Deadline to buy health insurance is March 31

By David Sayen

Gazette Contributor

As the March 31 deadline for buying health insurance gets closer, I wanted to tell you about alternative ways to purchase a health plan – especially if you have a higher income.

Many lower-income Arizonans will qualify for lower costs on their coverage, but only if they purchase it through the Health Insurance Marketplace, at www.HealthCare.gov.

If you’re not eligible for lower costs, however, you can buy health coverage through an insurance company, an agent or broker, or an online insurance seller – as well as HealthCare.gov.

Eligibility for lower costs on health coverage is based on your income and household size. Generally, you won’t qualify if your estimated 2014 income is above $45,960 for an individual. For a family of four, the income cutoff is $94,200.

If you don’t qualify for lower costs based on your income, you can get coverage in one of the following ways:

·       Directly from an insurance company. You can contact any health insurance company and see plans available in your area. Many have websites that let you compare all plans available from that company.

·       With the help of an insurance agent or broker. Agents generally work for a single health insurance company. Brokers generally sell plans from a number of companies. They can help you compare plans based on features and price and complete your enrollment. You don’t pay more by using an agent or broker since they’re generally paid by the insurance company whose plans they sell.

·       From an online health insurance seller. These services offer health plans from a number of insurance companies. They let you compare prices and features and then enroll with the insurance company.

·       Through the Health Insurance Marketplace. You can apply and enroll through www.HealthCare.gov whether or not you qualify for lower costs based on your income.

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

Most plans available outside the Marketplace meet the requirement to provide adequate coverage under the health care law. This means you won’t have to pay the penalty that some people must pay if they don’t have coverage in 2014.

But keep in mind that not all plans you buy outside the Marketplace meet the adequacy requirement. Most insurers must tell you if the plan you’re buying qualifies as coverage under the health care law. Be sure to ask.

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

Even outside the Marketplace, open enrollment ends March 31.

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

That’s true whether you buy your health insurance through the Marketplace or other ways.

David Sayen is Medicare’s regional administrator for Arizona, California, Hawaii, Nevada, and the Pacific Territories.