Open Enrollment 2021 is here!

October 30, 2020
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The Patient Protection and Affordable Care Act, popularly known as Obamacare ensure that all Americans have access to quality, affordable health care. According to estimate about 22 million Americans have coverage through ACA/Obamacare via exchanges and Medicaid expansion. The Affordable Care Act provides subsidies to qualifying individuals and families to help make coverage more affordable.

If you currently don't have health insurance through a job, Medicare or Medicaid, or any another source that provides qualifying health coverage, the Marketplace can help you get covered. Open Enrollment for 2021 runs Sunday, November 1–Tuesday, December 15, 2020. Plans sold during Open Enrollment Coverage starts January 1, 2021.

Are you eligible to use the Marketplace?

To be eligible to enroll in health coverage through the Marketplace, you:

  • • You must live in the United States.
  • • You must be a U.S. citizen or lawfully present in the United States.
  • • You are not currently incarcerated.
  • • If you have Medicare coverage, you’re not eligible to use the Marketplace to buy a health or dental plan.

Are you eligible for Obamacare Subsidy?

When applying for coverage in the Health Insurance Marketplace, you may qualify for subsidy also known as a “premium tax credit” that lowers your monthly premium. The amount of subsidy or premium tax credit depends on the estimated household income for 2021 that you declare on your Marketplace application. Your eligibility for a premium subsidy for 2021 is based on the Federal Poverty Level number announced in 2020.

What is Premium Tax Credit?

The premium tax credit is a refundable tax credit designed to help eligible individuals and families with low or moderate income afford health insurance purchased through the Health Insurance Marketplace. Those who have a lower income get a larger credit to help cover the cost of their insurance.

You are eligible for the premium tax credit if you meet all of the following requirements.

Have household income that falls within a certain range. Your income is no more than 400% of the federal poverty level

Family Size Poverty Level 400 percent of poverty level
1 $12,760 $51,040
2 $17,240 $68,960
3 $21,720 $86,880
4 $26,200 $104,800
5 $30,680 $122,720
6 $35,160 $140,640
7 $39,640 $158,560
8 $44,120 $176,480

  • • Do not file a tax return using the filing status of Married Filing Separately
  • • Cannot be claimed as a dependent by another person.
  • • Meet these additional requirements: In the same month, you or a family member:

a. Have health insurance coverage through a Health Insurance Marketplace.

b. Are not able to get affordable coverage through an eligible employer-sponsored plan that provides minimum value.

c. Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE.

d. Pay the share of premiums not covered by advance credit payments.

Cost Sharing Reduction

You may qualify for cost sharing reduction if you only enroll in to a marketplace silver plan. This is an additional discount that lowers the amount you have to pay for deductibles, copayments, and coinsurance. When you reach your out-of-pocket maximum, your insurance plan covers 100% of all covered services.

How cost-sharing reductions work

How cost-sharing reductions work

  • You'll have a lower deductible. For example, if a particular Silver plan has a $1,000 deductible, you have to pay the first $1,000 of medical care yourself before the insurance company pays. But if you qualify for cost-sharing reductions, your deductible for a Silver plan could be less than $1,000, depending on your income.
  • You'll have a lower copayment. Co-payment is a fixed amount ($30, for example) you pay for a covered health care service after you've paid your deductible. If you enroll in the plan and qualify for cost-sharing reduction, you may pay $20 or $15 instead.
  • You'll have a lower out-of-pocket maximum. This means the total amount you'd have to pay in a would be lower. Instead of $5,000, your out-of-pocket maximum for a particular Silver plan, if you qualify for cost-sharing reduction it could be $3,000.

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Coverplushealth.com is an independent marketplace operated by Health Plans Direct, Inc. National Producer Number 17854932 and is not the Health Insurance Marketplace website. We Invite application for insurance in states where we maintain our agency/broker licenses and appointed for each state that requires a license to conduct health insurance sales and services.We are required to comply with all applicable federal laws, including standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Marketplace plans being offered in your state through our partner websites. To see all available data on Marketplace plan options in your state, go to the Health Insurance Marketplace website at HealthCare.gov. If you have questions or concerns, please contact us at support@coverplushealth.com

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