2021 Individual and Family Health Plan Guide
This guide will help compare differences between ACA compliant plans and Non-ACA plans. Non-ACA plans can save you a great deal of money and offer greater access to providers. Having said that, Non-ACA plans aren’t for everyone. If you have significant health issues and very specific needs you may need to stay in an ACA plan. Keep reading for more information.
|ACA Plan||Non-ACA Plan|
|Nationwide PPO Network||No||Yes|
|Cost||$$$$ – Expensive*||$$ – Reasonable|
|Pre-Existing Conditions||Covered||Covered after 12 months|
|Maternity, Mental Health & Preventive Care||Covered||Not Covered|
|Health Questions Required||No||Yes, 5|
|Enrollment Period||November 1st – December 15th||Year Round|
Cost* – Those whose incomes are within the sweet spot can obtain sizable subsidies making their ACA plan little to no money.
Non-ACA Plan is a very generalized term that people use to describe anything that is not compliant with the ACA. The problem is that non-insurance plans get lumped in like faith-based cost-sharing plans which are not insurance. There are also a lot of new options from carriers that no one has ever heard of pushing plans that sound like the greatest thing since sliced bread. None of these have passed our sniff test and as a result, the only non-ACA plan that we recommend is Short Term Medical Insurance (STM).
Due to recent changes in the law, these plans are now able to be purchased for 12-months at a time.
STM plans are low-cost alternatives to the expensive ACA options. They are 100% real health insurance with large PPO networks. There are many benefit levels available to suit all budgets. While these plans do not cover pre-existing conditions and typically offer very little in the way of prescription coverage, they provide maximum premium savings and access to nationwide PPO networks which is something that simply can’t be found with ACA plans.
This depends on you and your present health condition. We encourage you to visit iHealthBrokers GoodRx Prescription Tool and review your own prescriptions to see if you can save any money. While STM plans typically don’t cover prescriptions (some actually do), for most healthy individuals this isn’t a concern. I personally take an expensive name brand prescription that costs me $300 a month even with GoodRx, however, that said, I’m saving $1,100 a month by choosing STM over an ACA plan so for me it still makes perfect sense.
When comparing between ACA an STM your prescription cost should be a factor. If paying cash for your prescriptions with GoodRx doesn’t net you any savings over an ACA plan, then you should be in an ACA plan.
A health care sharing ministry is an organization that facilitates sharing of health care costs among individual and families who have common ethical or religious beliefs. A health care sharing ministry is not actual insurance, is not regulated by the Department of Insurance, does not use actuaries, does not accept the risk or make guarantees, and does not purchase reinsurance policies on behalf of its members.
While members of these plans are exempt from paying the tax penalty for not having health insurance, there is still a significant risk to these plans. Because these plans are not actual insurance and because of the significant risk we do not endorse these plans.