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Thursday, January 21, 2016

My son is turning 26, and this year will become ineligible to remain on my employer-provided health insurance. He has a low/moderate wage job (makes about $30,000 a year) that does not offer health insurance as an option, and is considering using Healthcare.gov to get insured. Are there any pros or cons we should be aware of? -Lynn G., Peoria, IL


First off, Healthcare.gov is an extension of the Affordable Care Act (ACA), also known as Obamacare. ACA was made to be an option for those, especially in an income range up to 138% of federal poverty level (a range up to about $47,000 for a single person), to receive coverage with reduced cost. This cost comes in the form of a tax-break or subsidy to be applied directly to premiums or when filing taxes at the end of the year.

It is important to note, however, that insurance agents can still be involved in this process, and many resources can be used other than Healthcare.gov. We advise you always speak to an ACA insurance professional to find what coverage you need and help to navigate this process beyond just pricing premiums.

Also - Open enrollment ends very soon, January 31st, 2016, meaning that unless your son, or any party interested, were to meet the specific criteria to apply out of the enrollment season - the window to apply for ACA insurance is closing fast.

As with any insurance, consider what level of coverage is needed for the individual. Many healthy 26 year-olds only seek catastrophic insurance with minor coverage for things like visits, and little worry for out of network services. This will vary radically on a case-by-case basis, so figure out what level of coverage works best for you. Of course, talking to a professional agent will likely be a huge help.