The Affordable Care Act (ACA) Health Insurance Open Enrollment is currently underway, and for those who haven’t kept up with recent changes, there are several positive developments aimed at both cost savings and expanding coverage to a larger number of Americans.
How to apply & enroll
- First timer? Welcome! Create an account.
- Returning user? Welcome back! Log in to update your application, compare plans, and change or renew for 2024. That way you’ll know your savings are correct and that your plan meets your needs and budget.
Thanks to provisions in the Inflation Reduction Act, which extends financial assistance initiated by the American Rescue Plan, many individuals can expect lower premiums until 2025. According to Xavier Becerra, Secretary of the Department of Health and Human Services (HHS), approximately 15 million consumers receiving premium tax credits through the federal insurance exchange are saving an average of $800 annually. Additionally, an extra 4.6 million individuals received financial assistance in 2023 compared to 2021.
Becerra emphasizes that health plans are currently more affordable than ever, making it easier for individuals to compare options. He notes that it’s not only about saving money but also about having the ability to choose the best plan that aligns with one’s family needs. In fact, he states that four out of five people will be eligible for plans that cost as little as $10 per month.
What is lowest income to qualify for healthcare gov 2023?
Federal Poverty Level (FPL)
|2022 income numbers
|2023 income numbers
|For a family of 2
|For a family of 3
|For a family of 4
Keep these deadlines in mind
- Open enrollment for 2024 coverage on the federal exchange runs through Jan. 15, 2024 (or Jan. 16, 2024 due to the federal holiday on Jan. 15).
- For coverage beginning on Jan. 1, 2024, you need to enroll by Dec. 15, 2023, on the federal exchange. In states with their own exchanges, you may have a bit more time, since they can set their own enrollment deadlines.
- Some special enrollment periods (the time outside of open enrollment) may be extended if you were disenrolled from Medicaid. Those with low incomes can sign up for Marketplace coverage or change plans throughout the year.
How federal poverty levels are used to determine eligibility for reduced-cost health coverage
- Income above 400% FPL: If your income is above 400% FPL, you may now qualify for premium tax credits that lower your monthly premium for a 2023 Marketplace health insurance plan.
- Income between 100% and 400% FPL: If your income is in this range, in all states you qualify for premium tax credits that lower your monthly premium for a Marketplace health insurance plan.
- Income at or below 150% FPL: If your income falls at or below 150% FPL in your state and you’re not eligible for Medicaid or CHIP, you may qualify to enroll in or change Marketplace coverage through a Special Enrollment Period.
- Income below 138% FPL: If your income is below 138% FPL and your state has expanded Medicaid coverage, you qualify for Medicaid based only on your income.
- Income below 100% FPL: If your income falls below 100% FPL, you probably won’t qualify for savings on a Marketplace health insurance plan or for income-based Medicaid.
What is the health insurance rate for 2024 in NJ?
The recommended Active PPO medical trend is 6.50% for Plan Year 2024. PPO Early Retirees: The Plan Year 2023 Early Retiree PPO medical trend is 6.50%, a 0.50% increase from the 6.00% trend from the Plan Year 2023 Rate Setting Analysis. The Plan Year 2024 medical trend is 6.50%.
Applying for Medicaid or CHIP allows you to apply for health insurance through the marketplace at any time. Other life circumstances that may qualify you include getting out of prison, becoming a U.S. citizen, starting or ending service in AmeriCorps, or gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) corporation shareholder.
What is EPO insurance?
A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network (except in an emergency).
To check if you qualify for special enrollment, follow the steps at healthcare.gov/screener/. If eligible, your health care plan would start on the first of the month after you enroll; for example, enrolling in February would initiate coverage on March 1.
It may seem surprising given a Kaiser Family Foundation analysis indicating an average 5% increase in unsubsidized plan premiums for 2024, particularly for the benchmark second-lowest-tier silver plans. However, the Inflation Reduction Act has played a crucial role by extending premium subsidies and eliminating the “subsidy cliff,” which previously capped financial assistance at 400% of the federal poverty level (equivalent to $120,000 for a family of four) until 2025.
Furthermore, the landscape is shifting positively, with more insurers entering new markets compared to those exiting the marketplace, according to KFF. This translates to increased choices for consumers, as Secretary Becerra highlights. He advises individuals to ensure a clear understanding of what qualifies them for subsidies, emphasizing the importance of a quick check on family income and household size to estimate potential financial assistance.
Selecting the appropriate plan is more straightforward this year
Choosing a healthcare plan can be a daunting task, but Secretary Becerra emphasizes that healthcare.gov aims to simplify the process. Current regulations mandate insurers to provide standardized plan options on federal and state exchanges. In 2024, insurers must offer no more than four qualified plans per metal level, including dental and/or vision coverage. This number decreases to two options per metal level starting in 2025. The healthcare.gov website has been redesigned for a more user-friendly experience, facilitating easier side-by-side plan comparisons.
Secretary Becerra assures that most preventive care, including vaccines, is covered under all plans with no out-of-pocket costs. He emphasizes efforts to ensure the availability of the COVID vaccine at no charge, even for commercially insured individuals.
For those not currently on the exchange or with high-deductible Bronze plans, healthinsurance.org suggests reevaluating options, as you may now be eligible for subsidies, capping premiums at 8.5% of your household income. State-based exchanges may also offer additional subsidies.
HHS is actively working to increase the number of primary care physicians, particularly those trained in behavioral and mental health. This is aimed at providing comprehensive healthcare services at the primary care level.
What is the meaning of HMO plan?
Health Maintenance Organization
A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency.
To assist in finding the right plan, Secretary Becerra advises visiting healthcare.gov to check subsidy eligibility. He recommends not automatically re-enrolling in your existing plan, exploring enhanced subsidies, and considering total yearly costs, including prescription drug coverage and specialist visits.
If confused, reaching out to the marketplace call center, marketplace navigator, or local assistance through brokers or agents is encouraged for personalized help in selecting a suitable plan and understanding financial forms. These services are adapting to nontraditional hours, mobile units, and virtual appointments to enhance accessibility and reduce health disparities.