Affordable Care Act (ACA) Coverage
The Federal Government partners with your State to create a fully public health insurance market that not only anyone can access but is also fully autonomous from private enrollment. This allows anyone with a Social Security number to view “on-market” health insurance plans and sign themself up without the assistance of an agent during the federal “Open Enrollment” period (November 1 - December 14th). These plans have no medical background check and exist so that anyone may have access to health coverage regardless of health conditions. The Affordable Care Act, passed into law in 2010, allows for the Federal, or State governments to offer government assistance (subsidies) to those who qualify based on their income and household size. This allows anyone, regardless of their income to have access to affordable health coverage.
Pro’s:
Income based discounts
Guaranteed Issue (no medical underwriting)
Minimal essential coverage requirements met (Full Coverage)
Cover certain conditions private insurance may not be the best for (e.g. Labor/ delivery, substance abuse treatment, advanced psychiatry)
Con’s:
Coverage and price related to income (Higher income = Higher Price, Worse Coverage)
Possibility of Tax Penalties if Income is different on tax filing than reported to the marketplace
Generally, have higher deductibles and out of pocket maxes than private plans
Can only enroll in these options during “Open Enrollment” unless you have a life qualifying event
What qualifies for special enrollement?
A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.
Involuntary loss of coverage
Individual plan renewing outside of the regular open enrollment
Becoming a dependent or gaining a dependent?
Marriage
Divorce (in some state-run exchanges)
Becoming a United States citizen or lawfully present resident
A permanent move
An error or problem with enrollment
Employer-sponsored plan becomes unaffordable or stops providing minimum value
An income increase that moves you out of the coverage gap
Gaining access to a QSEHRA or Individual Coverage HRA
An income or circumstance change that makes you newly eligible (or ineligible) for subsidies or CSR
Various exceptional circumstances
Do I qualify for Subsidy Tax Credits on ACA plans?
Our agents at HQMEasy can easily determine your eligibility for tax credits towards your insurance. By simply filling out our form to get a free health quote, one of our licensed agents will not only show you the subsidy you qualify for but can also make recommendations for the best plans that fit your needs and budget at no cost to you.
