The US is the only wealthy, developed country without universal health care.
The Affordable Care Act, passed in 2010, was meant to get more Americans insured by expanding Medicaid, making sure people had access to coverage regardless of employment, and requiring plans to cover people with pre-existing conditions. (More on all that here.) You’re no longer subject to a fine if you’re uninsured, but medical insurance is generally considered a smart, worthwhile expense. If you’re currently uninsured or wondering whether to switch plans, you’re not alone. Because of mass layoffs during the pandemic, millions of Americans lost their employer-sponsored insurance in 2020. If that’s you, then you may be eligible for coverage under the ACA in 2022.
If you're considering new insurance, here’s what that could mean for your health (and health coverage).
Did you lose your job or benefits during the pandemic?
COBRA. Not the snake. It stands for Consolidated Omnibus Budget Reconciliation Act. Translation: It’s a federal law that lets you keep your insurance for a period of time (usually 18 months) if you lose your job and your employer offers it. The catch? You have to pay the full cost of your premium — which is what your employer paid all or a portion of when you worked there — plus an administrative fee.
the Marketplace. You might want to opt for a Marketplace plan instead. If your COBRA is running out, you can switch to a Marketplace plan even if it’s not within the Open Enrollment Period.
Medicaid. If your income falls below state eligibility limits (do the math here), you may be able to get health benefits under Medicaid — especially if you live in a state that expanded Medicaid coverage under the ACA. Learn more about Medicaid eligibility here.
Wondering whether to stick with COBRA or go for the Marketplace?
Here are some things to consider. COBRA and marketplace plans can be expensive. Shop around for the most competitive rate based on your health care needs. Also: with COBRA, you know what you’re getting, and you won’t run the risk of needing to switch doctors if they’re out-of-network, like you could with a new ACA plan. Anddd if you’re close to hitting your deductible on your employer insurance plan before you leave your job, it might make sense for you to stick with what you’ve got and enroll in COBRA.
Do you have private insurance?
If you’re insured through your job, your partner’s job, or a parent’s job, there are some things you need to know.
If you’re on your parents’ plan, you can keep riding that train until you turn 26. Then, you’ll be automatically kicked off at the “Adulthood” stop.
You don’t need to be married to get on your partner’s plan. Domestic partners (aka people living together and sharing a domestic life, but who aren’t married) can get shared coverage if one partner claims the other as tax dependent or if they have a child together. Requirements to qualify vary by state and employer.
Note: Just because your employer offers insurance, doesn’t mean you have to take it. You can still opt for Marketplace insurance. You might stick with employer coverage if it’s available, because your employer pays all or part of your monthly premium. And know that if your employer offers insurance, you likely won’t qualify for any savings on a Marketplace plan.
Open enrollment dates may vary according to state or employer (if you’re looking at a job-based plan). So check to see when yours is happening, and mark your calendar (Our guide will help you choose the right health insurance plan when the time comes).
Are you already insured through an ACA plan?
Here’s how to make the system work harder for you.
Under the American Rescue Plan, more Americans than ever before qualify for savings on Marketplace plans. Find out if you qualify here.
If you’re looking to renew or change your existing plan, check this out to see alllll your options.
Are you helping your parents shop for health insurance?
Here’s the 411 on lending a hand.
Medicare is the federal gov’s insurance program for people 65 and older and for people with certain medical conditions. If your parents qualify and you’re helping them sign up, buckle up — it’s confusing AF, and there’s a lot to cover.
There are two main plans under Medicare: Original Medicare and Medicare Advantage. Original Medicare includes the core components of care like hospital care, outpatient services, and preventative care. You can add on prescription drug coverage. Medicare Advantage plans are run by private insurance companies and follow the rules set by Medicare. What they offer is more of an “all in one” package, including benefits not offered by Original Medicare.
The plan should reflect your parents’ needs and budget. To get started, click “Find plans” on the Medicare site.
Want to phone a friend? You’re in luck. The US gov funds a resource called the state health insurance program (SHIP) that lets you talk through your Medicare options with a real, human expert.
The Affordable Care Act is the federal gov’s way of saying, ‘We’ve got you covered.’ But it’s up to you to shop and sign up for the health insurance plan that works best for your life stage and budget, whether that’s through an employer or the Marketplace.
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