discuss in greater detail later in article). Also, with most policies, by notifying the insurer within 30 days of birth, benefits will become retroactive to the actual date of birth. NOTE: The expectant mother also is entitled to specific benefits under most plans such as breast-feeding supplies, lactate consulting and related rental of equipment.

The easiest way to cover your new addition is to add them to an existing policy...preferably, your own. If you are actively insured at the time of the birth, typically, most plans allow you to add a dependent within 30 days of the birth. Most policies either cover your newborn immediately, or when the baby has been released from doctor's care.

If you have recently purchased a Marketplace policy (covered in additional detail below) from a state or federal Exchange, the birth of a child qualifies for a "Special Enrollment Period (SEP). Thus, regardless if the Open Enrollment period is current or has already ended, you can purchase coverage without answering medical questions, qualify for a subsidy (if applicable), and have all pre-existing conditions covered.

This option will, of course, increase your premium, but not substantially. In many Midwestern states, the monthly increase may be as little as  $35-$65 per month. In other areas, the premium could be higher. If you already have dependents covered under your own plan, there's a possibility that there will be little or no change in your monthly cost, since certain policies charge the same amount once you exceed two dependents. And adding a dependent could could possibly result in a larger subsidy.

Purchasing A Marketplace Policy

Get Cheap Baby Healthcare Coverage

We Find Affordable Healthcare For Your Baby


You can also purchase an individual private policy through a state or federal Marketplace. Because premiums are based on age (among other factors), you won't have to pay a high rate. Although Open Enrollment periods (under The Affordable Care Act) are towards the end of the year, special circumstances will allow you to apply for coverage if specific events occur.

The birth of a child is one of those events (mentioned earlier). For 2015, Open Enrollment began on November 15th (terminating on February 15th 2015). Most states feature new carriers, including UnitedHealthcare and Aetna, who have significantly increased the number of states where they offer policies.

If you have an existing plan, simply adding your son or daughter to the current policy will often result in very little (or no) rate increase, especially if you qualify for a federal subsidy (see below). With the passage of the Affordable Care Act legislation a few years ago, baby benefits cover all pre-existing conditions and all needed preventive pediatric expenses.

This includes include well-child visits, immunizations and approved vaccines (Hepatitis A and B, Influenza, Meningococcal, Varicella and many others). Overall, as your baby gets older, more than 25 specific treatments for children must be covered. Listed below are several of the services you may not be aware of and typically can be used in the earlier years:

Screening for autism between the ages of 1 1/2 and 2

Developmental and depression screening

BMI (Height and Weight) screening at most ages

Hearing and vision screening

Sickle cell and Hemoglobinopathies screening

Hypothyroidism testing

Iron supplements

PKU and obesity screening

Oral risk assessment

Iron supplements

Federal Subsidies Through The Exchanges

A federal subsidy could easily pay the bulk of your premium, depending on your income. If your household income, for example, for you, your husband (both age 30) and your child is approximately $50,000, you will qualify for a $4,655 subsidy to assist paying your premium. However, if your income is only $35,000, the subsidy amount jumps to $6,897. NOTE: To qualify for financial aid, you must enroll in a Marketplace (Exchange) plan. "Off-Marketplace" policies, such as temporary and limited-benefit contracts are not eligible for any subsidy funds.

Therefore, whether the birth occurs in January, June or December, coverage for the baby can be purchased. Medical issues (if there are any) no longer have any impact on the price you pay for a policy. One of the main concerns is finding a large reputable insurer that offers a contract with all of your network providers included. Typically, Aetna, Blue Cross, Humana, Cigna, and UnitedHealthcare offer the most competitively-priced products with large countrywide provider networks.

We'll help you find the proper fit since each state will have a different set of participating insurers. Although Obamacare has lowered premiums for many Americans, it has also reduced the number of companies that offer a policy. While some states (such as Ohio and California) have many options, smaller states often only have a few carriers to choose from.

CHIP And Medicaid

You may also be eligible for Medicaid, or your newborn may be eligible for special government assistance. More than 50% of kids in low-income households qualify, so it is a viable option to consider. If the total family income is under $45,000, there's a very good chance that Medicaid or CHIP (Children's Health Insurance Program) will be available.

Many states have either expanded Medicaid eligibility, or are considering legislation to expand. If approved, depending on the size of the state, hundreds of thousands of persons can become eligible, as the Federal Poverty Level guidelines "expand" from 100% to 138% of FPL household income. When Ohio expanded in 2014, more than 300,000 persons were now able to qualify for these benefits.

Find Kids Free Preventive benefits

A Federal Subsidy May Reduce Your Rate


Infants that have mothers already enrolled in Medicaid should be immediately eligible for CHIP. And if a child has not had his/her 6th birthday, and the family income is under $30,000, once again, CHIP may be offered.  The coverage is very comprehensive and is known as "EPSDT," which is the shortened version of  earl,y periodic screening, diagnosis and treatment. Federal funding is expected to continue for CHIP for many more years (and hopefully beyond).

You also are protected by "The Newborn's Act." Under this legislation, if you have medical coverage, you are entitled to at least 48 hours of hospital benefits if the delivery is vaginal. If caesarian,  the minimum amount of covered benefit is four days. Preauthorization is not necessary when there is a two or four-day stay in the hospital. However, you are required to stay the full time-period if it is required by the treating physician.

No Coverage?

