A health insurance premium is the amount – typically billed monthly – that policyholders pay for health coverage. Policyholders must pay their premiums each month regardless of whether they visit a doctor or use any other healthcare service.| healthinsurance.org
If you have a health plan in the individual market, on-exchange or off-exchange, you can probably just let it renew for the coming year without doing anything during open enrollment. But this is generally not in your best interest.| healthinsurance.org
In addition to the Platinum, Gold, Silver and Bronze individual health insurance plans, the ACA allows catastrophic plans for people under age 30, or for those 30 and older who qualify for a hardship exemption from having to maintain health insurance coverage or pay a penalty. But subsidies cannot be used to purchase these plans, so enrollment is very low.| healthinsurance.org
The federal poverty level (FPL) - also referred to as the federal poverty guidelines – is used to determine eligibility for Medicaid and CHIP, and for premium subsidies and cost-sharing reductions in the health insurance marketplace.| healthinsurance.org
A health insurance deductible is the amount an individual must pay for healthcare expenses before insurance (or a self-insured company) covers the costs. Often, insurance plans are based on yearly deductible amounts.| healthinsurance.org
If you're like the vast majority of consumers, you may be hearing about CSRs for the first time and wondering why these subsidies are so important, and whether they actually affect your own coverage. Here's what you need to know:| healthinsurance.org
A cost-sharing reduction (CSR) is a provision of the Affordable Care Act that reduces out-of-pocket costs for eligible enrollees who select Silver health insurance plans in the marketplace. CSRs – often referred to as cost-sharing subsidies – reduce enrollees' cost-sharing by lowering a health plan's out-of-pocket maximum, and increasing the actuarial value (AV) of the plan.| healthinsurance.org
See if you're eligible for the Affordable Care Act's premium tax credits (premium subsidies), how subsidies are calculated, and why they are more robust in 2023.| healthinsurance.org
While the Affordable Care Act's premium subsidies help pay the cost of the health insurance itself, cost-sharing subsidies help to reduce out-of-pocket spending for eligible enrollees when they select Silver plans. The Trump administration eliminated federal funding for cost-sharing reductions, but the benefits are still available to eligible enrollees. And because the cost of cost-sharing reductions has been added to premiums, premium subsidies are much larger than they were prior to 2018.| healthinsurance.org
All plans (whether Bronze, Silver, Gold or Platinum) must cover the same essential benefits, including free preventive care; they all provide comprehensive coverage. But plans with the lowest premiums (Bronze, and to a lesser extent, Silver) require you to pay a larger share of your health costs. This means that your co-pays and deductibles will be higher, and your maximum out-of-pocket will generally be higher as well.| healthinsurance.org
Learn how the Affordable Care Act (Obamacare) improved health coverage and made it more affordable through income-based subsidies.| healthinsurance.org