The Patient Protection and Affordable Care Act (Obamacare) mandates that every U.S. citizen must carry a health insurance policy or face annual penalties for failing to be properly insured. As a result, options for free, low-cost, and moderately-priced insurance coverage have been made available through the healthcare marketplace, or by way of state exchanges, offering a variety of options for policies. In some cases, low-income individuals or families will qualify for free or low-cost coverage through Medicaid. Others can purchase policies for less than they might otherwise pay for polices directly from the insurance carriers. But this shift begs the question: what role does private health insurance play in this new system? How does it work now that Obamacare has renovated the industry?
There have been a lot of complicated changes to the private health insurance industry in the wake of Obamacare. However, you don’t necessarily need to know every detail; the most important fact to know is that private insurance is now regulated under the ACA/Obamacare. Obamacare is not government provided insurance, it is a law that regulates how insurance is distributed. Those who prefer to obtain private policies directly from the carriers, as opposed to going through the health insurance exchange, may still do so. In some cases, you will also have access to private health insurance through your employer. In fact, many people who were previously insured through private insurance providers saw no difference in their coverage or payments as a result of Obamacare’s implementation. And many companies elected to continue offering benefits with the same private insurance companies they used in the past.
Some businesses, on the other hand, switched to marketplace options or at least added them to the list of choices for employee coverage. But what if you don’t receive insurance benefits through your job? If you are in a low-income bracket, chances are good that your best choice for affordable coverage is to apply for Obamacare to see what kind of reduced rates you are eligible to receive on select private insurance options. You may be able to get free or low-cost services for your entire family, or at least for specific family members like children, pregnant women, the elderly, or those with disabilities.
But if you have a decent income and you want more decision-making power when it comes to the services available to you, you might be more interested in health insurance options directly from the carriers. And for the most part, you will not experience undue trouble obtaining this type of policy. As you would have before Obamacare, you will probably want to compare providers, policies, cost, coverage, and so on. But you can also go through independent insurance agents or even companies that work with a variety of insurance providers. They provide you with options for coverage that best suit your particular wants, needs, and budget.
The major difference is that most providers now offer packages in the “bronze,” “silver,” “gold,” and “platinum” models, both on the exchange and directly. But this allows you to select the level of coverage you want (including co-pays, deductibles, access to preferred vendors, and so on), as well as the pricing you prefer. If your policy does not have one of these “Metallic” modifiers, then it is most likely not regulated under the ACA/Obamacare and will not be considered Qualified Coverage. This could cause you to be fined by the ACA as if you did not have coverage at all, although exemptions from this penalty are available.