The final option is not costly, but it is risky. By self-insuring (going without coverage) and paying for all services in cash, although there are no coverage premiums to pay, an expensive hospital stay will be difficult to immediately pay for. Therefore it is likely, you will inherit a monthly payment obligation for quite some time. .

If you remain uninsured, you are also breaking the law. Beginning in 2014, the federal government began imposing a special tax of 1% of your household income if you remained without coverage. The tax increased to 2% of household income in 2015 (or $325 per adult and $162.50 per child, whichever is greater). Thus, a $60,000 income household could pay about $1,200 in penalties. NOTE: Although Christian Healthcare plans have grown in popularity, not all of these policies meet the ACA guidelines enabling you to avoid the special tax.

Your newborn needs the proper medical attention to start life on the right foot. We'll help you find affordable health insurance coverage from either a reputable company, the government or a combination of both.


November 13 2014 -- According to the CDC (Centers For Disease Control And Prevention), the US preterm birth rate fell to its lowest point in almost 20 years. Based on a 37 weeks gestation period, the number of early deliveries is at 11.4%, with a short-term goal of less than 10% within the next five years. But there still is plenty of room for additional improvement since our country ranks in the bottom half of all countries, according to the World Health Association.

The passage of the Affordable Care Act (ACA) should continue to help improve the numbers, since women have much better access to free preventive care and maternity benefits. Many Southern states, including Mississippi and Louisiana have bigger challenges since their current preterm birth rates are close to 15%.

Ohio Health Insurance Marketplace Plans – Best Rates

The 2015 Ohio Health Exchange offers individuals, business owners and families the opportunity to purchase affordable coverage with the help of a federal tax subsidy and guaranteed-approval of submitted applications. Easily, you can shop for quality Ohio medical benefits at the cheapest available rates. There are no exclusions, waiting periods or surcharges for pre-existing conditions. We do the shopping so you save.


In less than a minute, you can compare the companies that will offer the lowest prices for Open Enrollment Exchange plans. You can not be denied for medical reasons and we will help you with the enrollment process. You don't have to worry about the constant glitches and delays that many persons experienced the first year on the .gov website. The application process is now much more streamlined and typically takes less than 20 minutes.

Missed Open Enrollment? We'll show you stopgap plans that will cover you throughout the year. Many "short-term" options are available from major carriers (UnitedHealthcare and Humana generally have the most competitive prices) that can be kept as long as 12 months. Special Enrollment Periods (SEP) are available at any time if you have lost existing coverage, move to a different area, get divorced, have a child, or have a major household income change. There are also several additional exclusions.

 Which Companies Are Available?


Anthem Blue Cross, HealthSpan, Humana and Medical Mutual offer coverage to consumers in the individual and family marketplace. Other carriers include  Aultcare, Coventry, SummaCare, CareSource, Ambetter, Molina, Paramount, Time (Assurant), and Coordinated Health Mutual.  UnitedHealthcare (Golden Rule) and Aetna are offering 2015 Marketplace policies after taking a "wait and see" position in 2014. Since both companies are among the largest carriers in the US, pricing will be competitive.


Premier (located in the Dayton area) is offering 2015 coverage in Montgomery County and other surrounding areas. Miami Valley Hospital and its affiliates are key components in their servicing area and network. Even nearby counties such as Miami, Warren, Clark, Preble and Greene will be the home of some Premier providers.


Miami Valley Hospital And Premier Healthcare Coverage

Premier Health Partners With Miami Valley Hospital In SW Ohio


Many companies also offer "off-Exchange" plans. These types of policies may NOT include "essential health benefits" and would therefore not be considered qualified options. That means you may have to pay an Obamacare tax (2% of household income) because you did not purchase the type of medical coverage that is required. Assurant is another carrier that will offer specialized options, including critical-illness and accidental expense contracts.


HCC Life and IHC Group also feature temporary plans that are not compliant with ACA regulations, but should be considered if you are not eligible for a special enrollment period. You can choose from a wide range of deductibles ($250 to $10,000) with several coinsurance options. These plans are not long-term solutions, but will prevent a catastrophic claim from taking most of your assets. You can email or call us for additional specific details.


In some situations (certainly not all), there are affordable policies that can be purchased outside of the Marketplace that do meet the "essential health benefits" requirement. Since subsidies will not be payed on these contracts, they are viable choices for families with household incomes that do not receive government financial aid. If you lack physicians or specialists in your area, these policies should also be considered since the number of participating doctors, hospitals, and facilities, may be higher than "on-Marketplace" policies.

For example, if you are a single person (Age 30 and no dependents) making more than $34,000, there's a very high probability that you don't qualify for a federal subsidy. Also, if your family consists of four persons (Ages 40, 40, 12, and 10), and your total household income is more than $95,000, you probably do not qualify for financial assistance. Therefore, selecting a policy away from the Marketplace will reduce the enrollment time, and allow you to choose plans that are customized for your specific financial situation.


Which Type Of Coverage Is The Cheapest?


Policies are available in four actuarial "metal" categories. They are Platinum, Gold, Silver and Bronze. The cheapest policy is the Bronze option since it pays the least out-of-pocket expenses (expected). Unlike the Platinum option that covers 90% of expected expenses, the Bronze plan only covers 60%. The State Department Of Insurance regulates the policies although the Federal Government operates the Exchange (for now). It's possible in the future (perhaps after 2016) we'll run our own program here in the Buckeye state, although tens of millions of extra dollars will be needed.

