ACA Archives - Healthedly Insurance Services

Determining Your Household Size for Premium Tax Credit

When applying for a premium tax credit, one of the most important factors determining eligibility is household size. Understanding your household size and how to correctly report it is essential for receiving the right amount of tax credits. Household size includes the primary applicant and any dependents on their tax return. It can also include individuals who may not be related to the primary applicant. In this blog, we’ll explain how to determine your household size. You’ll learn how to report your household size when applying for a premium tax credit.

Who is Eligible for Premium Tax Credits

Under the Affordable Care Act, individuals and families who buy health insurance through the Health Insurance Marketplace can be eligible for premium tax credits. These credits are based on income, cost of insurance, and family size. To qualify, individuals must meet certain income requirements. They can have no access to employer-sponsored health insurance. Lastly, they cannot be eligible for other programs like Medicare or Medicaid. The size of the premium tax credit depends on a household’s income and the cost of their insurance plan. People with lower incomes or higher insurance costs will receive larger premium tax credits. Premium tax credits can lower the amount an individual or family has to pay for health insurance each month. Moreover, the credits can be used to reduce the amount they owed on their taxes.

What are Premium Tax Credits?

Premium tax credits are a critical financial resource for many American families. These tax credits can be used to purchase health insurance and to help lower the cost of insurance premiums. Premium tax credits are available to people with incomes between 100% and 400% of the federal poverty level. These credits are based on factors such as family size, income, and geographic area. Premium tax credits can significantly reduce the amount of money individuals and families have to spend on health insurance premiums each month. This makes health insurance accessible and more affordable. By helping to reduce the cost of health insurance, premium tax credits can help individuals and families access the health care they need.

What Kind of Marketplace Health Insurance Plan can Someone Buy with the Credit?

With a premium tax credit, individuals and families can purchase a health plan through the Health Insurance Marketplace. These plans divide into four metal tiers: bronze, silver, gold, and platinum. Bronze plans have the lowest premiums and highest deductibles, while platinum plans have the highest premiums and lowest deductibles. Individuals and families can choose a plan that best suits their budget and health care needs. All plans offered through the Marketplace are comprehensive and must cover a range of health care services. These include preventive care, hospitalization, prescription drugs, and mental health services. Additionally, plans provide specific essential health benefits and protect against high out-of-pocket costs.

More about Eligibility

To be eligible for a premium tax credit, an individual or family must meet certain criteria. Generally, individuals and families making between 100% and 400% of the federal poverty level. Hence, they are not eligible for other types of health coverage. For instance, Medicare or Medicaid can receive a tax credit. Additionally, individuals and families must purchase a health plan through the Marketplace to be eligible for a premium tax credit. The amount of the premium tax credit is based on the estimated household income and family size. It is also based on the cost of the second-lowest silver-level health plan in the Marketplace. The premium tax credit helps to pay for the monthly premiums of a health plan purchased through the Marketplace.

What is the Federal Poverty Line for Premium Tax Credit

The federal poverty line determines eligibility for a premium tax credit. The poverty line is determined by the US Department of Health and Human Services. It is based on household size and income. Generally, individuals and families who make between 100% and 400% of the federal poverty level. They are not eligible for other types of health coverage, are eligible for a premium tax credit. For example, the 2023 federal poverty line for an individual is $14,580. Meanwhile, the poverty line for a family of four is $30,000. These amounts vary by family size and may change based on inflation and other factors.

Ultimately, understanding and correctly reporting your household size is essential for receiving the right amount of tax credits. Household size includes the primary applicant and any dependents listed on their tax return. It also includes individuals not related to the primary applicant. It is important to be aware of the factors that can affect your household size. These factors include as marriage, divorce, and adoption. Make sure you understand the different factors involved in determining your household size. This can help you receive the right amount of premium tax credit.

That’s where Healthedly comes in. Our agents are ready to answer your questions about premium tax credits, open enrollment, and health insurance eligibility, plus so much more! Give us a call at 855-522-2201 for more information!

February 7, 2023

What you need to know about Open Enrollment Period

ACA, Obamacare

Everything you need to about Open Enrollment this year

Open Enrollment period, the most wonderful time of the year, is upon us. This period usually happens at the same time of every year, from November to January, and gives people the opportunity to find the right coverage that fits their individual needs, financial situation, and employer network.

