Affordable Care: waiting for employer plan to start

Employer offers to insure me after 6 months. Should I get insured now from the marketplace or wait to see what employer offers? Can I opt out of marketplace insurance if I sign up and employer offers something better? 

Weighing My Options

Dear Weighing My Options,

First, you should avoid going without insurance for more than three months if possible. Under the law, you can go three months uninsured without having to pay a penalty. There are, obviously, other reasons to want to stay insured but as far as the health reform law goes, you can go three months “bare”.

Yes, you can go to the marketplace and get a plan while you are not eligible for your employer’s plan. When you become eligible for your employer’s plan, you would no longer qualify for any government subsidies for marketplace-based plans. In theory, you would be kicked out of the exchange plan as soon as your employer plan was open to you. In practice, this could take months and during that time, you might be getting government subsidies that you would then have to pay back.

So you can’t really comparison shop between your employer’s plan and the marketplace plan. One is open to you only if the other one is not. You can, however, buy your own plan “off exchange” — which means that it gives you no government subsidy. It’s likely that an off-exchange plan would cost you more than joining your employer’s plan. Usually, group rates are lower than individual ones. But depending upon your age and your state, you might find a cheaper deal on your own.

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.