The Affordable Care Act, also known as Obamacare, has significantly changed the Health Insurance market. the individual market saw the vast majority of the changes due to the original implementation of the law and has since continued to change as insurers have to find ways to survive in the unfriendly market.
If you do not have coverage under an ACA compliant plan, you are subject to the Individual Mandate Penalty, collected on your taxes. The penalty is currently the greater of $695 or 2.5% of the household income for every adult in the household without coverage and half of that amount for every child under 18 (1/12th of the penalty is assessed for each month without coverage). This Individual Mandate and Penalty are scheduled to go away in 2019.
Individual insurance is still available and are still Guaranteed Issued! There is at least one carrier in every county in Texas, though many counties may only have one carrier to choose from. Plans can be bought through your agent directly from the carrier or through the Individual Marketplace (or exchange). Any plan bought from healthcare.gov is a Marketplace plan, though you can also purchase on exchange plans directly from the carrier. If you want us to be your agent on your plan, please follow the instructions and links in the Medical Enrollment section below.
In order to purchase an Individual Health Insurance plan, you must sign up during the Open Enrollment Period or during a Special Enrollment Period.
Open Enrollment is the time of year that you can switch plans or sign up for new coverage. This Enrollment Period can change from year to year. For plan year 2017, Open Enrollment runs from November 2016 through January 31st, 2017.
Special Enrollment Periods are 60 days before or after a qualifying event. Qualifying events are when an individual has a change in family status (birth, adoption, marriage, divorce, etc.), change in residence or an involuntary loss of coverage.
If you choose to purchase a plan on the Marketplace, you may qualify for a Premium Tax Credit to lower the cost of monthly premium if you fall in the household income level of 133%-400% of the federal poverty level.
If you have missed Open Enrollment and do not have a qualifying event, your next option is Temporary Health Insurance. These plans are limited to 3 months of coverage but may be the thing you need to get you to the next Open Enrollment. These plans are medically underwritten, and are therefore not an ACA compliant plan, but can cost significantly less than other plans.
