People who obtain health insurance through an employer are limited to the plans their employer offers. Self-employed individuals, on the other hand, are free to choose the plan that best fits their situation. Self-employed individuals can also deduct 100 percent of their health insurance premiums paid during the year, with certain exceptions. See Barton’s “Tax Guide for Locum Tenens Providers” for more information.
If you are new to locum tenens and have never obtained your own health insurance, there are several options available. This guide will explain these options, and help you decide which is best for you.
Enrollment Options
Enroll in Your Spouse’s Plan
If your spouse has access to an employer-sponsored health insurance plan, he or she may be able to enroll and add you to that plan. Keep in mind that if you have access to a spouse’s employer-sponsored plan but decide to opt out of this plan and obtain your own independent plan, your premiums are NOT tax deductible.
Use State Insurance Exchanges
With the passage of the Affordable Care Act (ACA), each state has developed an insurance exchange marketplace allowing residents to purchase health insurance. Health insurance plans found in the marketplace offer the “essential health benefits” mandated under the ACA, which include:
- Emergency services.
- Hospitalization.
- Maternity and newborn care.
- Lab services.
- Chronic disease management.
- Pediatric care.
- Rehabilitative care.
- Mental health and substance abuse services.
- Prescription drug coverage.
Plans also come in four coverage levels based on the percentage of healthcare costs they cover:
- Platinum plans must cover 90 percent of an average person’s expected costs.
- Gold plans must cover 80 percent of an average person’s expected costs.
- Silver plans must cover 70 percent of an average person’s expected costs.
- Bronze plans must cover 60 percent of an average person’s expected costs.
You can access your state’s insurance marketplace via HealthCare.gov. There you can compare plans and view the associated premiums, deductibles, and out-of-pocket costs.
Use Private Insurance Exchange Websites
Private insurance exchanges, such as eHealthinsurance.com, provide an experience similar to Healthcare.gov, allowing users to compare plans side by side and purchase from a variety of insurance companies.
Plans offered on private insurance exchanges meet the Affordable Care Act’s individual mandate, as long as they offer the “essential health benefits.” You can read more about essential health benefits on HealthCare.gov.
Contact an Independent Insurance Agent
Independent insurance agents understand the health insurance market and can help you find options that will best fit your needs. You can use the National Association of Health Underwriters (NAHU) website to find agents in your area.
Contact Insurance Companies Directly
You can always contact insurance companies directly to inquire about individual plans and compare policy options yourself. It may not be as convenient as using the online exchanges or an agent, but it’s an option.
Open Enrollment Period
Open enrollment is a designated period during which individuals can obtain health insurance coverage with fewer restrictions. The open enrollment period for coverage starting in 2017 ended on January 31, 2017. Please see HealthCare.gov for further information.
If you miss the open enrollment period, you can still enroll in a new plan if you have a qualifying event, which includes the following:
- Marriage, having a baby, adopting a child or placing a child for adoption or foster care, moving your residence, or gaining citizenship.
- Losing health coverage because of losing employer-sponsored health insurance, divorce, the end of an individual policy plan year, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances. Important: Voluntarily ending coverage does not qualify you for a special enrollment period, and neither does losing coverage that doesn’t qualify as minimum essential coverage.
- Gaining status as member of an Indian tribe.
If you leave an employer-sponsored insurance plan to become an independent contractor outside of the open enrollment period and do not have a qualifying event, you can still obtain coverage via short-term health insurance.
Short-Term Health Insurance
Short-term health insurance policies protect individuals who miss open enrollment until the next open enrollment period. Short-term health insurance policies are meant to cover unforeseen accidents or illnesses, and typically do not include coverage for preventive care, dental, or vision. They are also not considered qualifying plans under the ACA, which means you may be subject to a tax penalty.
Short-term health insurance policies are available through private insurance exchanges, insurance agents, or insurance companies directly.
We hope this guide has given you some direction when it comes to acquiring health insurance. Please remember, this information is a summary of suggested health insurance considerations for locum tenens providers, and is subject to change. Please consult a health insurance expert and/or tax professional with specific questions.
