Public market health insurance plans, also known as individual market plans, are a type of health insurance that individuals can purchase for themselves and their families. These plans are primarily available to people who do not have access to employer-sponsored health insurance or government-funded programs like Medicaid and Medicare.

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Individuals who qualify for income assistance, such as those who are living below the poverty line, may be eligible for subsidies that can help lower the cost of these plans.

 

Additionally, people with pre-existing conditions, which are health conditions that existed before the individual applied for insurance, may also be able to purchase plans on the public market.

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The Affordable Care Act (ACA), also known as Obamacare, requires insurers to offer coverage to individuals with pre-existing conditions and prohibits them from charging higher premiums based on an individual's health status. However, it is important to note that the ACA is facing legal challenges and its future is uncertain.

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Additionally, there is also Medicaid expansion under ACA, which expands the income eligibility criteria for Medicaid, making it available to more low-income individuals and families.

In summary, public market health insurance plans are primarily for people who do not have access to employer-sponsored health insurance or government-funded programs, but may qualify for income assistance or have pre-existing conditions.

 

Private market health insurance plans, are a type of health insurance that is offered by private insurance companies to individuals and families. 

These plans are primarily for clients who are relatively healthy and can get accepted for coverage, as insurance companies may deny coverage to individuals with certain pre-existing conditions.

 

Additionally, private market plans are not subject to the same regulations as public market plans, so insurers may be able to deny coverage to individuals with pre-existing conditions or charge higher premiums based on an individual's health status.

 

Private market plans tend to offer lower rates and better coverage up front, such as low deductible options, compared to public market plans. This is because the risk of covering a group of people is spread out among all the members of the group, which allows the insurance company to charge lower rates.

 

However, it is important to note that private market plans also have their own set of rules and regulations and they may not cover all the benefits that public market plans do. And also, the cost of the plans can be more expensive for individual policies.

In summary, private market health insurance plans are primarily for clients who are relatively healthy and can get accepted for coverage, and they tend to offer lower rates and better coverage up front, such as low deductible options, compared to public market plans.