Q. I’m trying to help my 31-year-old son find health insurance. He is currently without, his employer does not provide and he does not qualify for Medicaid. Where should we start looking?
A. Finding affordable health insurance can be tough, but it’s certainly not impossible.
A good place to start is with the health insurance marketplace that was established by the Affordable Care Act (ACA).
You can explore the options, but you should hurry, said Jody D’Agostini, a certified financial planner with AXA Advisors/The Falcon Financial Group in Morristown.
Open enrollment is through Dec. 15.
You would need to enroll by then or you will not be able to enroll until next year unless you have a qualifying event, such as getting married, having a baby or a job loss, she said.
“You will be able to explore the various plans and the premiums for each,” she said. “If you do not find what you are looking for, you can look to the marketplace which is specific for New Jersey.”
Or, you could start by seeing what plans are accepted by the doctors your son already sees.
“If he has special medical issues, you certainly want to be sure that there are acceptable specialists in the plan,” D’Agostini said.
Because he is young, if he is healthy, choosing a high deductible plan might make sense.
“His annual physical would be included at no extra charge, but his premiums would likely be lower,” she said. “If he chooses this option, he could consider opening a health savings account (HSA). You can put away money tax-free to help you pay for unmet medical bills.”
D’Agostini said insurance companies, by law, must charge the same premiums for the same plan no matter where you purchase your insurance, be it through the marketplace, directly with the insurance company or through a health insurance agent.
“Agents can help you sort through the various complexities, and help you customize the plan that fits your needs at a cost that is affordable for his budget,” she said. “There are also online health insurance services if you know what you are looking for.”
D’Agostini notes that if your son recently left an employer where he was insured, he could apply for coverage under COBRA. This would allow him to stay on his company plan for 18 months. He would pay the premiums, but these may be more competitive than what he finds on the marketplace.
Also know if your son has been uninsured for more than three consecutive months, there is a penalty that he would have to pay when he files his taxes in April. The penalty will be repealed for 2019, but it stands for now.
“For 2018, the penalty is the greater of $695 or 2.5% of income,” D’Agostini said. “So for this year, if he doesn’t have insurance, he will have to pay the penalty.”
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