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If you do not have health insurance, you have a few weeks left to sign up for private or low cost coverage through the public marketplace.
A special enrollment period, which opened on February 15 and closes on August 15, allows individuals to use health.gov (or their state exchange) to enroll in a plan that may come with significant subsidies to reduce what you pay for coverage. Unless you have a qualifying life event – ie. to get married, have a child, etc. – after the current window closes, you generally have to wait for open registration in the fall to register.
About 1.5 million Americans have secured coverage in the current enrollment period, according to government data through June 30. An additional 2.5 million people already enrolled through the market have been able to lower the cost of their premiums. Around 12 million in total are enrolled through the marketplace, which was approved by the Affordable Care Act of 2010.
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Most entrants receive financial assistance. And because of the U.S. Rescue Plan Act, which was signed into law in March by President Joe Biden, the subsidies (technical tax deductions) are larger for 2021 and 2022 and will reach a larger number of people.
Prior to this expansion, the support was generally available to households with an income from 100% to 400% of the poverty level. The ceiling is eliminated through next year, and the amount that someone pays in premiums is limited to 8.5% of their income as calculated by the stock exchange.
In addition, per. July 1 zero-premium health plans that come with minimal or no cost sharing – ie. deductible and copies – available through the market for persons collecting unemployment at any time this year.
“People who have been unemployed at any time this year can essentially get very generous or free health coverage,” said Cynthia Cox, vice president of the Kaiser Family Foundation and director of its Affordable Care Act program.
Overall, about 3 out of 5 qualified uninsured Americans should have access to zero-premium plans, according to the Centers for Medicare & Medicaid Services. This includes those who would qualify under the unemployment provision.
“Even if you were unemployed earlier this year but got employment, if you still have no cover, you can get it now,” Cox said. “You just have to demonstrate that you were considered eligible for unemployment benefits.”
There is no income test to take advantage of this benefit, she said. Be aware, however, that you generally cannot qualify for subsidies through the ACA market if you can get health coverage through your employer.
“Generally speaking, [enrollees] are people who can not get insurance in any other way – not through their work or their spouse’s work or through Medicare or Medicaid, ”said Cox.
If you are new to the market and think you want to qualify for unemployment benefits, this is the best place to start. health.gov. Once you have connected your information and the subsidies have been applied, you should generally see at least a few free “silver” plans, Cox said.
“This is where you get premium help and also additional help with [cost-sharing]”Cox said.” And the deduction is so low that it’s more like a “platinum plan”, which is the best you can get. “
Separately, anyone who gets coverage under the Consolidated Omnibus Budget Reconciliation Act – the law that allows you to stay on your employer’s plan when you leave your business – may see if it makes sense to switch to coverage through the market.
COBRA coverage is typically expensive because you are responsible for the full premium instead of having your employer chip in. However, the federal government is picking up the tab for COBRA payments through September under the American Rescue Plan Act.
When it expires, you either have to pay the full monthly premium or find alternative coverage.
“They might want to see if it makes sense to switch to the stock market before then,” Cox said.
The cheap silver plans cover about 94% of a person’s costs, Cox said, compared to 85% in employer plans.
If you qualify for Medicaid, health.gov should also indicate so. About 81 million people were enrolled in the Medicaid or Children’s Health Insurance Program in February, according to government data. That’s about 11 million more than pre-pandemic.
The Biden administration has also proposed expanding the annual open enrollment in the ACA market. Instead of running from November 1 to December 15, as it has done in recent years, it would remain open until mid-January, according to the proposal.
In addition, the administration has proposed that households with up to 150% of the poverty level can be registered all year round. (Individuals who qualify for Medicaid can already sign up at any time.)
“For now, though, people have to shop when there is a sign-up opportunity,” Cox said.
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