Bronze Deductibles are higher, and if you utilize the prescription benefits, you'll pay more. However, you do pay a lower premium, and that extra savings can be used to offset some of your higher expenses. This option is closely comparable to HDHP plans that have been "grandfathered" for many consumers. Silver plans are the second-least expensive policy and are ideal for Ohioans willing to pay a slightly higher premium to reduce deductibles and copays.


NOTE: Silver tier contracts are the only policies that offer "cost-sharing," a special feature that lowers your out-of-pocket expenditures (deductibles,coinsurance, and copays) if your income is within specific ranges. For example, under $29,000 for individuals, and $59,000 for a family if four. Some popular "Silver" plans include: Market Classic 2000 and Market HSA 3000 (Medical Mutual), Silver Pathway X PPO 3500 and Silver Pathway X PPO 2500 for HSA (Anthem), 5000 60 S and 3000 70 S (Aultcare), HealthSpanOne 1500-70 and HealthSpanOne 2000-70 (HealthSpan) Balanced Care 2 (Ambetter) and Silver 4600 HMOx (Humana).


Catastrophic Options


A catastrophic plan is offered to consumers that may not be able to afford more expensive policies with the required mandated benefits. If you are under age 30, you can automatically qualify. If you are older than age 30, if there are no "affordable" plans available in your area, you will be able to buy this type of bare minimum coverage. Although the deductible is high ($6,350), the rates are typically cheap. Another method of qualifying is if you can prove "financial hardship."


Ohio Financial Hardship Exemptions For Healthcare

Bankruptcy Qualifies For A "Financial Hardship" Exemption


The financial hardship exemptions that you are most likely to utilize include recent death of a family member, bankruptcy filing within the last 180 days, large unpaid medical expenses in the last two years, individual plan was terminated and no other affordable options, and Medicaid ineligibility because of lack of state expansion. A few of the least-likely exemptions you might utilize are if you are homeless, received a shut-off notice from your electric/gas company, and recent victim of domestic violence.


The Society of Actuaries had predicted that prices would increase by an average of 88% in 2014. They based this prediction by comparing the current average monthly premium of $223 to the projected premium of $420. Although rates did go up (and sharply for many individuals and families), the average increase was actually much lower. However, for married persons 55 and over with no children in the household, price increases were the highest. 2015 rates increases varied, depending on the company. The average increase was about 8%.

The new federal tax credit helps many consumers pay some of these increases. There are more than 200 plans offered, so broker and website assistance (which we provide free) is highly recommended. Each year, plans change and often, you actually may be forced to switch policies because your existing contract no longer meets "Metal" guidelines. That is, the actuarial value (AV) changes and a new tier must be classified.


What Specific Plans Are The Least Expensive?


Listed below are many of the most affordable individual (and family) plans available for 2015. It is important to understand that not all plans are offered in all counties, and federal financial subsidies do not apply to "catastrophic" tier contracts. Also, as previously mentioned, catastrophic-tier contracts have unique eligibility requirements.


The "cheapest" option may not be the most cost-effective, depending upon many factors, including medications you take and yearly medical expenses. Please contact us before applying for coverage. We will review and compare the specific benefits and cost of your best options.


Catastrophic Tier


Market Young Adult Essentials (Medical Mutual)

Pathway X PPO 6600 (Anthem)

Catastrophic Plan (Aultcare)

Individual Value-LA Select (SummaCare)

Individual Value-LO Select (SummaCare)

Catastrophic (Paramont)

Basic 660 HMOx (Humana)


Bronze Tier


HealthSpanOne 6000 (HealthSpan)

Just4Me Healthcare With Heart (CareSource)

Essential Care 1 (Ambetter)

Pathway X PPO 5000/30% (Anthem)

Individual 6450-LD Select (SummaCare)


Is The Government Paying Part Of My Premium?


Ohio health insurance rates, like other states, will be reduced, if you qualify for the new immediate tax credit (subsidy). Here's how it works: Individuals and families that have incomes between 100% and 400% of the Federal Poverty Level (FDL), and who buy an "Exchange" policy are eligible for assistance. Medicaid and Medicaid recipients  are not eligible.


The tax subsidies will immediately reduce your premium. Unlike a normal credit, you don't have to wait for a refund to use the money. Based on current FDL levels, a 30-year-old (male or female) that makes %$50,000 per year, will not receive a subsidy. However, if their income is only $25,000, they will receive approximately $1,700. You will also find that some plans will be free!


Find Cheapest Ohio Exchange Insurance

Affordable Ohio Health Marketplace Plans Are Available

For a family of four (husband and wife age 40 and two children) with a household income of $75,000, the subsidy will be $4,422, or about $370 per month. For this example, we assumed the family was applying for a "Silver" plan. Of course, a "Bronze" plan would cost less, but would involve more risk. Once the family income reaches about $95,000, you are no longer eligible for financial assistance.


When And How Do You Apply For A Policy?


Our website will have direct links that will make it easy for you to apply for coverage. Tax subsidies will automatically be calculated so you know how much (if any) of the premium will be paid by the federal government. Open Enrollment began in October for 2014 effective dates. For the first year only, it extends through March so some of the glitches can (hopefully) be fixed. But starting in 2015, the Open Enrollment period will be much shorter.


Although the standard application has various questions, none are related to any medical condition you had in the past or are currently being treated for. The vast majority of questions refer to members of the household and other administrative topics. We're always available to help you fill out and complete the application. Choosing the most cost-effective plan may also require some assistance.


