June 23, 2022
  • June 23, 2022

There is still time to get health insurance through the public exchange

By on December 29, 2021 0


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Open enrollment in the public health insurance market is taking a month longer than usual this year, which means there is still time to get coverage.

Until January 15 – unless your state has a different closing date – you and your family can subscribe to a plan through the federal market (or your state’s market, if it has one) if you have need health insurance. The swap will also alert you if you qualify for Medicaid instead or if your children might be eligible for the Children’s Health Insurance Program, also known as CHIP.

“The market coverage is the most affordable it has ever been,” said Karen Pollitz, senior member of the Kaiser Family Foundation. “Even if you’ve looked in the past and are discouraged, it’s a good idea to check back. “

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In total, there are about 27 million uninsured Americans, according to a recent Kaiser study. It is estimated that 10 million of them could benefit from financial assistance with private insurance in the public market. Another 7 million could benefit from coverage through Medicaid and / or CHIP.

Already, 13.6 million people have signed up for 2022 coverage through the federal exchange or state market, according to the Centers for Medicare & Medicaid Services.

Most registrants – which include the self-employed and workers without employment-based health insurance – receive grants (technically tax credits), which reduce what you pay in premiums. You may also get help with cost-sharing, like deductibles and co-payments on certain plans, depending on your income.

Market coverage is the most affordable it has ever been.

Karen pollitz

Senior Fellow with the Kaiser Family Foundation

For 2021 and 2022, the subsidies are larger, due to legislation passed in March. Prior to this expansion, aid was generally only available to households with incomes between 100% and 400% of the poverty line.

This income cap is eliminated until next year, and the amount anyone pays in bonuses will be limited to 8.5% of their income as calculated by the exchange. (The Democrats’ $ 1.75 trillion Build Back Better law, which cleared the House in November but stagnated in the Senate, would extend changes until 2025.)

Be aware that while people who have experienced unemployment at any time this year may be eligible for zero premium health plans in the market, this provision is not in place for 2022 (although it is also being extended until ‘in 2025 as part of the construction approved by the Chamber. Return Better action).

The market grants you qualify for are based on factors that include income, age, and the second cheapest “silver” plan in your geographic area (which may or may not be the plan you sign up for).

For example, a 30-year-old with an income of $ 35,000 would pay an average of $ 142 per month for a silver plan – instead of $ 389 per month – after a premium tax credit of $ 247, according to The Kaiser Family Foundation’s online estimation tool. A married couple, both aged 50, with a child under 18 and an income of $ 65,000, would receive an average of $ 1,169 per month, which would bring the cost of a silver plan down to 316. $ for $ 1,485.

The best place to start if you’re new to this is health care.gov, where you can create an account and explore your plan options. Or, if your state runs its own health care exchange, the federal site will direct you there. Once you’ve entered information such as income and the number of dependents, you should be made aware of what assistance you are eligible for.

If you want to shop without creating an account, there is a federal tool exchange (or on your state’s site) which allows you to enter general information about yourself to see if you qualify for grants and how much you would pay in premiums.

Meanwhile, in states that have extended Medicaid, you may qualify for coverage through the program if your income does not exceed 138% of the federal poverty line. For an individual, that would mean up to $ 17,774; for a family of four, $ 36,570. (The Build Back Better Act would also create grants for individuals in states that have not extended Medicaid.)

It should also be noted that if you are eligible for Medicaid, you can enroll at any time (not just during this open enrollment). The program bases your eligibility on your income when you register.

However, for a marketplace plan, you need to estimate your income for the entire year. So if you underestimate your 2022 income for a market plan and your grants are based on that amount, you may have to return some of it at tax time in 2023.

Likewise, if you overestimate your income, you will usually be able to claim an additional tax credit when you file your 2022 taxes in 2023. You could also adjust your income estimate during the year if it changes, Pollitz said.

The bottom line is that anyone who is uninsured should at least check out what their options are, she said.

“If you haven’t figured out what you qualify for, you really should be doing it,” Pollitz said. “According to our estimates, millions of people could be pleasantly surprised. “