No health insurance? You could be one of the millions of people eligible for assistance
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If you don’t have health insurance, it might not be as inaccessible as you might think.
According to a study by the Kaiser Family Foundation, 10 million uninsured people could benefit from financial assistance with private insurance in the public market. Another 7 million could benefit from coverage by Medicaid and / or the Children’s Health Insurance Program, also known as CHIP.
“If you haven’t figured out what you qualify for, you really should be,” said Karen Pollitz, senior member of the foundation. “We estimate that millions of people could be pleasantly surprised.”
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In total, there are about 27 million uninsured Americans, according to a Kaiser study.
From November 1 to January 15 – unless your state has a different closing date – individuals or families without medical coverage can sign up for a plan through the Federal Health Market (or their state’s federal health market, if any). he has one). The exchange will also alert you if you qualify for Medicaid instead (or if your children might qualify for CHIP).
This year, around 12 million people benefit from coverage in the market.
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 can also get help with cost-sharing, like deductibles and co-payments on some plans, depending on your income.
For 2021 and 2022, the subsidies are larger, due to legislation that was enacted 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 last week but is awaiting Senate action, would extend the changes until 2025.)
Be aware that while people who have hit unemployment at any time this year are 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 under the Build Back Better Act).
The market grants you are eligible 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 Illustration Only: The best place to start if you’re new to this is Healthcare.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 have entered information such as income and the number of dependents, you should be notified of what assistance you are eligible for.
If you want to shop without creating an account, there is a tool on the Federal Stock Exchange (or your state site) that lets you enter general information about yourself to see if you are eligible for it. grants and how much you would pay in premiums. Alternatively, the Kaiser Family Foundation has an online tool that offers a similar estimate.
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 at the time of registration.
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 might 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 on your 2022 tax return. You can 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.
“The market coverage is the most affordable it has ever been,” Pollitz said. “Even if you’ve looked in the past and are discouraged, it’s a good idea to check back.”