Can You Buy A Policy That Is Not Through The Exchange?


Yes. It is feared that the provider list for Exchange plans will be limited. If this is true, an alternative may be to purchase a plan outside of the Marketplace. They will be offered by many of the large companies and the number of participating doctors and specialists should be quite robust. However, some of the options will not contain all required benefits (such as maternity or mental illness). So although prices will be lower, benefits will be less and there may be a special penalty charged by the Dept. of Health and Human Services.


Prices for these options have yet to be determined, but will be released shortly (check our website for quotes). Mandated essential benefits will have to be included, so coverage will not be an issue. But it's possible rates will be lower than Exchange plans if you don't qualify for a subsidy. The difference is likely to be in the 5%-20% range.


Will Rates Be The Same In All Areas Of  The State?


The cost of healthcare in Ohio will be different, depending upon which county you reside in. For example, prices in and around Columbus are going to be less expensive than prices in Cleveland.  Cincinnati pricing will be different than Athens. It may not necessarily be a substantial difference (as it once was), but there will be a variance. Typically, cities in the Northern counties may be the most expensive.


Cheapest Medical Plans Cleveland

Low Cost Cleveland Healthcare Will Be Offered

Naturally, older persons will pay higher premiums and smokers will pay more, unless they quit for at least 12 months. But, as previously discussed, your pre-existing conditions (if applicable) will not impact what you pay. And you can not be denied for a medical issue. Whether you had cancer 10 years ago, or you were just diagnosed with cancer, it will not affect the premium.


Will HSA Plans Be Available?


They will be available under "Bronze" plans, the least expensive policy that will be offered. These types of plans must meet a "60%" requirement (this means they are expected to pay 60% of the average anticipated medical expenses for an applicant) with a possible deductible of $6,000. "Catastrophic" plans may also feature HDHP plans.


HSA plans have historically helped consumers become more cost-conscious with their spending, so their out-of-pocket costs reduce, and a tax-break is included. Coupled with the negotiated pricing that saves money, this type of option will once again, be very popular.


Are There Special Plans For Self-Employed Persons?


Although there are not "special" options available, there are many policies that would work well if you work for yourself. For example, an HSA (previously mentioned) is designed to keep rates low, reduce your taxes, and allow you to accumulate money in a side-account.  Additional HSA information online  can be found on another page. You can also use these funds to pay for medical, dental, vision or long-term care benefits. Funds not used are never lost. You can allow them to continue to accumulate.


Certainly,  many other plans can be purchased since health insurance rates in Ohio are cheaper than most other states. We're experts on finding the best Marketplace policies for single, family or business situations. Quote, email or call. We'll try to help.


2-14-14 -- About 60,000 applicants from here in Ohio have enrolled in the Marketplace through the end of January. These numbers are a bit lower than originally predicted, and match the lower than expected enrollments of young persons under age 35.

3-13-14 -- About 18 days remain in this year's Open Enrollment period. However, once the date expires (April 1), Buckeye residents will not necessarily have to wait until November to purchase a policy. There are several plans that can be purchased at any time throughout the year.
Temporary policies cost about 35%-75% less than conventional plans (without the subsidy), and can be kept for as long as one year. There are limitations, including a maternity exclusion, but it will provide up to $1 million of major medical coverage until you can enroll through the Marketplace again.

6-24-14 -- Ohio Open Enrollment for 2015 is less than five months away! It begins on November 15th and there will be numerous changes. Additional carriers will be offering policies (possibly Aetna and/or UnitedHealthcare) and rates are expected to only slightly increase. In specific areas, prices may actually reduce from 2014 levels. Tax subsidies will continue to reduce premiums and the noncompliance penalty for not enrolling is still in effect.

Anthem, Medical Mutual, Humana and HealthSpan are early favorites to have the most competitive pricing. As soon as the 2015 prices are posted, we'll discuss them with you.

10-3-14 -- Ohio is one of 15 states that have lowered the number of uninsured consumers. Almost 50,000 fewer persons went uncovered in 2013, according to figures from the US Census Bureau. The 2014 statistics will be available next Fall, and are expected to show a continuing trend, and possibly as many as 100,000 fewer persons without benefits.

10-12-14 -- "OneExchange," will administer the Medicare-eligible coverage for the Ohio Public Employees Program (OPERS) in 2016. About $150,000 persons and their spouses will be impacted. The change should result in a higher number of available options at a lower cost. Typically, persons enrolled in OPERS receive more than $300 per month to apply towards their medical plan selection.

Affordable Healthcare For Young Adults And Children

Low cost health insurance for children and teenagers is available from many reputable and top-rated companies. State-subsidized Marketplaces, government programs, and many private insurers now offer inexpensive policies that cover pre-existing conditions, office visits, prescriptions and major medical expenses. The enrollment process is quick and easy.


In the past, young adults often payed high premiums  for their healthcare coverage. But now, children and adults may be eligible for a substantial federal subsidy that could drastically reduce their premiums. Since medical benefits are now required (Affordable Care Act legislation), and a major expense is just an accident or illness away, we provide the best available options. Our expertise and unbiased recommendations will help you save money and find the most suitable coverage.


Short-Term Policies


Because most children and teenagers are still healthy, purchasing your own health insurance is one available option that will save money. An individual plan is offered by almost all major carriers, with numerous carriers offering short-term and long-term coverage. Some private plans can cost as little as $40 per month for young adults (short term coverage), and  can be a significant savings over the costs of other policies. These types of policies are typically approved within 24 hours.


