Insurance in US

Moohamin12@lemmy.ml to Asklemmy@lemmy.ml – 8 points –

Hello,

I have a question about the healthcare insurance in US.

I have heard that it is tied to your employment and the company provides for it.

So here are a couple of questions:

  1. Is there no way for an individual to get their own personal insurance and not be dependent on the company?

  2. What about freelancers, business owners and retirees? Do they forfeit their insurances?

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  1. Yes, however it’s usually a little more expensive to get the same coverage, as the employer pays a part of employee’s insurance costs.
  2. Forfeit? No, they’ll still need insurance (you get a fine if you’re without insurance for more than 3 out of 12 months (at least, I think that was the case)).

a little more expensive

This is a gross understatement. Companies usually pay 50% or more of the insurance their employees get.

My partner and I pay $200 for the ~$1800/mo healthcare plan through their employer. There was a fully-covered option but the deductibles are so low on this plan it's incredible.

This is the first time I’ve heard about being fined for not having insurance.

Tv etc has led me to believe if you don’t have insurance you just hope and pray you don’t need to go to a&e. What about homeless people, for example? Is there something in place that issues fines to all the people who don’t have insurance at all? I’m so confused.

On point 2, the individual mandate was repealed in 2018. There's no federal penalty for not having insurance.

Apparently it is still upheld at the state level in 5 states.

So you get fined if you don't take one of the slightly more expensive plans if you are a freelanced individual?

Yes, because you would be without insurance. A person can buy insurance on an exchange and it is similar in price as employer sponsored insurance - you just have to pay all of it. Typically an employer pays for at least some of the insurance if it is a benefit they offer.

It is worth noting that the fine is captured as part of a person's taxes, so it can be a bit obvuscated. Although in typing this, I vaguely recall a SCOTUS ruling that said the fine wasn't allowed.

It is actually more wild than all of this even! Each state has additional rules/requirements beyond Obamacare. So what is covered in Washington State may not be covered in Texas.

If you need help sorting through insurance, reach out to me - I've done a lot of it as a business owner with two special needs kids.