Dear Insurance Adviser,
I’ve been reviewing whether to get health insurance for my wife through my employer or via the Obamacare health insurance marketplace. To add my wife to my plan at work, the cost increase per month would be $170 (pretax). The cost through HealthCare.gov is similar but with a big catch: “Premium before tax credit: $170.” Of course, the amount of the tax credit differs from plan to plan, but here is my question: If the tax credit were to give me, say, $100 back per month on insurance, for a total of $1,200 over the course of a year, then why would I ever want to cover my wife through my employer?
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Based on those facts alone, you wouldn’t. But there are other variables to consider, such as a comparison of the coverages, deductibles, annual out-of-pocket maximums and, of course, the network of participating doctors and hospitals. These differ greatly from plan to plan.
One advantage of buying an individual plan from the Obamacare health insurance marketplace, or exchanges, is that you have a lot more choices available to you. For example, you may not like the deductible in the group plan where you work. In the marketplace, you can choose the deductible that suits you better.
Or perhaps your wife’s OB-GYN doctor is not participating in the network of physicians available through the group plan. In the health marketplace, you can pick a plan that includes her OB-GYN as a participating in-network provider.
One other advantage of shopping for an individual plan is that you don’t have to compare coverages by yourself. For no extra charge, you can work with an insurance agent who can do the comparing for you. The agent will be able to provide information about the insurance companies that you may not have otherwise, such as whether they’re good at paying claims.
The bottom line is that when you get health insurance, you should never make a choice between plans based on the upfront costs alone. But all things being equal, I would choose an individual plan over a group plan.
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