Should I Use the Affordable Care Act?
What is the Affordable Care Act and How Does it Work?
Most of us have heard about the Affordable Care Act (sometimes referred to as Obamacare), but as to what it is and how it works...that's a different story. Even though the Affordable Care Act (ACA) has been around since 2010, there is still a lot of confusion surrounding it.
That's why I'm here today to help explain how it works and whether it is a good health insurance option for us traveling healthcare workers.
The founding goal of the ACA was to extend health insurance coverage to Americans who were uninsured, to lower health care costs and to eliminate the possibility of being denied due to pre-existing conditions.
Normally, how much you pay for your health insurance through the ACA depends on your monthly income.
However...that doesn't quite apply to us travelers.
If we decide to sign up for the ACA instead of taking the recruitment company's health insurance, then we are technically turning down company insurance and so we don't qualify for any tier-based pricing or discounts; we must pay full price. But we make great money as travelers so we really shouldn't qualify for discounted prices anyway!
(psst...you can read about the company insurance in our awesome post here!)
When to Apply
Anybody can apply for health insurance with the Affordable Care Act through the marketplace at www.healthcare.gov .
And the ACA has a limited enrollment period (for 2018, it was between the dates of 11/1/17 and 12/15/17). So if you missed the enrollment period, most likely you will have to wait until the next year to apply.
However, there are a few exceptions where you can apply outside the enrollment dates. And luckily, as traveling healthcare workers, we qualify for one of those exceptions.
The ACA states that ending your employment qualifies as an exception to the brief enrollment period and gives you a 60-day open-enrollment period after job termination.
And since we take on multiple assignments per year, we are given multiple chances to enroll.
So if you missed the enrollment period this year, no worries! Just wait until your next contract is completed and apply then!
What State do I Apply From?
Another thing that traveling healthcare workers must consider when applying for the ACA is which state to apply from. Since we will be traveling from state to state for our contracts, this is a tricky one.
You would think that we would have to update our home state every time we travel so that our insurance travels with us... Unfortunately this isn't how it works.
If you have a tax home (read all about tax homes here) then you need to apply for the ACA using your tax home state as your location.
While the ACA applies to all 50 states, each state has its own plan options.
This means that the ACA will find plans for doctors that are near your home address.
"But...if the options are based off my home address and not where I am currently living, how will that benefit me?" - said any logical traveling healthcare worker.
Ah...yes! You discovered the snag.
Once you are on a travel assignment, the options for doctors are much more limited, and the deductible for using an urgent care or emergency room can be through the roof!
Now we're left wondering..."Should I even bother with the Affordable Care Act then?"
Is the ACA Beneficial to Traveling Healthcare Workers?
It's true - the ACA appears kinda useless for travelers like ourselves.
If we can only use doctors when we are in our home state, then how would we benefit from signing up for the ACA?
Well...it can actually be a great option if used the right way! So here are some pro-tips on how the ACA can benefit us:
If you have a pre-existing condition: It is required under the ACA rules that every plan MUST cover chronic disease management and rehab services and you cannot be denied due to a pre-existing condition. (You can read all about the minimum coverage requirements here).
If you need regular prescriptions: Anybody who needs a regular prescription knows that the costs can be insane if they're not covered by insurance. Luckily, it is also a requirement under the minimum coverage for every health plan that prescriptions are covered. And it doesn't matter what state you pick it up in as long as the pharmacy accepts your insurance plan.
If you only use it as catastrophe insurance and for wellness check-ups: Pay attention to this one... We mentioned that it is a downfall that the ACA only works in your home-state, however, you can work around that! Since we are required to spend at least 30 days at home to maintain a tax home, then we can schedule all of our wellness checks during that time and take advantage of our ACA coverage. Just choose the cheapest state insurance that is offered (it'll usually be around or under $300) and take advantage of the minimum plan requirements.
If you use it as a supplement along with Telephone doctors: Have you heard about telephone doctors before? No? Well you should know about them! For a monthly subscription fee (usually around $15/mo.), you can have access to 24/7 doctor consultations. There is no deductible and no co-pay, just the monthly fee. If you feel sick, you can call or video-chat with a doctor who can diagnose you and prescribe prescriptions for you just like that! No expensive urgent care visits!
So if you pair your ACA annual wellness checks and prescriptions with a telephone doctor subscription, you have all your bases covered!
How Much Should I Be Paying for Health Insurance?
When you sign up for the ACA, it gives you a list of health insurance packages to choose from with varying costs.
It can appear overwhelming and feel impossible to know which one to choose...
One tool that we found for getting a cost estimate and comparing packages is Value Penguin.
Once you go to the Value Penguin homepage, drop down the tab at the top that says "insurance" and choose the "health insurance" option.
This will bring you to a page where you can fill in your info such as home state, county, annual income, household size and age.
For this example, we used Hillsborough County in New Hampshire. And we used random numbers for the age and income.
When filling in your income, keep in mind that the ACA is based only off your taxable income and does not include any travel stipends.
This is the total yearly income that appears on your W-2.
Putting in this information will give you an idea of the average rate and what's fair to pay for your health insurance.
Below are the cheapest few options that came up for out search:
The most expensive insurance option that came up for our search was $556/month.
As you can see, the rates can vary widely based off your plan and your family situation. But the average cost of health insurance for an individual is in the $300-$500 range and is usually over $1,000/ month for a family.
Yeah...Having health insurance is pretty expensive. But when you need it, you'll thank your lucky stars that you have it!
Laura & the Nomadicare Team xo
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