You may be wondering why the health insurance marketplace exists. For most people, if you are not a resident of a state that is a part of the Affordable Care Act (ACA), you do not qualify to use the marketplace. However, you may qualify to apply for a subsidy to purchase a health plan.
You may qualify for a subsidy
If you have a family and you are looking for health insurance, you may be eligible for a subsidy. Subsidies are tax credits to help you afford health insurance. The government determines the amount of subsidies that you are entitled to.
You may qualify for a premium tax credit, which can lower the cost of your monthly insurance premium. Alternatively, you could receive a Cost Sharing Reduction (CSR), which decreases out-of-pocket costs for covered health care services.
You may also qualify for Medicaid. These are federal programs that help low-income people and families with medical expenses. However, you must meet certain requirements. For example, your household income must be below 138% of the poverty level.
To get the most from your premium tax credit, you should take the time to understand what you are expected to report on your taxes. For instance, you must provide an income estimate when you sign up for Marketplace coverage. In the event you earn more than you expected, you might be required to repay some of the excess subsidy dollars.
Non-elderly Americans don’t need health insurance marketplace
The number of uninsured Americans is up for the third year in a row. According to the Centers for Disease Control, nearly 30 million people are without coverage. And that number is expected to continue rising. Fortunately, there are ways to find affordable health insurance.
One is to look to state-sponsored programs. For example, the Affordable Care Act expanded Medicaid eligibility to lower-income individuals. However, eligibility is limited in some states. So, many low-income individuals have to rely on private plans to fill the gap. Fortunately, some of them are eligible for tax credits to make their purchase easier.
Another way to find affordable health insurance is to shop for a plan at a Marketplace. In the United States, a Marketplace is a government website that allows you to compare and apply for insurance. There are tax credits for a wide range of income levels, and some moderate-income folks can even get subsidized coverage. Of course, you need to be legal to qualify for a Marketplace health plan, and you can only use it for a single individual.
Off-exchange plans allow insurers to structure plans in different ways
Off-exchange plans are an alternative health insurance option for consumers. They are typically purchased from a health insurance carrier. Unlike on-exchange plans, off-exchange plans do not offer premium subsidies. However, they can be less expensive. It is important to understand what off-exchange plans are and how they differ from on-exchange plans.
Before a consumer buys an off-exchange health plan, insurers must be fully compliant with the Affordable Care Act (ACA). The insurer’s plan must also meet state adequacy standards. A summary of the health plan’s benefits must be provided to the consumer.
In addition, off-exchange plans aren’t eligible for cost-sharing reductions, which are offered to people who purchase qualified health plans on the exchange. Cost-sharing reductions can help lower the total costs of a health plan, but not the premiums.
However, the ACA does require that insurance companies sell standardized plans. These plans must be offered in all service areas. There are eight states that already require standardized options, and the rest of the country will be required to offer them by the end of 2023.
eHealth has ACA-compliant health insurance
The Affordable Care Act (ACA) expanded access to health insurance and lowered costs. It created a marketplace and allowed individuals and small businesses to buy affordable health plans. Insurers were required to offer ACA-compliant plans. While the market is volatile, more unsubsidized people are seeking coverage. eHealth, a health insurance broker, is betting on the cheaper, individual market.
eHealth’s intuitive site allows consumers to search, compare, and enroll in health plans. With no premium tax credit or subsidy, eHealth plans are about half the price of ACA-compliant plans.
During the Open Enrollment Period for ACA-compliant plans, individuals and families can enroll in a new policy. Some individuals may qualify for a Special Enrollment Period to purchase a plan if they lose other coverage, become sick or have a baby.
Short-term policies are offered through two large online private insurance marketplaces. These policies usually have lower monthly premiums, but higher deductibles. When comparing short-term health plans, be sure to compare monthly premiums to those posted on the marketplace.