Here is everything you need to know about open enrollment for 2023 and finding the right health insurance coverage.

When is Open Enrollment?

November 1, 2022 marks the day Open Enrollment begins this year. Starting November 1, you can enroll or re-enroll in health coverage for 2023, or even change that insurance plan.

Dec 15, 2022 is the last day you can enroll or change up your plan for any coverage set to start on January 1, 2023.

2023 coverage becomes effective on January 1, 2023 for anyone who enrolled by December 15.

February 1, 2023 is the day that health coverage begins for those who enrolled between December 16, 2022 and January 15, 2023.

What do you need for Open Enrollment?

Make sure you have all the information necessary to enroll, as well as information for your dependents if applicable. Ensure you have all your IDs on hand as well as your employer and income information. Also, you may get savings on health coverage.

What is the ACA?

The Affordable Care Act, or Obamacare, makes health insurance accessible to individuals and families who otherwise couldn’t obtain insurance. You can talk with an agent TODAY at 855-522-2201 about what you are eligible for and the kind of healthcare coverage you can access.

Open Enrollment Period is here, and if you aren’t sure where to even start with health insurance, what you qualify for, or the insurance quote you might be eligible for, then you need to know that Healthedly is here to help! Our agents are ready to help you find the best coverage for your individual needs, so don’t hesitate to get started TODAY!

November 1, 2022

The Quick and Easy Guide to Open Enrollment for Health Insurance in 2023

ACA, General

A stethoscope and an open enrollment medical insurance form.

Open enrollment for health insurance in 2023 will be here sooner than you might think.

The earliest you can sign up for 2023 coverage through the federal government health insurance marketplace is Nov. 1, 2022, according to Healthcare.gov. General enrollment ends on Jan. 15, 2023.

It’s crucial to have a plan and make sure you find and purchase the health coverage you need before the open enrollment period ends. Otherwise, you may not be able to secure coverage or need to wait to see if you qualify for a special enrollment period.

There are plenty of questions about open enrollment for 2023. We’ll answer some of the most frequently asked questions to help you make a more informed decision about your health care and insurance coverage.

Can I get Health Insurance Outside of Open Enrollment in 2023?

Yes, but only if you have a qualifying life event during that time. The Kaiser Family Foundation (KFF) points to these qualifying events that open up special enrollment, including:

Loss of coverage (leaving a job that provided insurance, for example)
Loss of dependent status
Income increases or decreases that affect health care marketplace eligibility
Marriage
Change in immigration status

Additionally, if you’re close to age 65, you can sign up for Medicare once you are three months away from your birthday. You can also explore Medicare Advantage, Supplement and Prescription Drug coverage.

Outside of those situations and a few others, you may not be able to purchase coverage outside of open enrollment for health insurance in 2023.

What if I Miss Open Enrollment for Health Insurance?

You can purchase short-term insurance from a private carrier if you miss open enrollment. These plans are an effective way to make sure you have some coverage. However, making sure you take action during open enrollment is your best option.

When Does Health Insurance Start After Open Enrollment?

The KFF explains that coverage can start at two points, assuming the first premium payment is made on time:

Enroll by Dec. 15, 2022, and coverage begins on Jan. 1, 2023.
Enroll after Dec. 15, 2022, and coverage begins on Feb. 1, 2023.

Can I Add My Spouse to My Health Insurance After Open Enrollment?

You can add a spouse to your health insurance within 60 days of your marriage. Otherwise, you generally need to wait until the next open enrollment period.

Will Pre-Existing Conditions be Covered in 2023?

Yes, pre-existing conditions are covered in 2023. An insurer in the health insurance marketplace can’t deny you coverage due to an existing medical issue.

Finding Health Insurance Coverage You Can Count On

There’s still time to look at health coverage, compare prices, and find a plan that works for you. Be prepared for open enrollment and start making your plan today.
Still looking for the right Health Insurance Plan? Browse available plans here!

September 14, 2022

Important Information About Special Enrollment Periods (SEPs)

ACA, Individual and Family, Medicaid, News, Obamacare, Special Enrollment Period, Supplemental

Special Enrollment Periods (SEPs) are a specific time frame during which individuals and families can enroll in a health insurance plan outside of the standard open enrollment period. SEPs are typically triggered by certain life events, such as getting married, having a baby, or losing employer-sponsored coverage.

