Receiving treatment for injury or illness is crucial to maintaining your health. Nobody plans on getting sick, and having health insurance will help you receive preventative care without accumulating unexpected costs. Studies repeatedly indicate that receiving preventative care decreases the risk of serious illness or disease. Under the Affordable Care Act, all healthcare plans are required to include 10 essential benefits. These benefits include doctors’ services, inpatient and outpatient hospital care, prescription drug coverage, mental health services, pregnancy and childbirth, and more. Although all health coverage plans are legally required to include 10 categories of essential benefits, premium prices and deductibles vary according to each plans’ coverage levels.
Health coverage plans in the marketplace are presented in 4 coverage levels or ‘metal tiers.’ These tiers will determine how much you pay and how much is covered by your insurance provider. Below is a table provided by healthcare.gov.
People under thirty or those who are eligible for a hardship or affordability exemption can buy a catastrophic plan. The monthly premiums for catastrophic plans are usually low, but you cannot use premium tax credits to reduce the cost. Catastrophic plans have the same 10 essential benefits as other plans, and they cover at least 3 primary care visits per year.
No matter which health coverage plan you choose, those that fall between 100% and 400% of the federal poverty line can qualify for premium tax credit. Find out if you qualify for federal subsidies in 30 seconds by filling out this calculator. When applying for federal subsidies, the amount you receive depends on your income, location, and the number of people in your household.
When applying for insurance through the marketplace, you will have to calculate your expected household income. Since marketplace savings are calculated based on your expected income for the year you want coverage, last year’s income does not apply. The marketplace uses an income number known as the Modified Adjustment Gross Income (MAGI) that totals the following income categories:
Visit healthcare.gov for a complete guide on how to estimate household income while applying for marketplace insurance. Not all forms of income need to be included in your estimation. For instance, gifts, supplemental security income (SSI), veterans’ disability payments, worker’s compensation, and proceeds for loans do not need to be included in your estimated household income.
After applying for coverage through the Health Insurance Marketplace, you will find out if your income and household information qualify you for premium tax credit or cost sharing reduction. Those who qualify for premium tax credit can apply the total sum or a partial amount to help pay for their monthly premiums. In what the IRS calls “advance payment of premium tax credit,” the marketplace will send your tax credit directly to your insurance company.
After applying for health insurance through the Marketplace, you will also find out if your income qualifies you for cost sharing reductions. Instead of lowering your premium, cost sharing reductions lower the amount you pay for deductibles, copayments, or coinsurance. Those who qualify for cost sharing reductions are required to enroll in a silver plan to receive extra savings.
Hands down, the best way to find affordable insurance is to shop your options. In general, you will be able to find affordable insurance through the federal marketplace if you have been considered high-risk by insurers in the past. However, applicants who are younger, in good health, and who don’t qualify for federal subsidies may not be impressed with the savings in the federal marketplace. Calling Insurance Line One for a free quote will help you quickly compare different insurance rates and know who will give you the best coverage. Call (800) 606-1671 to find out more about how to save money on monthly premiums while receiving comprehensive health coverage for you and your family.
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