Obamacare enrollment runs through Dec. 15. Here’s what you need to know
With six years of cost and revenue data under their belts, long-established insurers like
Three companies that offered 2019 plans in
They are joined by a fourth provider --
Is the ACA’s future still uncertain?
Yes it is. But that won’t affect consumers’ ability to purchase coverage for 2020. A federal appellate court is expected to rule any day on a
What’s happening with premiums?
Nationwide, premiums are set to decline 4% for one of the most popular 2020 plans, the
What’s the difference between on- and off-exchange policies?
First, it’s necessary to know that there are two different types of individual health insurance policies -- those purchased “on-exchange” and those purchased “off-exchange.” Since
The key difference is on-exchange plans are eligible for government tax credits and additional cost-sharing revenue. To be eligible, these must be purchased through the government-created marketplace Healthcare.gov. This is why more than 90% of “on-exchange" buyers receive some government subsidies.
Off-exchange plans are not eligible for government help, but are also available from more insurers with a wider range of costs and benefits. Typically, consumers whose incomes are too high to qualify for government subsidies purchase off-exchange plans.
But costs of these unsubsidized plans remain high, forcing an increasing number of higher-income workers to forego insurance, the New York Times reported
For example, the cheapest plan that a 50-year-old
High costs have also prompted expansion of so-called “short term” plans that are exempt from many of the ACA’s consumer protections and minimum coverage requirements.
Who can buy an ACA policy?
Subsidy-eligible plans can be purchased by consumers who don’t have access to employer-based plans or Medicare. Also, immigrants who are in the country illegally cannot qualify, nor can people who are incarcerated.
Typical ACA purchasers are low-income parents with children, people who are self-employed, workers whose employers don’t offer affordable health insurance, and early retirees who don’t yet qualify for Medicare.
Who qualifies for tax credits?
Households earning between 100% and 400% of the federal poverty level qualify for tax credits that can lower their monthly premiums.
To be eligible for tax credits, a single-household consumer would need an adjusted gross income between
Why is Obamacare so important in
Because of the state’s low wage base and high percentage of service jobs, many households qualify for government subsidies and would otherwise go without coverage.
Nearly half of Florida’s enrollees -- about 800,000 -- live in
Prices are confusing. Why?
Prices vary widely, even with the maximum monthly tax credit.
Generally, the lower the deductible, co-pay and co-insurance and out-of-pocket maximum offered, the higher the monthly premium.
For example, a 55-year-old man living alone in
If he opted for the highest-benefit “platinum” coverage, he would pay
But because of the high monthly premium, that plan would end up costing
Opting for the highest-deductible plan, Oscar Simple Bronze, would cost the same consumer nothing for monthly premiums but he would have to pay full price for emergency room visits, primary physician and specialist visits until reaching the
Assuming “medium” health care usage, Healthcare.gov estimates this plan would cost the consumer
Additional benefits:
In addition to eligibility for premium tax credits for households earning between 100% and 400% of the federal poverty level, households earning between 100% and 250% of the federal poverty level are also eligible for special “modified” Silver plans with additional cost-sharing reductions that will bring down the deductibles, copays, coinsurance and out-of-pocket limits.
For example, the 55-year-old in our example above who opts for the Ambetter Balanced Care 15 plan would pay
With additional cost-sharing reductions, a couple in their 30s with three children under 10 would get the same plan for
Where can I get more information and sign up?
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