Marketplace coverage is affordable

Added October 18th, 2013 by Jan Hudson | Email This Entry Email This Entry
Jan Hudson

We all need access to affordable, quality healthcare coverage so that we can make responsible healthcare decisions to take care of ourselves and our families. Access to unprecedented opportunities will become available when the problems that have plagued the opening of the Health Insurance Marketplace are resolved – and they will be resolved.

Affordable coverage is made possible by the advance premium tax credits available to those with incomes between 100% and 400% of the federal poverty level – $23,550 to $94,200 for a family of four, and the cost-sharing subsidies available to those who purchase a silver-level plan with incomes between 100% and 250% of the federal poverty level – $23,550 and $58,875 for a family of four.

The advance premium tax credits are available to those who qualify in three ways:

  • The full credit can be used to reduce monthly premium costs,
  • A portion of the credit can be used to reduce monthly premium costs, with any remaining amount refunded at the end of the year when taxes are filed, or
  • The credit can be taken entirely when one’s taxes are filed, providing no monthly reduction in the premium.

While the necessary fixes are being made to the enrollment part of the Marketplace, consumers do have the opportunity to shop, compare, and understand the available plans without creating an account or logging onto the Marketplace. There are many informative sections on the Marketplace website as well as comprehensive Questions and Answers on a variety of topics. Exploring the website is an educational adventure.

If you do choose to shop and compare plans without creating an account on the Marketplace, you must be aware that premium tax credits for which you may qualify will not be reflected in the premium costs you see.  And premiums and deductibles are only part of the story. The rest of the story that makes coverage from the Marketplace affordable is the premium tax credits and cost-sharing subsidies. To get an idea of what you might qualify for you can use the Kaiser Family Foundation premium and subsidy calculator or the Department Insurance and Financial Services premium estimator.

Do your shopping and comparing – remember, it is not just about premiums – deductibles, co-insurance and copays will add to your total out-of-pocket cost. Don’t forget to check for possible premium tax credits and cost-sharing subsidies to reduce your cost and make quality coverage affordable.

— Jan Hudson

One Response to “Marketplace coverage is affordable”

  1. […] have income below 250% of the federal poverty level ($58,875 for a family of four). These are the keys to affordability for plans sold in the […]

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