Affordable Care Act: best plan depends on age, income, health

What is the best insurance option for someone who is self-employed and lives in Indiana?


Dear Salesman,

The best plan depends upon your age, your income, and your routine use of medical services.  First your age: if you are under age 30, you can choose a less expensive Catastrophic Plan.  This works well if you have no identified illness that call for regular office visits and medications.

Your income: if you are earning less than 400% of Federal Poverty (about $46,000 for a household of one person), then you can get government help to buy your health insurance.  To get these subsidies, you have to buy your health insurance on your state’s health insurance exchange.  Indiana is using the federal exchange, so you need to go to Health Insurance Marketplace, Affordable Care Act , create an account, and apply for your plan there.

If you are earning less than 133% of Federal Poverty (about $15,000 for a household of one), then you cannot qualify for subsidies.  You also cannot get Medicaid in Indiana, unless you have another factor such as children under age 18 in your household or a disability.  At that income level, you also would not be penalized for going without health insurance.

If you are earning more than 400% of Federal Poverty, you can choose to buy your plan on or off the exchange.  You might want to find a health insurance broker to help you, if you go off-exchange.

Your medical needs: People who have ongoing illnesses generally will want a plan that has lower deductibles and co-pays for office visits and drugs.  It’s simply is a tradeoff between paying health insurance premiums and paying for medical bills. 

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.