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BUYING HEALTH INSURANCE

Our best health advice for 2018

There is one central piece of information you'll need to plan your 2018 health insurance: your income. In particular, you need to know the ratio (as a percentage) of your individual or household income to the official Federal Poverty Level. Look up your income level in this table to narrow down your options.

If your income is above the FPL but less than 400% of the FPL then you qualify for tax credits. And, if it's under 250%, also you'll get Cost-Sharing Reductions (CSRs). After you choose the best policy there are two ways to use the credits: you can purchase insurance on a government exchange or through a commercial comparison service such as our partner HealthSherpa. and Go to marketplace or use HealthSherpa

If your income is above 400% of the FPL you do not qualify for any tax savings, and you'll want to try to avoid a tax penalty. Consider an "off-market" silver plan which may cost less than the government marketplace. These can be found directly from insurers, or brokers such as eHealth Insurance. You can also buy from the government exchange. Go to eHealth

If your income is below 138% of the FPL, you may qualify for cheap insurance through Medicaid. Your eligibility can depend on if your state government chose to expand Medicaid or not. Tragically, in states that did not expand Medicaid, many individuals below the Federal Poverty Level don't qualify for Medicaid or tax credits, and thus many are unable to afford insurance. Look up your state's cutoff level. There is an online Medicaid application for those who qualify. If you live in a state that refused to expand Medicaid, be sure to get an exemption from the tax penalty, and consider writing to your state legislature to express your opinions if you are upset to not be included in Medicaid.

Look up your income level

When considering which course to take with health insurance, it all comes down to Modified Adjusted Gross Income (MAGI) compared to the 2017 Federal Poverty Level (FPL). MAGI does not appear as a line on your tax return, but for most it's identical or quite close to Adjusted Gross Income.

Base FPL 138% FPL 250% FPL 400% FPL
Individual $12,060 $16,643 $30,150 $48,240
Family of 2 $16,240 $22,411 $40,600 $64,960
Family of 3 $20,420 $28,180 $51,050 $81,680
Family of 4 $24,600 $33,948 $61,500 $98,400
Family of 5 $28,780 $39,716 $71,950 $115,120
Family of 6 $41,210 $56,870 $103,025 $164,840
Family of 7 $46,440 $64,087 $116,100 $185,760
Family of 8 $51,670 $71,305 $129,175 $206,680
Note: Hawaii and Alaska have different FPL levels than the above.

If you Qualify for Tax Credits or CSRs

You qualify for tax credits if your income is between 100% and 400% of the FPL. You qualify for Cost-Sharing Reductions (CSRs), which are additional savings that reduce out-of-pocket costs for deductibles and copayments, if your income is between 100% and 250% of the FPL. But you must sign up at the correct time.

What is the window for signing up?

November 1st to December 15th in most states. Six weeks is not much time compared to the three month window available last year. While all state sign ups start on the same date, a few states provide an extra month or two. These states operate their own health marketplaces and aren't restricted by the shortened window imposed on the Federal marketplace used by most states.

State End Date
California Jan. 31
Colorado Jan. 12
Connecticut Dec. 22
Massachusetts Jan. 23
Minnesota Jan. 14
New York Jan. 31
Rhode Island Dec. 31
Washington Jan. 15
Washington, D.C. Jan. 31

What policy is best for me?

If you qualify for tax credits and CSRs, you may be best off with a Silver plan, as these are the only type that CSRs apply to. However, considering Bronze or Gold plans may be worthwhile considering how affordable they have become for some this year.

Source: Premium data from Healthcare.gov gathered and analyzed by the KFF

If CSRs are unavailable, then considering Gold and Bronze tiers is highly suggested. In some counties, the cheapest Gold plan may cost less than the cheapest Silver plan (see map above). Furthermore, the cheapest Bronze plan in some states may be free or cost only a few dollars per month.

Source: Premium data from Healthcare.gov gathered and analyzed by the KFF

The trade-off with the Bronze option is the large out-of-pocket costs you'll have to pay if you need to make use of insurance. We don't generally recommend a Bronze plan because regardless of how healthy you are, one can never predict when serious injury or illness may strike.

Where should I get a policy from?

While policies can be found via the government marketplace's website Healthcare.gov, these same policies can be seen (more easily, at the same prices, and with year-round responsive customer support) via brokers such as Health Sherpa.

If You Don't Qualify for Tax Credits

If someone makes over 400% of the FPL, tax credits and CSRs are not available. You can still buy insurance via a government exchange. Also, insurers in many states offer “off-market” silver plans which may cost less than those sold on the government marketplace. These can be found directly from insurers, or brokers such as eHealth Insurance (all of which should have the same prices as set by the insurer). One benefit of this option is the ability to bundle other coverages in with the health insurance These include things like GAP insurance, dental, critical illness, accident, vision, and even telemedicine.

So-called "Medical Packages" that do not meet ACA requirements (such as those offered by eHealth) exist, but there is a sizable tax penalty. Under certain circumstances, however, an individual can apply for an exemption to this fine.