Temporary policies have some limitations including not covering pre-existing conditions and limiting the length of time you can own the coverage. An experienced agent or broker at our website or in your area can quickly determine if this type of policy is the best choice. It's possible it might not be appropriate and other options will be more cost-effective.


However, if you missed Open Enrollment and you do not qualify for a special enrollment exception, we recommend quickly applying for these types of policies so you can quickly cover major medical and hospital claims, while waiting for your eligibility for a more permanent plan. Often, you are provided up to $1 million of coverage, which is almost always sufficient until the next policy is applied for and approved.


The Impact Of Obamacare


Obamacare Healthcare Rates And Quotes

Obamacare (Affordable Care Act) Legislation Was Signed Into Law In 2010


With the passage of Obamacare (ACA), the lower your income, the cheaper the cost of a plan. For instance, let's use an example of a 22-year old in Dallas, Texas that  makes $15,000 per year and needs to purchase their own policy.


Amazingly, there are many policies that are free or feature very low costs. We listed some low cost "Bronze" plans below. There are five plans that cost under $65 per month, and additional options that cost less than $100.


$0 Blue Cross HMO 005

$0 Blue Cross PPO 006

$11 Cigna MyCigna Savings 6100

$18 Cigna MyCigna Health Flex 5500

$62 Aetna Advantage 6350


There are also several low-cost "Silver" Metal-tier plans that feature lower deductibles and smaller out-of-pocket expenses that are still quite affordable:


$18 Blue Cross HMO 003

$24 Blue Cross HMO 004

$47 Cigna MyCigna Health Flex 1500

$52 Cigna MyCigna Health Flex 2750

$66 Molina Marketplace


Comprehensive Preventive Benefits

Since most young persons are typically healthy and are not regularly treated for chronic illnesses, the free preventive benefits are utilized the most. Whether it's a routine annual physical, immunizations, depression, vision, or hearing screenings, iron supplements, or obesity counseling, there is no cost to the patient (or parent), and availability of network providers is widespread in the vast majority of counties across the US.


Each year, the list of covered items is updated. For instance, one of the more recent additions was the nasal spray flu vaccine that has an impressive history of safety. The Centers For Disease, Control and Prevention (CDC) recommends this treatment for children between ages 2 and 8. However, anyone with previous symptoms of asthma, certain allergies, immune system issues (and several additional symptoms) may wish to consider the injectable option. Naturally, your family physician can provide the specific information you need.


The Magic Of Silver Tier Plans


"Silver" Exchange policies offer a special "cost-sharing" feature that is unique to these types of contracts. These subsidies increase the insurance company's share of paying for benefits, which subsequently lowers needed spending for many expenses. Maximum caps are reduced, resulting in some of the best available Marketplace offers. In many situations, the subsidy exceeds the entire cost of the policy (more often on Bronze plans), creating "free" health insurance.


You are eligible for a cost-sharing reduction if your household income is between 100% and 250% of the Federal Poverty Level. For example, for a family of four persons, this would be approximately $24,000-$59,000. And depending on your income level, a typical $2,000 deductible could be reduced to $250 or $600. Also, office visit copays to primary-care physicians and specialists could reduce from $25- $50 to no charge. When shopping and comparing, the "Silver" tier policies should always be at the top of the list to review (assuming you qualify for a subsidy).


Since the federal government pays these reductions directly to the insurance company, you are not required to pay the higher amount and wait for reimbursement. You also are not taxed on the cost-savings since this feature is built into the Affordable Care Act legislation. While the Silver plan is not always the best option for your teenager or child, it should always be one of the plans you consider.


Baby Coverage


Of course, if your young one is still a toddler, cheap newborn health insurance can be easily purchased. Even if it is not an Open Enrollment period, the birth of a child is considered a "qualifying event" and you would be able to obtain benefits easily through an SEP (Special Enrollment Period). Any pre-existing conditions would be covered and federal financial assistance would be provided, if you meet eligibility requirements.


Some of the benefits typically provided on a "toddler" policy include routine check-ups, immunizations, diagnostic testing, prescriptions and emergency services. Screening is also provided for autism, vitamin deficiencies, sickle cell anemia, congenital hypothyroidism, and hearing issues. If there are recurring problems, often testing and treatment is needed, and it is important that the proper plan be selected to minimize your out-of-pocket costs.


If you are under the age of 26, staying on your parents plan is another option. No longer is it a requirement that an individual has to be a full-time student to remain or even be added to their parent’s health care policy, which is an advantage for you. And, if health insurance is offered through your employer, you can use that coverage instead. Often, it will include maternity benefits, which many private plans did not cover before 2014. Now, it is part of a required "Essential Health Benefits" package.


Employer-Provided Policies


Many group plans offer very comprehensive benefits to the employees. Of course, some others do not, instead, providing options that contain high deductibles and out of pocket costs. It's important to study the differences between both types of options since often, purchasing personal coverage is the best choice. You can choose the deductible and decide if paying extra to lower coinsurance and maximum potential expenses is worth it.


However, if you're fortunate to work for an employer that pays more than 50% of your premiums, and your income is above 400% of the Federal Poverty Level, purchasing Marketplace coverage (if you were eligible) would likely result in higher policy costs. The latest trend of many businesses is to create a medical savings account (MSA) and contribute from $1,000 to $3,000 to be used for qualified expenses.


