Health Insurance Plans: The Pros and Cons
The information below outlines the types of health insurance plans available to U.S.
consumers and the pros and cons of each.
Term Health Plans
Pros
- Affordable premiums than are less expensive than Affordable Care Act health plan
- Applications for insurance enrollment can be made any time during the year
- Generally has a broad network of medical care providers and is typically accepted at
most of the top hospitals and cancer centers in the U.S.
- Savings on premiums can be used to buy other care such as dental or vision coverage
Cons
- Does not cover pre-existing medical conditions
- Enrollees are still subject to Affordable Care Act uninsured penalty tax
- Health status and pre-existing conditions evaluated as part of application approval
process; applicants can be rejected
- Prescription drugs may not be covered (or have restricted coverage)
- Some benefits not covered (e.g. pre and post natal care is excluded)
Affordable Care Act Insurance
Pros
- Coverage for many generic, brand name, and specialty drugs
- No review of health; applicants will not be rejected based on health conditions
- Some people may qualify for subsidies for premium & out-of-pocket costs
- Wide range of health insurance benefits
Cons
- Includes health insurance benefits you may not need or want
- Plans may limit enrollees to narrow network of medical care providers
- Premiums are expensive without subsidies
- Unable to enroll in health plan outside of annual enrollment period without a
qualifying life event (e.g. moving to a new region)
- Very high deductibles in bronze plans
Employer-Based Insurance
Pros
- Coverage for a pre-existing condition can be denied for a maximum of 12 months
- Employer premium subsidies not treated as taxable benefits for employee
- Lower premiums are available due subsidization from employer
- Often has a broad range of health insurance benefits
Cons
- Coverage ends when the enrollee's employment is terminated
- Health insurance choices limited to selection approved by employer
- Health insurance may by subsidized at a lower level by smaller employers
