What is different when you are your own employer
Three things usually change. First, your health plan comes from the individual market, which for most Texans means the ACA Marketplace on HealthCare.gov. Second, your income can vary from month to month, and Marketplace savings are based on your estimate for the coming year, so that estimate matters. Third, if you cannot work, there is no sick leave or employer disability plan standing behind you.
None of that is a problem on its own. It just means the decisions are yours, and it helps to make them with someone who does this every day.
What Dagan checks with you
- Which Marketplace and other individual plans include the doctors you already see and the prescriptions you take.
- How a realistic income estimate affects your Marketplace application, and what to do if your income changes mid-year.
- Whether an HMO or a PPO fits the way you use care, and what each one costs over a full year rather than per month.
- Whether your savings could carry you through a few months without income, which is the starting point for a disability conversation.
- Whether anyone depends on your income, which is the starting point for a life insurance conversation.
Dagan's background in biology helps here. He is comfortable with medical terminology, pre-existing conditions and drug formularies, so the comparison is built around your actual health needs.
Good times to talk
During Open Enrollment, when you can choose or switch a Marketplace plan for the coming year. Within 60 days of losing other coverage, for example when a W-2 job ends, because that usually opens a Special Enrollment window. And whenever your income changes enough that your Marketplace application should be updated. HealthCare.gov sets the exact dates and rules each year.
Coverage that usually comes up
- Health insurance: Marketplace, PPO and HMO plans compared against your doctors and prescriptions.
- Disability insurance: Replaces part of your income if illness or injury stops the work.
- Life insurance: Term or whole life for the people who depend on your earnings.
- Dental and vision: Shopped separately so you can keep your dentist and eye doctor.
Plan availability, benefits and costs vary by carrier, county and plan year.