We have entered the final weeks of Open Enrollment for 2014 health insurance.
As such, many individuals are scrambling to meet the March 31 deadline to purchase 2014 coverage. If you are one of them, you may be wondering — EXCHANGE or NO EXCHANGE?
Should you go through your state’s health insurance exchange (in Virginia, the federal marketplace, or healthcare.gov) or should you purchase coverage directly from a carrier?
The good news is, whichever route you choose, Virginia Medical Plans can help, as we are an authorized broker both on the exchange (in Virginia, Maryland, and DC), and for all the major carriers off-exchange.
Why Buy Coverage on the Exchange?
The main reason for purchasing health insurance on the Exchange is that it is the only way to collect a subsidy to help pay for coverage.
Eligibility for a subsidy is based upon household income as follows:
|
# People in Your Household |
||||||
|
1 |
2 |
3 |
4 |
5 |
6 |
|
| You may qualify for a premium subsidy if your yearly household income is between …. |
$11,490 -$45,960 |
$15,510 – $62,040 |
$19,530 -$78,120 |
$23,550 – $94,200 |
$27,570 – $110,280 |
$31,590 – $126,360 |
If you think you are eligible for a subsidy, click here for instructions on using the exchange in Virginia, Maryland, or DC.
Why Buy Coverage OFF the Exchange?
If you are not eligible for a subsidy, then we always recommend you consider plans offered off-exchange as well. Why?
Provider Networks: Some of the plans sold outside of the exchange offer wider provider networks. This means access to more doctors, pharmacies, hospitals, etc. when you need care. We even have found cases where the same carrier offers plans both on and off the exchange, and the off-exchange plans have different networks than the exchange plans. One of the primary carriers in Virginia, for example, has a significantly reduced network of hospitals on the exchange version of its plans.
Options: Plans sold off-exchange offer more options in terms of combinations of deductibles, co-pays, coverage, etc. Although all plans — sold either on- or off-exchange — will cap deductibles at $6,350 for an individual and $12,700 for a family, the more flexible the options, the better the selection in terms of finding the right balance for each customer’s needs, wishes, and budget. For example, someone who may have trouble paying a high monthly premium may be better off with a plan that has a higher deductible. More options off-exchange mean a better likelihood we can find the right plan. Click here to read an earlier post about this.
Application Process: It is no secret that both the federal and state health insurance exchange websites have seen some problems. By purchasing off-exchange, you avoid those issues by applying directly with the carrier.
Deadline to Purchase is March 31
Whether you purchase your coverage on- or off-exchange, the deadline for buying a 2014 policy is quickly approaching. You have until March 31.
After that, absent a qualifying event (change of job status, change in marital status, birth/death/adoption of a child, loss of coverage, etc.), your next opportunity to purchase coverage will be during 2015’s open enrollment (currently set at November 15, 2014 – February 15, 2015).
We are available to assist with on- and off-exchange applications. You can reach us by phone 1-800-867-0800 or email jkatz@vamedicalplans.com.
Or you can get started now by clicking 
.
For exchange applications, our broker information is found below. When you enter this information into your online application, you are guaranteed our guidance and assistance for the life of your policy:
First name: Jonathan
Last name: Katz
FFM User ID: JONKATZAGENT
NPN Number: 1585616
Thank you for your patience as we manage a high volume of calls and emails.
