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Saturday, Oct 25, 2014
Healthcare Exchange Q&A

My wife buys her own health insurance. Can she shop on the health insurance exchange?

Published:

Q: My wife pays for private health insurance, and as you can imagine, the cost is extremely high. Is my wife eligible to secure health insurance with the new Affordable Health Care Program? Would she go about choosing a plan just like anybody else? — Ira from Tampa

Answer: People under the age of 65 who buy private insurance generally qualify as customers on the new health insurance exchange. Your wife is among the roughly 5 percent of Floridians who fall into that category. By comparison, 42 percent get health insurance through an employer plan, and another 31 percent are covered under Medicare or Medicaid.

But don’t automatically assume the new plan will help reduce your wife’s health insurance costs. You need to do a lot of comparison shopping first, and you have time. The deadline to buy insurance for Jan. 1 is Dec. 15. However, the government won’t penalize you if you wait and buy a policy by March 31.

It’s important to know what her current policy covers, and how it may compare to what is available in 2014 and beyond. For example, if your wife was charged higher premiums based on a pre-existing condition, that restriction no longer applies, according to the Affordable Care Act.

Also, a lot of individual policies currently cover only certain treatments, while new policies on the exchange are required to include a list of 10 “essential benefits.” See a list here: http://tbo.com/list/healthcare/qa/what-exactly-will-be-covered-on-the-online-marketplace-20130802/ That change could increase your wife’s premiums, depending on her current policy.

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