It’s important to understand that SEPs have strict eligibility requirements and time frames, and failing to enroll during an SEP can result in a gap in coverage or a tax penalty. Here’s what you need to know about SEPs:

Eligibility Requirements

SEPs are only available to individuals and families who experience a qualifying life event, such as:

Marriage
Divorce
Birth or adoption of a child
Loss of employer-sponsored coverage
Moving to a new area with different health plan options
Gaining citizenship or legal resident status
Leaving incarceration

It’s important to note that SEPs are not available to individuals who simply decide they want to change health plans outside of the open enrollment period. You must have a qualifying life event in order to be eligible for an SEP.

Time Frames

SEPs have strict time frames during which you must enroll in a health plan. The time frame begins on the date of the qualifying life event and typically lasts for 60 days. However, the exact time frame can vary depending on the specific life event and the state in which you live.

For example, if you get married, the SEP begins on the date of your marriage and lasts for 60 days. If you have a baby, the SEP begins on the date of your child’s birth and lasts for 60 days. It’s important to enroll within this time frame, as failing to do so may result in a gap in coverage or a tax penalty.

Coverage

SEPs allow you to enroll in a health insurance plan outside of the standard open enrollment period. This means that if you experience a qualifying life event, you can enroll in a health plan even if the open enrollment period has already ended.

It’s important to note that SEPs do not guarantee coverage. If you enroll in a health plan during an SEP, the plan may still have a waiting period before coverage begins. This means that you may have a gap in coverage between the date of your qualifying life event and the date that your coverage begins.

Plan Options

During an SEP, you have the option to enroll in any plan that is available through the marketplace. This includes both individual and family plans. It’s important to compare different plan options and consider factors such as premiums, deductibles, and out-of-pocket costs before making a decision.

It’s also important to note that SEPs do not guarantee that you will be eligible for subsidies, such as premium tax credits or cost-sharing reductions. If you are eligible for subsidies, you must enroll during the open enrollment period in order to receive them.

Enrolling in a Plan

To enroll in a health plan during an SEP, you must complete an application through the marketplace. The application will ask for information about your qualifying life event, as well as your personal and financial information.

You will also need to provide proof of your qualifying life event, such as a marriage certificate or a birth certificate. It’s important to provide all required documentation in order to ensure that your application is processed smoothly.

If you are approved for coverage, you will receive a notice of eligibility. This notice will include information about your premium, deductible, and out-of-pocket costs. You will then have the opportunity to select a plan and enroll in coverage.

If you have any questions about SEPs or the enrollment process, you can contact the marketplace or a licensed insurance agent for assistance. It’s important to get the help you need to make an informed decision about your health coverage.

In summary, SEPs are a specific time frame during which individuals and families can enroll in a health insurance plan. This period is outside of the standard open enrollment period. SEPs are triggered by certain life events, such as getting married or having a baby. These events have strict eligibility requirements and time frames. It’s important to understand SEPs and to enroll within the designated time frame to avoid gaps in coverage or tax penalties.

If you have any questions about SEPs or the enrollment process, be sure to seek the help of our licensed agents here at Healthedly! Give us a call at 855-522-2201!

March 24, 2022

Thirteen Million People In The U.S. Have Two Weeks To Apply For Zero Cost Health Insurance

ACA, Individual and Family, Obamacare

The deadline for enrolling in health insurance through the marketplace is quickly approaching. And, 13 million individuals have until December 15th to sign up for coverage.

The marketplace, also known as the Health Insurance Exchange, is a platform created by the Affordable Care Act (ACA). This platform allows individuals and small businesses to compare and purchase health insurance plans. It is an important resource for those who do not have access to employer-sponsored health insurance. It’s also a resource for those who cannot afford the high premiums and out-of-pocket costs associated with private insurance plans.

Open enrollment for the marketplace typically takes place between November and December each year. It is the only time when individuals can enroll in a plan without experiencing a qualifying life event (such as getting married, having a child, or losing employer-sponsored coverage).

This year, the enrollment period has been shortened. It will only last until December 15th. So, it is important that those who are in need of health insurance act quickly.

