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

• 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

• 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

• 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

• 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

• 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

• 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