During the ACA annual enrollment, the push is on to help more Americans get health insurance coverage for less
By Beth Newcomb
Just like last year, the annual enrollment period for Affordable Care Act (ACA) coverage has been extended until Sunday, January 15, 2023. The reason? “The push continues to help more people get insured,” says Roni Bell, a licensed insurance agent with HealthMarkets Insurance Agency. “We’ve been shown time and time again how crucial health insurance coverage really is.”
The Affordable Care Act, you might be surprised to learn, has been around since 2010, with millions of Americans enjoying health equity and gaining health coverage without lifetime limits on most benefits. (https://www.healthcare.gov/health-care-law-protections/lifetime-and-yearly-limits/)
The American Rescue Plan Act, signed into law in March of 2021, provides significant, although temporary, enhancements to the ACA. The purpose was to help more people access coverage courtesy of increased subsidies, with the elimination of the upper income limit for subsidy eligibility in 2021 and 2022. However, due to the Inflation Recovery Act, this has been extended through 2025. (https://www.cms.gov/newsroom/fact-sheets/inflation-reduction-act-lowers-health-care-costs-millions-americans)
What this means is in the past if you didn’t qualify for a subsidy to help offset the cost of your health insurance coverage, you may now. And a great way to find out is to schedule a meeting with Roni, or her new associate, licensed insurance agent Debby Brzozowski, for a no-cost review of your standing and what options are available.
“It’s a good idea to meet with us now,” Debby states.
What is a Subsidy?
A subsidy is essentially a premium tax credit the federal government provides to individuals to help offset the cost of an insurance premium. For example, if your premium is $1,500 a month and you get a subsidy of $900, the government pays that amount and your total out-of-pocket to secure coverage is $600.
“Subsidies are based on household income,” Roni explains. “The way things stand now, nobody purchasing coverage through the ACA has to pay more than 8.5% of their household income. Because subsidies are higher, some enrollees can get $0 premium Bronze or Gold plans.*”
In fact, with the current ACA marketplace structure, many more Americans have become eligible for lower premium Bronze plans. (https://www.healthinsurance.org/obamacare/will-you-receive-an-aca-premium-subsidy/)
Subsidies do not exist for people who have healthcare coverage under their employer-sponsored plans. “ACA coverage is for people who are self-employed, unemployed, or for people who work at a company that does not provide health insurance,” Roni shares.
ACA coverage can also be a good fit for people who have pre-existing conditions. Under the ACA coverage umbrella, insurers can no longer charge more or deny coverage to you or your child because of a pre-existing condition like asthma, diabetes, cancer and even pregnancy. (https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html)
Preventative care is another big benefit. Most plans must cover a set of preventative services, like blood pressure, diabetes and cholesterol tests, at no cost to you. Also included are well-baby and well-child visits, and routine vaccinations to prevent diseases such as measles, polio and meningitis.* (https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/preventive-care-background)
However, understanding your coverage options and subsidy amount (if any) can be confusing.
“You can certainly go it alone,” Roni says. “But as a licensed insurance agent with HealthMarkets, I’m qualified to help you understand your options in an easy-to-digest format. I’ll break it down so you can make the best choice for you and your family. And the best part is, my guidance is offered at no cost to you.”
Within the different ACA coverage levels there are numerous plans to choose from. “Simplify the process by putting my experience to work for you,” she suggests.
One of the biggest advantages to choosing coverage under the ACA is that you can pick a plan that does not require underwriting. “Preexisting conditions are allowed and there are preventative coverage benefits that may not be available elsewhere,” Roni says.
Plans can change every year in the ACA marketplace which means there could be benefits available that better suit your needs. A review can help to make everything clear and give you the tools to make an informed choice for what’s best for you and your family.
“Everyone deserves access to affordable, quality healthcare coverage and services,” Roni says. “The ACA provides an avenue for people to do just that.”
HealthMarkets Insurance Agency is located at 1039 Pearl Road, in Brunswick. Call Roni at 330-225-2550. Visit the website at HealthMarkets.com/RoniBell.
HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and the District of Columbia. Not all agents are licensed to sell all products. Service and product availability varies by state. Agents may be compensated based on enrollment. No obligation to enroll.
*Source: Healthcare.gov - 49067-HM-1122