There are several factors to consider when choosing a health insurance plan through the marketplace. First, it is important to determine whether you are eligible for financial assistance. For example, are you eligible for premium tax credits or cost-sharing reductions. These subsidies can significantly reduce the cost of health insurance. This makes it more affordable for those with low or moderate incomes.

To determine your eligibility for financial assistance, you will need to provide information about your household size and income. You can do this by filling out an application on the marketplace website. Or, you can contact a local enrollment assistance center.

Next, you will need to choose a health insurance plan that meets your needs.

There are four main types of plans available through the marketplace: bronze, silver, gold, and platinum. These plans get categorized based on the amount of coverage they provide. Bronze plans offer the lowest level of coverage and platinum plans offer the highest.

In general, bronze plans have the lowest premiums but also have the highest out-of-pocket costs, such as deductibles and copays. On the other hand, platinum plans have the highest premiums but the lowest out-of-pocket costs.

It is important to carefully consider your healthcare needs when choosing a plan. If you have a chronic condition or take expensive medications, for example, you may want to consider a plan with a higher premium and lower out-of-pocket costs. On the other hand, if you are generally healthy and only visit the doctor occasionally, you may want to choose a plan with a lower premium and higher out-of-pocket costs.

Another important factor to consider is the plan’s provider network.

Most health insurance plans give a list of providers that they have negotiated lower rates with, and these providers get considered as “in-network”. If you see a provider who is not in the plan’s network, you may have to pay a higher out-of-pocket cost.

It is a good idea to check the provider network before enrolling in a plan. By doing so, you ensure that your preferred doctors and hospitals are included. You can typically find this information on the plan’s summary of benefits and coverage, which is available on the marketplace website.

Finally, it is important to remember that health insurance plans can change from year to year, so it is a good idea to review your plan annually to make sure it still meets your needs. If you already enrolled in a marketplace plan, you will receive a notice in the fall with information about any changes to your plan for the following year.

The deadline for enrolling in a health insurance plan through the marketplace is quickly approaching. It is important for those in need of coverage to act now. By taking the time to consider your healthcare needs and researching the available options, you can find a plan that meets your budget and provides the coverage you need.

If you are unsure about your options or have questions about the enrollment process, you can reach out to Healthedly for more information.

You can also contact your state’s insurance department for help with understanding your options and enrolling in a plan.

Enrolling in health insurance is an important step in taking care of your health and protecting yourself and your family from unexpected medical expenses. Don’t wait until it’s too late – now is the time to act and get the coverage you need.

Remember, the deadline for enrolling in a health insurance plan through the marketplace is December 15th. Don’t miss your chance to get the coverage you need – visit healthcare.gov today and start exploring your options.

August 5, 2021

Proposed change to the “Birthday Rule”

ACA, Individual and Family, Medicare

The “birthday rule” is a provision that exists in many retirement plans, including 401(k) plans. This dictates that an individual must reach a certain age before they can begin to withdraw money from their account without incurring a penalty. The current age that the birthday rule specifies is 59 1/2 years old. However, there has been a proposal to change this rule in order to make it easier for individuals to access their retirement funds earlier in life.

One of the proposed changes to the birthday rule?

Lower the age at which individuals can begin to withdraw money from their retirement accounts without incurring a penalty.

This change is being considered because many people are finding it difficult to save enough money for retirement. This alteration allows them to access their funds earlier in life. Hence, this could provide them with the financial support they need to meet their expenses.

Another proposed change to the birthday rule? Allow individuals to use their retirement funds to pay for certain expenses.

For example, they can use the fund for the cost of education or the purchase of a first home, without incurring a penalty.

This change is being considered because these expenses can be significant and may not be covered by other sources of funding. Allowing individuals to use their retirement funds to pay for these expenses could help them to achieve important financial goals. It could also improve their financial security.

There are also proposals to allow individuals to withdraw money from their retirement accounts on an ongoing basis. They wouldn’t have to wait to do so at one specific age. This change is being considered for what reason? It would give individuals more flexibility in terms of when they can access their funds. It could make it easier for them to manage their retirement savings. Overall, the proposed changes to the birthday rule are intended to make it easier for individuals to access their retirement funds. And they can do so earlier in life. They can use them for a wider range of expenses.

These changes could help to improve financial security and provide individuals with more control over their financial futures. However, it is important to carefully consider the potential consequences of these changes before making a decision. They may have an impact on an individual’s overall financial strategy and retirement planning.