Any unused funds for the calendar year will not be lost, so there is a great incentive to stay healthy and utilize the 100% free preventive benefits. Since children (whether at home or at college) rarely incur large medical expenses, if your contribution from the company is based on the number of household members, you have an increased chance of accumulating substantial savings if everyone stays reasonably healthy.


It's Now The Law


Since purchasing healthcare in the US is now the law, another reason to secure coverage is to avoid the IRS tax. Currently, the penalty is $325 per adult or 2% of the household income, whichever is higher. The 2% tax will gradually increase to 2.5% over the next few years. Thus, if you make $60,000 per year and don't buy coverage, potentially, you would be forced to pay a tax of $1,500. Ouch!


In July (2014) a three-judge panel ruled that subsidies paid to consumers are not legal in states where the federal government operates the Marketplace. Thus, the legality of the IRS 2% penalty would seem to be in jeopardy. The next stop may be a District Cort in Washington DC, possibly followed by a Supreme Court ruling. We will keep you updated on what impact any ruling may have on your policy options and the cost.


Cheap Medical Plans For Kids

Affordable Health Insurance For Young Adults

Although we all know that making comparisons is something that should be done before purchasing a policy, many times young people simply do not understand the significance of this step. Comparisons involve taking a look and closely examining several companies and their prices, determining where the best value lies and opting for the best value that you find.


Once you have the benefits and costs of the plans you are likely to buy, the decision process may take a few minutes or a few hours and is one that will be well-worth your time to do. And of course, consulting an experienced broker helps. They do not charge any fees and can potentially save you thousands of dollars per year.


University Student Medical Plans


Are you in college or preparing to further your education? Not only does this mean you are taking big steps toward a great future, it also means that you can greatly reduce the costs you will pay for healthcare.


Most public as well as private universities will offer coverage to students, even those attending part-time, who are not a part of their parent’s plan. Choosing to use the services offered through your school could result in hundreds (or thousands) of dollars in savings over the course of a year. However, be careful because some school plans are very expensive and may not offer or include specific coverages you need.


Some University plans may have a limited network of facilities that may limit treatment out of the area in the event of a serious illness or accident. Comparing your private policy options with your school's student plan will help ensure you are properly covered. Sometimes a combination of a private subsidized policy with a supplemental contract from a school (Ohio State University is one of many schools that has affordable and cost-effective supplemental coverage) covers all bases.


Medicaid Options


If you are unable to afford the costs of coverage, government programs may be able to help you secure coverage. Medicaid is one option for low income individuals, offering reduced cost coverage. In addition there are also plenty of community  centers offering healthcare at discounted rates. Many states are expanding their eligibility guidelines, so lower incomes are able to now qualify.


Medicaid uses a sliding fee scale to evaluate the total amount that is owed for the services rendered. Either of these options will help ensure that you are covered should illness or sickness need to be treated. And they offer very good preventive benefits, especially for children. Often, immunizations and well-check visits are available at no charge. "CHIP" plans are available in all states and utilize a large provider network of doctors and other medical facilities. Copays are very low and deductibles rarely are applicable.




Because of age, paying less for young adult and children's healthcare coverage is often possible by purchasing a private plan. There are a number of options available that will help you save money while still getting the policy that you need. As earlier mentioned, the recent Obamacare legislation now provides financial aid to pay your premium, And of course, whether you're health is perfect, or you take multiple drugs that cost more than $500 per month, you can not be turned down for medical reasons.


Which plan is best for you? Often, by comparing different options, there may be multiple policies that provide the benefits that are most important to you at a very reasonable cost. We help you understand the differences between policies and how to easily and quickly enroll in the best plan. Low cost medical plans for teenagers (and younger persons) are available.




September 9 2014 -- Funding for the CHIP program is expected to change in October of 2015. At that time, the federal government matching ratio will increase to 93%. State spending is matched at a ratio much higher than Medicaid. However, each state is allotted a specific number of dollars, which can change on an annual basis.

How A Broker Will Help You With Your Medical Coverage

Without health insurance in place, the cost of being treated for the most basic  services can be a bank account draining process. For this reason, each person must ensure that he or she has coverage at all times. In fact, it became the law starting in 2014, with the passage of "The Affordable Care Act." Although the penalty was not severe the first year (just $95), it gradually increases to 2.5% of household income for noncompliance.  A knowledgeable broker can keep this from happening to you, and also help compare the new Exchange plans.


While we assume we will always be healthy, tomorrow is always an uncertainty, and a multitude of illnesses, sickness or an accident could occur at any moment in time. Your coverage will give you preventive benefits and security, but first you must choose the policy that will meet your needs. And yes, that can be quite a task considering how many reputable carriers there are.

Further complicating the decision-making process is that not all companies participate in State Marketplaces. For example, although Blue Cross (Blue Shield) participates in every State Exchange, heavyweight carriers Aetna, UnitedHealthcare and others have selected the states that they wish to offer plans. Although the number of states is increasing (especially in 2015), in many situations, you may not be able to choose your preferred company, if you want a federal subsidy.


An Insurance Agent Can Help


Whether you’ve been covered under different health insurance plans in the past or are new to the process, one thing always remains the same- choosing the right policy can be tricky. There are an enormous amount of essential terms for you to understand in order to select a policy that will live up to your expectations while remaining within your budget. To learn how to get a healthcare quote online is a process you can be helped with. There are many challenges and obstacles and our job is to explain them and make the enrollment process easy.


