In the evolving world of health care, Scott McEvoy, a licensed insurance agent with HealthMarkets, keeps tabs on updates to the Affordable Care Act. Here’s what’s happening for 2025
By Beth Newcomb
Every year, many hardworking Americans are faced with the challenges of navigating their personal healthcare needs, without the benefit of an employer-sponsored plan. That’s why the Affordable Care Act (ACA) offers a beacon of hope. But it can be overwhelming to understand all the policies and provisions that evolve each year. That’s why it may be prudent to work with a licensed insurance agent like Scott McEvoy, with HealthMarkets Insurance Agency.
Scott offers anyone interested the opportunity to sit down with him or a member of his team to review the available options, then help them make the selections that make the most sense for them and their families.
“Plan details and availability change every year, so what was available to you last year may not be the same this year,” he notes.
Open enrollment for the ACA plans begins on Friday, November 1, and runs until Wednesday, January 15, 2025.
Key Updates for 2025
The ACA will offer more generous advanced premium tax credits, expanding financial assistance to a wider range of income levels. This adjustment will help to reduce premiums for a larger number of people, making health insurance more affordable.1
Additionally, new updates include caps on out-of-pocket costs such as deductibles and co-pays.2 “The goal is to ease the financial burden of medical expenses,” Scott notes.
The ACA will also include provisions for lower co-pays on medications and expanded access to specialized care for chronic conditions.3
Additional support for low-income families includes enhanced premium tax credits and improved access to affordable care options.4
Are You Eligible?
The ACA has had a significant impact on health care in the U.S. By 2016, the law had helped reduce the uninsured rate to a historic low. More than 20 million Americans gained insurance through the expansion of Medicaid, subsidies and marketplace plans.5 Protections for pre-existing conditions and essential health benefits have become widely popular.
“The ACA provides health insurance coverage for a broad range of individuals and families,” Scott explains. “Eligibility for benefits and programs generally depends on several factors, including income, citizenship and specific health needs. Some people will qualify for premium tax credits and cost-sharing reductions for health insurance purchased through the ACA Marketplace.5”
One important feature of ACA plans is that they must cover pre-existing conditions. This applies to all individuals seeking coverage through the ACA Marketplace, regardless of their health history.6
“It’s important to note that everyone who participates in ACA plans is free to make their own choices,” says Scott. “They can opt to go it alone, making their selection for the coming year, or they can tap into the knowledge base of someone like me who has spent part of the year reviewing the changes for 2025.”
Scott suggests calling his office to make an easy, informative appointment to meet with him. “That’s where many of my clients like to begin,” he suggests. “It can be overwhelming to sift through the options available to you. But when you schedule a time to meet with me or someone on my team, we can help you sort through the options. I'll provide you with information about important changes and the options available to you to help you find a plan that best suits your needs. Some people may understand the changes that apply to them and others may need help understanding plan changes, so I believe it's best to meet with a licensed insurance agent.”
HealthMarkets Insurance Agency is located at 9551 Vista Way in Garfield Hts. To reach Scott McEvoy or a member of his team, call 216-815-1850. Virtual, phone and office appointments are available.
*Source: kff.org/policy-watch/five-things-to-know-about-renewal-of-extra-affordable-care-act-subsidies-in-inflation-reduction-act/ 1, hhs.gov/about/news/2024/07/16/biden-harris-administration-releases-final-part-two-guidance-help-people-medicare-prescription-drug-coverage-manage-prescription-drug-costs.html 2, cbpp.org/research/health/entering-their-second-decade-affordable-care-act-coverage-expansions-have-helped 3&4, HHS.gov5&6.
HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability may vary by state. Agents may be compensated based on enrollment. No obligation to enroll. 51654-HM-1124