Get your free quote at Healthedly or call 855-522-2201

July 28, 2021

Do You Know the Signs of a Silent Heart Attack?

ACA, Health Resources, Individual and Family, Medicare

A heart attack is a serious medical emergency that occurs when the blood flow to a part of the heart is blocked, causing damage to the heart muscle. While most heart attacks are accompanied by clear and noticeable symptoms, such as chest pain and shortness of breath, some heart attacks, known as silent heart attacks, may not have any obvious symptoms at all.

Silent heart attacks, also known as asymptomatic or “silent” myocardial infarctions, can be just as dangerous as heart attacks with symptoms and can even lead to death. It is important to be aware of the signs of a silent heart attack and to seek medical attention if you think you may be experiencing one.

Here are some common signs of a silent heart attack:

Chest pain or discomfort:

While chest pain is often the most common symptom of a heart attack, some people may experience a more subtle form of chest discomfort during a heart attack. This can feel like a tightness or pressure in the chest, and may be accompanied by pain in the arms, neck, jaw, or back.

Shortness of breath:

Difficulty breathing is another common symptom of a heart attack, but it may be less noticeable during a silent heart attack. You may feel short of breath during physical activity or when you are at rest.

Fatigue:

If you are experiencing a silent heart attack, you may feel extremely tired or exhausted, even if you have not been physically active. This can be a result of the heart not pumping blood effectively due to the blockage in the coronary artery.

Nausea:

Some people may experience nausea or vomiting during a heart attack. This can be caused by the increased heart rate and blood pressure that can occur during a heart attack.

Sweating:

Sweating is another common symptom of a heart attack, and it may be more noticeable during a silent heart attack as it is often one of the only noticeable symptoms.

Heart palpitations:

If you are experiencing a heart attack, you may feel a racing or skipping sensation in your heart. This can be caused by the heart trying to compensate for the lack of oxygenated blood flow due to the blockage in the coronary artery.

Dizziness:

Dizziness or lightheadedness can also be a sign of a silent heart attack. This can be caused by a decrease in blood flow to the brain due to the blockage in the coronary artery.

It is important to note that not all heart attacks have the same symptoms, and some people may not experience any symptoms at all. If you have any of the above symptoms, or if you are experiencing any other unusual symptoms, it is important to seek medical attention as soon as possible.

Risk factors for silent heart attacks

There are several factors that can increase your risk including:

Age:

The risk of experiencing a silent heart attack increases as you get older, especially in men over the age of 45 and women over the age of 55.

High blood pressure:

High blood pressure is a leading cause of heart attacks, and it can increase your risk of experiencing a silent heart attack.

Diabetes:

People with diabetes are at an increased risk of experiencing a heart attack, as high blood sugar levels can damage the blood vessels and increase the risk of blockages.

Family history:

If you have a family history of heart disease, you may be at an increased risk of experiencing a silent heart attack.

Smoking:

Smoking increases the risk of heart attacks, and it can also increase the risk of experiencing a heart attack.

It is important to be aware of the signs of a silent heart attack and to seek medical attention if you think you may be experiencing one. In addition to being aware of the symptoms, it is also important to be aware of the risk factors for silent heart attacks. By taking steps to reduce your risk factors, such as quitting smoking and managing high blood pressure and diabetes, you can help to prevent a silent heart attack.

If you have had a silent heart attack, it is important to follow the treatment plan prescribed by your doctor.

This may include medications to help control risk factors such as high blood pressure and cholesterol, as well as lifestyle changes such as eating a healthy diet and exercising regularly.

It is also important to pay attention to your overall heart health. This includes getting regular check-ups and screenings, such as cholesterol tests and blood pressure checks, to help catch any potential issues early on. While silent heart attacks can be serious and even life-threatening, they are also treatable. By being aware of the signs and taking steps to prevent a silent heart attack, you can protect your heart health and reduce your risk of future heart problems. To seek proper medical advice from your doctor at an affordable price, contact a licensed agent at Healthedly now at 855-522-2201!

June 22, 2021

Healthcare.gov: You Can Do This!

