Health Insurance Shopping Aid

October 17, 2020

This shopping aid compares ACA compliant health insurance plans and alternative health plans available to individuals who are self-employed or running a new business. Those eligible for Medicaid, CHIP, Medicare or a group health plan through a spouse or parent, should consider those plans before these individual options.

ACA compliant plans also known as Obamacare plans meet the definition of health insurance under the healthcare law and offer the most comprehensive coverage available which includes essential benefits. Plans for 2021 can only be purchased during the open enrollment period that runs from November 1st through December 15 or during a special enrollment period triggered by changes in employment, immigration or family situation. A premium tax credit may be available to help pay your premiums and out of pocket expenses.

To apply for a premium tax credit in Texas you must enroll in a plan offered through the federal exchange. Below are the 2020 income ranges by household size which are used to determine if a household qualifies for a premium tax credit.*

*Some insurance companies offer ACA Compliant Plans outside of the exchanges for people whose income is too high for the premium tax credit. Full 2021 guidelines wil be published on this web page:https://aspe.hhs.gov/poverty-guidelines

Alternative Health Plans

Since 2019, the tax penalty for not having an ACA Compliant plan is no longer in place. Small business owners and self-employed individuals looking for lower premiums can now consider alternative health plans which offer benefit packages that are more limited and have lower premiums than ACA Compliant Plans. The most common ones include Short Term Health Plans, Health Sharing Ministry Plans and Fixed Indemnity plans. These plans are not considered “health insurance under the current healthcare law.

How to Read the Comparison Table

This information is based on a limited sample of plans offered through independent insurance agencies in Texas and is only a frame of reference. The intent is to save you time while you research and narrow your choices. The top 2 rows provide an overview for each plan. The bottom 12 rows compare affordability, coverage and flexibility features subjectively by highlighting the most favorable option in green, less favorable options in light orange and the least favorable option in bright orange. Scroll Down to view the table. When you are ready to compare quotes and select a plan, a local independent agent can facilitate that for you.

Plan Comparison

Click this link to download full size pdf version: Comparison Table

**Essential benefits are a set of 10 categories of services that include doctor’s services, inpatient and outpatient hospital care, prescription drug coverage, birth control, pregnancy and childbirth, mental health services, and more. Plans must cover dental and vision care for children. Source: https://www.healthcare.gov/glossary/essential-health-benefits/