HEALTH INSURANCE MARKETPLACE

With rising coverage rates, you need to find the best health insurance plan. To see if you qualify for subsidy and financial assistance to reduce your healthcare costs, we are here to help. Get in touch with our friendly experts, our services are always at no cost.

Health Insurance Marketplace

You may get health insurance that meets your requirements and your budget through the Health Insurance Marketplace. The same core health services, such as doctor visits, preventative care, hospitalization, prescriptions, and more, are included in every health plan available in the Marketplace. Before making a decision, you can evaluate plans based on their costs, advantages, quality, and other aspects that are relevant to you.

You can check your eligibility for Medicaid, the Children’s Health Insurance Program (CHIP), free or low-cost coverage, or discounts on Marketplace plans with just one application. The majority of applicants will be eligible for discounts of some kind.

In the US, everyone is required to have some form of health insurance or pay a charge.

Who is eligible for Health Insurance Marketplace?

To be eligible to use the Health Insurance Marketplace, you:

must reside in the United States
be a citizen or national of the United States (or be lawfully present)
cannot be incarcerated

You can use the Marketplace regardless of the state where you reside. Several states run their own markets. The Marketplace is managed by the federal government in other states.

What is Affordable Care Act?

The “Affordable Care Act” (ACA) is the name for the comprehensive health care reform law and its amendments. The law addresses health insurance coverage, health care costs, and preventive care.

Three main goals of the law are:

Make more people eligible for affordable health insurance. For households with incomes between 100% and 400% of the federal poverty threshold, the law offers customers subsidies (referred to as “premium tax credits”) that reduce prices (FPL).
You can still be eligible for the premium tax credit in 2022 even if your income is higher than 400% FPL.
You may be eligible to sign up for or make changes to your Marketplace coverage during a Special Enrollment Period if your income is at or below 150% FPL.
Increase Medicaid coverage to include all adults with incomes below 138% of the federal poverty level. (Not every state has increased the scope of its Medicaid programs.)
Encourage cutting-edge medical care delivery strategies intended to reduce overall health care expenditures.

Significant Benefits of Affordable Care Act (ACA)

Longer Access to Quality Care
The ACA allows young adults to remain on their parents’ insurance policy until age 26. New college graduates now have access to health insurance even if they are unable to find a job right away.

Lower Health Care Expenses
The ACA controls rising health care costs by requiring all insurance plans to cover preventive services, including various health screenings, critical immunizations, health screenings, and counseling services with no cost-sharing.

Medicare Part D
The ACA covers the prescription drug gap, giving more savings to Medicare patients. The average Medicare beneficiary will save $4,200 from 2011 to 2021, and the ones with higher prescription drug expenses will save as much as $16,000 over the same period.

Improved Consumer Protection Nationwide
The ACA requires insurance companies to provide consumers with easy-to-understand facts about their health insurance and its costs and protects consumers from irrational price hikes thru reinforced rate-review laws. Moreover, the Medical Loss Ratio (80/20 standard) prohibits insurance companies from spending more than 20 percent of premium dollars on non-medical expenses such as marketing, administrative costs, etc.

Significant Benefits of Affordable Care Act (ACA)

The Affordable Care Act (ACA) requires that both individual and family health insurance policies include the following 10 essential health benefits:

Hospitalization
Emergency services
Outpatient services
Prescription drugs
Preventative and wellness services
Pediatric services
Maternity and newborn care
Mental health and substance abuse care
Rehabilitative services
Laboratory services

You are ensuring that you will at least be covered if you require one of the aforementioned services by choosing individual health insurance.

Individual health insurance metal tiers

The five metal tiers of individual health insurance policies define the percentage of your medical expenses that are covered.

For those who require continuing or pricey medical care, a higher-tier plan, like a Gold or Platinum one, is a suitable option because it will typically cover a larger share of medical expenses. In comparison, a Bronzer or Catastrophic tier health insurance policy will be less expensive monthly but may cost more when you visit the doctor.

How much does a private health insurance cost?

Your prices will vary based on your age, the metal tier of coverage you choose, and the state in where you live. The insurance provider you pick will also have an impact on the cost of your coverage and the level of service you receive. Each insurer has advantages and disadvantages, and consumers frequently opt to spend a little bit more for an individual health insurance plan that offers better and more expedient service as a method to lessen the stress and difficulty associated with handling insurance claims.

Can I buy health insurance at any time?

There are designated windows of time called open enrollment periods for customers wishing to buy health insurance for themselves or for a family that complies with Obamacare.

During the Open Enrollment Period, often known as OEP, everyone has the option of purchasing new health insurance or changing existing health insurance acquired on the exchange. OEP is an annual event that typically lasts from November 1 to December 15 and is available around-the-clock.

Be sure to check the dates for your state since this date can change slightly every state. The yearly OEP is the easiest time to purchase ACA-compliant, qualified health plans (QHPs). Y ou must weigh your options and apply for coverage before the OEP ends.

What happens if I want to buy health insurance outside the open enrollment period?

Things change for customers in need of individual or family health insurance when the Open Enrollment period ends. You must meet the requirements for special enrollment in order to purchase insurance plans on the exchange that comply with the ACA. The federal marketplace or exchange, Healthcare.gov, defines a special enrollment period during which individuals and families with special needs can purchase coverage. If you experience a qualifying life event, you can qualify for special enrollment. Several qualified events are:

A recent marriage
A recent divorce
A new baby
A death of someone on the current policy

A qualifying event can also be a change of residence, such as:

moving to a different county or zip code
relocating to the US
Moving students to or from school
Seasonal employees
Living arrangements in transition, such as moving from a shelter to an apartment.

Special enrollment is also possible if your current insurance plan is lost. This change could result from:

ending of employment-based insurance.
loss of the present family or individual plan via no fault of your own. For instance, the insurance company may stop providing coverage or you may no longer have access to a student plan. You will not be eligible for special enrollment if you stop paying your premiums or cancel your insurance. To purchase insurance, you must hold off until the subsequent open enrollment period.
getting kicked off of Medicaid, Medicare, or CHIP.
loss of protection provided by a family member. Say you reach the age of 27 and are no longer eligible for your parent’s insurance.

What if I don’t qualify for special enrollment?

If you are not eligible for special enrollment but still require coverage until the next open enrollment period, you do still have a few options. Other options like temporary insurance and low-cost prescription drug plans, help you cope while you wait. These are not compliant with Obamacare, but they can be good options for someone seeking for health insurance. Keep in mind that these possibilities can consist of supplemental, rather than health insurance, products. Non-Obamacare items won’t shield you from conceivable uninsured-person penalties (such fees will generally disappear after 2018). Non-Obamacare insurance plans also have additional restrictions: they are not required to include the core health benefits mandated by Obamacare, they are free to forgo pre-existing condition coverage, and they are not eligible for government tax breaks or subsidies.

We are here to assist you in identifying the type of coverage that best suits your needs both now and in the future. You can check the insurance plans you have access to at your convenience or get in touch with our representative by phone or email.

Need help comparing health insurance plans?

*By completing this form, you agree that an authorized representative or licensed insurance agent may contact you by phone,email,text, mail or face to face to answer your questions or provide additional information about your Medicare plan options. Not affiliated or endorsed by Medicare or any state or federal governmental agency.