Reinsurance is essentially insurance for insurance companies. Just like individuals count on their insurance company to cover a portion of their medical bills if and when they have a claim, reinsurance programs pay a portion of the insurer's bills when enrollees have high-cost claims.| healthinsurance.org
The Inflation Reduction Act would extend ARP's health insurance subsidy enhancements – helping millions eligible for ACA marketplace subsidies.| 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
What will happen to Marketplace health insurance subsidy availability and size when the subsidy enhancements instituted under the American Rescue Plan sunset after 2025?| 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
If your employer-sponsored insurance becomes unaffordable or stops providing minimum value, the change may make you eligible for a special enrollment period.| healthinsurance.org
Under the Affordable Care Act, individual and small-group health plans that are not grandfathered must cover items and services in 10 health benefit categories.| 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
As of 2023, the IRS has fixed the ACA's "family glitch." The family glitch previously made millions of Americans ineligible for premium subsidies in the exchange, even though their cost for employer-sponsored family health coverage was unaffordable. This disproportionately affected lower-income families.| 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
From 2015 through 2021, the IRS did make an annual change — usually quite small — to the percentage of income that you have to pay for self-purchased (individual/family) health coverage. But there’s a lot more to it than just the percentage of income that the IRS says you have to pay for the benchmark plan.| 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
The ACA's subsidy cliff has been temporarily eliminated (through 2025), saving some health insurance buyers thousands of dollars per year.| healthinsurance.org