Fortunately, that’s where an agent comes is able to help.  They are experts in researching and finding coverage and can help you choose a personalized policy that meets or exceeds your expectations, and hopefully stays within your budget. New federal tax subsidies can help reduce premiums if you are eligible. Typically, if your income falls under 400% of the Federal Poverty Level, you will receive financial assistance. If under 100% (sometimes higher in some states), you may be eligible for Medicaid. If you're in between (and millions of persons are), Comparing Bronze, Silver and Gold plans (and sometimes Platinum and Catastrophic) is needed before applying for coverage.


Blue Cross Agent

Save Money By Using An Experienced Broker

Your representative can give you personalized attention that you can’t get anywhere else. With their in-depth knowledge of the various carriers and policies, they can quickly and easily assist you in obtaining a policy and also servicing the contract in future years. That’s a lot better than having to call a 1-800 number and speaking to a stranger every time you need help. Especially, if you are re-routed outside the US.


Your representative also can explain all of the details that may be hard to understand, as well as address any and all concerns that you may have. While using the Internet may offer a bit of assistance, it doesn’t get any better than speaking to an expert that you already know and trust. And when the State Exchanges are up and running (in 2014), you will need to consult a broker to determine the best plan to purchase and what tax breaks you will qualify for. Open Enrollment typically begins in November each year.


For persons that prefer working online with their broker, modern quote engines will allow you to compare, shop and even purchase your policy without seeing anyone in person. But a quote engine still can not interpret which of the many options best fits your personal budget. That's why most experienced agents utilize a combination of experience and online applications. The new Obamacare federal subsidy must also be correctly calculated, or a reduction of a tax refund may result the following year.


With the latest information and unbiased advice working for you, viewing the best offers while getting a better policy is something you can always count on. Shopping and comparing multiple plans is necessary if you are going to get the lowest rates. Each carrier offers various policies in different areas, so your provider network will also have to be checked to verify your physicians are participating.


Don’t Try To Do Too Much Alone


An experienced broker can explain the variations in policies, what specific terms mean and make it an all-around more pleasurable experience when you are searching for information.  You will always get coverage that is tailored for your needs when you have the experts working on your side. Yes, a little like Nationwide!


As a licensed professional who has made it his job to provide you, his or her customer, with the best policy at the lowest possible rates, you're also in "good hands." (Yes...just like Allstate!) As premiums and coverage change over the years, he/she can take the time to update your existing policies and make any appropriate recommendations. Unbiased advice is always a great tool to have. But it is also important to stay abreast of all the changes (especially in the healthcare field) that occur.


Why would you not want to deal with an expert in the field when they are there ready to serve you? With benefits as previously mentioned, you can see why it is always in your best interest to consult with someone who will have your best interests in mind at all times. Typically, you can choose to meet face-to-face or simply communicate via email and/or phone.


There is no cost to use the services of a licensed agent, and they are accessible online as well as over the phone. You can contact them any time that you would like to have all of your questions answered and your needs met. If you can find a person that is experienced and is located near you, that’s a great start! And of course, you can contact us directly for the same expert help.


Our website helps you find apply for the right plans. You can choose whether you apply direct or with the help of a broker. Regardless of which option you select, there are never any fees or obligation. Our  guidance and assistance is always free, including helping with the enrollment process on State Health Exchanges. We can also help you to determine your eligibility for a federal subsidy.


The Best Way To Get A Health Insurance Quote

Get free health insurance quotes, compare the cheapest individual available rates, and apply for the best medical plans without paying any fees. We make sure you can view the lowest prices in the shortest period of time. Whether it's during Open Enrollment or after you missed the Marketplace deadline, we get you covered quickly. Often, signing up for a plan takes less than 15 minutes.
You probably understand the importance of obtaining a quote before purchasing car or life coverage, and it is also important to obtain health insurance quotes from reputable and reliable sources. Regardless if you are currently without coverage, or feel like you are paying too much for your current policy, a quick and easy comparison can help you get what you need without paying more than you should. If you qualify for a federal subsidy, instantly, your Exchange plan premium will reduce.
In addition, our comparison shopping should help you find better coverage and prices than searching different websites yourself. And with modern quote engines available, viewing your options is now quicker and more accurate. If the carrier makes a change to benefits or the price they charge, it is automatically applied and typically shows up the next business day. That's one of the purposes of this website -- to provide the most accurate online offers from each of the top insurers.

Compare Medical Plans For Individuals

You Can Find Free Health Insurance Quotes Online


Do more with  Quotes
There are hundreds of available medical policies. Each of these plans will have its own advantages and disadvantages, and some may be better than others. We carefully show you the differences between, Platinum, Gold, Silver, and Bronze options, so you do not waste money on coverage that you aren’t using. Low-cost catastrophic policies can also be purchased if you are under age 30 or can not afford other Marketplace plans.
The new Affordable Care Act (ACA) plans are much different than pre-2014 options. And of course, accurate calculation of your subsidy is critical. It's "free money" that is designed to help you pay the premium regardless of any existing conditions. If correctly calculated, these funds are not taxable and never have to paid back.