ACA, Health Resources, Individual and Family, Medicaid

COVID-19 Relief Package Includes Expansion of Health Care Coverage

ACA, News

As Biden Reopens ACA Enrollment, Are You Eligible To Sign Up Or Switch Health Plans?

ACA, News

The Affordable Care Act (ACA), also known as Obamacare, is a federal law that was enacted in 2010. Its goal? The goal of increasing the affordability and accessibility of health insurance for Americans.

The ACA has faced a lot of political controversy and legal challenges over the years. Regardless, it remains the law of the land and has helped millions of Americans get health insurance coverage.

One of the key provisions of the ACA is the establishment of an open enrollment period during which individuals and families can sign up for health insurance or switch to a different health plan. The open enrollment period usually takes place during a specific time of the year, and it is typically the only time that individuals and families can sign up for ACA-compliant health insurance or switch to a different plan without experiencing a gap in coverage.

The open enrollment period for the ACA is usually held between November and December of each year. It allows individuals and families to enroll in health insurance plans that will take effect on January 1 of the following year. However, the COVID-19 pandemic has caused disruptions to the ACA open enrollment period in recent years.

In 2021, President Joe Biden reopened ACA enrollment for a special enrollment period in response to the COVID-19 pandemic. This special enrollment period allows individuals and families who are uninsured or who want to switch to a different health plan to do so outside of the usual open enrollment period.

So, if you’re wondering whether you are eligible to sign up for or switch health plans now that Biden has reopened ACA enrollment, here’s what you need to know:

You may be eligible if you are uninsured or if you want to switch to a different health plan.

Are you are currently uninsured and wanting to get coverage under the ACA. Are you insured but you want to switch to a different health plan? Then, you may be eligible to do so. But you can only do so during the special enrollment period that has been reopened by President Biden.

To be eligible to enroll in an ACA-compliant health plan during the special enrollment period, you must meet the following criteria:

You are a U.S. citizen or a legal resident.
You do not have access to employer-sponsored health insurance.
You do not have access to other types of qualifying coverage, such as Medicare or Medicaid.

You may be eligible if you have experienced a qualifying life event.

Are you uninsured or wanting to switch to a different health plan? If yes, then you may also be eligible to enroll in or switch to an ACA-compliant health plan. This is only if you have experienced a qualifying life event. Qualifying life events include events such as:

Losing your job or experiencing a reduction in income that affects your ability to pay for health insurance.
Getting married or divorced.
Having a child or adopting a child.
Moving to a new area where your current health plan is not available.

For example, you might have experienced a qualifying life event. You may be eligible to enroll in or switch to an ACA-compliant health plan outside of the usual open enrollment period.

You may not be eligible if you have missed the deadline for the special enrollment period.

The special enrollment period that has been reopened by President Biden has a deadline. If you have missed this deadline, you may not be eligible to enroll in or switch to an ACA-compliant health plan. You may have to wait until the next open enrollment period.

It’s important to note that the deadline for the special enrollment period may vary depending on where you live. So, it’s a good idea to check with your state’s health insurance marketplace or a licensed insurance agent. By doing so, you can find out the specific deadline for your area.

You may be eligible for financial assistance to help you pay for your health insurance.

One of the key features of the ACA is that it provides financial assistance to help individuals and families pay for their health insurance premiums. If you are eligible for financial assistance, you may be able to get help paying for your health insurance through the ACA.

To be eligible for financial assistance, you must meet the following criteria:

You have an income that is between 100% and 400% of the federal poverty level.
You are not eligible for employer-sponsored health insurance or other types of qualifying coverage, such as Medicare or Medicaid.

If you are eligible for financial assistance, you may be able to get help paying for your health insurance premiums through the ACA. This financial assistance is available in the form of tax credits, which are applied directly to your health insurance premiums to lower the amount you have to pay.

In conclusion, if you are uninsured or if you want to switch to a different health plan, you may be eligible to do so during the special enrollment period. This period has been reopened by President Biden. You may also be eligible if you have experienced a qualifying life event. But, you may not be eligible if you have missed the deadline for the special enrollment period. Additionally, you may be eligible for financial assistance to help you pay for your health insurance. This is if you meet the income and coverage criteria. If you are unsure of your eligibility, it’s a good idea to check with your state’s health insurance marketplace or a licensed insurance agent to find out more. Contact Healthedly at 855-522-2201 for more information!

February 15, 2021