Least Expensive Types Of Plans
"High-Deductible" plans (some qualify as "HSAs) are the cheapest type of medical coverage that can be purchased. And although it's quite affordable, there are plenty of benefits that were not previously included in this type of option (such as pregnancy, mental health and substance abuse). An optional tax-deferred savings element is offered with HSA-eligible options. The additional account works like a Bank savings account and pays a nominal amount of interest while you wait to disperse the funds.
Several deductible options are offered, although the $6,350 and $5,000 choices are the most popular. This type of policy is most appropriate when you feel you will probably not meet your deductible during the year, and you have no impending major medical expenses. It's a great opportunity to gain more control over your healthcare expenditures and save money, and we make it easy to purchase an HSA plan online. There are no costs or fees.


When you compare policies, it's also important to consider your eligibility for federal ACA tax subsidies. The impact on your premium can be substantial. We'll help you calculate the amount you are eligible for, which is directly related to your projected household income for the current year. The FPL (Federal Poverty Level) determines if you will receive an Obamacare subsidy and how much you will receive.
Since the amount of money you receive is based on your ESTIMATED earnings for that year (actually, Modified Adjusted Gross Income), it is possible that by the end of the year, you may have underestimated or overestimated your household income. If this occurs, it is possible your potential refund will be impacted the next year, with the appropriate adjustment made.
Simple Process
You’ll walk away with coverage that actually helps you in your time of need, all from a simple quoting process. And you can eliminate items that you are likely not to use, which can potentially lower your cost. In most cases, these items can be added again at a later date, since Open Enrollment takes place annually. Some benefits, such as maternity, can not be removed unless you switch to a non-compliant policy.
Keep in mind that your health status and age, as well as city and state in which you reside will also affect your insurance rates. Individuals who do not smoke, have no pre-existing health conditions and are not overweight or obese, will pay the lowest prices for their coverage. Of course, these guidelines apply mainly to temporary plans that are not subject to new guidelines established by "The Affordable Care Act."
The Impact That Obamacare Had Starting In 2014
Starting in 2014, pre-existing conditions were covered on Exchange policies and medical questions were no longer asked. Unless the law is overturned (we don't believe it will be), the new underwriting guidelines will remain. The makeup of Congress after the 2016 election will greatly determine the direction of future healthcare legislation. However, we believe there will be tweaks and changes, but not the elimination of Obamacare.
This doesn’t mean that you must pay excessive rates if you smoke or aren’t in the best of health, since you can no longer be declined because of pre-existing conditions. But for short-term plans, if you alter your diet and change other factors, an insurer will consider and often reduce your premium.
You will find that no two companies offer the same rates, even for the same policy, and only with comparisons will the best rates be found. And premiums do change and policy specifics also can change as well. Even those who have been with a particular company for many years may find a reputable company that can offer them a better price for outstanding coverage, far better than what they are currently getting.
This is information to be learned during the process of an estimate. But you should never terminate an existing contract unless you have been approved by the carrier you applied with. And this approval should be in the form of an email or hard-copy letter from the underwriter, providing you the policy number and effective date.
How to Obtain Information
There are a couple of different ways in which quotes can be obtained. As expected, online is one of the most common ways to get them, as well as one of the quickest. If you have access to the internet, prices can be obtained any time 24 hours per day, 7 days per week after you provide a bit of basic information. Our website never goes to sleep or closes!

Save money

Save Time And Money With The Right Website


Some sites make it possible to get as many as 8 to 10 rates in just a few minutes (such as ours) and with only one simple form. Look for this type of site if you are looking to save more. But also utilize the broker that owns the website so you can take advantage of his/her experience. You can easily email, fax or call them and get instant information. The quote engine on the website gives you a lot of information that you may need expert assistance with.

If you prefer, picking up the phone and calling companies directly can also result in a quote. Simply ask for rates and it shall be provided to you! Calling the health insurance company directly is perfect for those who do not want to use the Internet to take care of such business, as well as those who have questions they need immediate help with. But you won't be effectively shopping since only one carrier will be providing prices.
Our brokers can help you purchase coverage. You can find additional details  here. Of course, there are no fees or cost when you utilize a broker and your service will last as long as you wish. There is never an obligation or cost. We will also help you re-calculate your expected federal subsidy each year, since it can potentially change as your income increases or decreases.
You can ask also as many questions as you would like during the process of obtaining an over the phone estimate directly from a single company. But as a rule, checking online may be a better option since you are getting unbiased advice instead of information from only one company. And you can buy coverage without paying any fees.
Keeping Healthy
Medical benefits in place means you can always get the medical services that you need, anytime there is an an emergency, illness or accident presents itself in your life. Insurance greatly reduces the cost of doctor visits, medications, ER visits, lab work, surgery and so much more. Depending on the type of plan you have, you may just be paying small copays for small items and deductibles (and coinsurance) for major claims. However, it's easy to customize a policy that is ideal for your specific situation, regardless whether you have no medical issues or a chronic illness.
It is essential that you a contract in place regardless of your gender, age or current health conditions. Be sure that you do have your policy in force, but not before you have taken the time to compare. With so many different and confusing benefits, it only makes sense to take a small amount of extra time to compare companies, policies and rates.

UPDATE: November 16 2013 -- Our health insurance quotes will include the Exchange rates so you can compare the lowest plans. You may qualify for the Obamacare subsidy that could pay some, most or all of your policy. You do not have to provide any medical information since policies will be approved regardless of any pre-existing conditions.

UPDATE: May 20 2014 -- Insurers are starting to project their 2015 rates, which will be available when Open Enrollment begins on November 15th. Rates are expected to increase in most areas, although prices will substantially vary from one company to another. Also, additional carriers will be entering the Marketplace, and established companies such as UnitedHealthcare and Aetna will will be increasing their presence.