New Healthcare.gov Subsidies Available For Those Approved For Unemployment

This blog content applies to health care coverage for 2021 and 2022.

Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2022, to Jan. 15, 2023.

Starting July 1, 2021, individuals may be eligible for additional savings and lower costs on their 2021 Healthcare.gov (Health Insurance Marketplace) plan if they received, or were determined eligible to receive, unemployment compensation in 2021.  

What does this mean for you?  

If you or your spouse received unemployment income for at least one week in 2021, your whole household may be eligible for a higher tax credit that may cover your monthly premium in full, regardless of your household’s income. In addition, you may be eligible for higher cost-sharing reductions to lower your deductible, copays and out of pocket costs if you select, or currently have, a Silver plan on Healthcare.gov. (See the difference between Bronze, Silver, Gold and Platinum plans in our Basic Health Insurance Terms blog post.)

What do I need to do?  

If you are currently enrolled in a Healthcare.gov plan, and you or your spouse received at least one week of unemployment compensation in 2021, you must report a change on your Healthcare.gov application and add unemployment compensation as part of your income. Even if you already reported that you received (or are receiving) unemployment, you will need to update your application to get these enhanced benefits. You can reselect your current plan or change plans if you want to.  

If you are not enrolled in a Healthcare.gov plan, you can apply to see if you qualify for these enhanced subsidies under the Special Open Enrollment Period open now through Aug. 15, 2021. (If you complete an application and select a plan before July 31, 2021, your plan will start on Aug. 1, 2021.) See the Get Covered section of our website to learn more and book an appointment with a Health Insurance Navigator.  

If I only received one week of unemployment and I have no income now, would I still qualify?  

Yes! You may be eligible to receive enhanced benefits even if you have no income at the moment and your unemployment compensation already expired.  

Learn more about how to get covered on Healthcare.gov, or call 980-256-3782 to reach a Health Insurance Navigator for free assistance. You can leave a message with a quick question or schedule a longer phone appointment.

Action Alert: Supreme Court Upholds ACA Once Again

Today the Supreme Court ruled 7-2 in favor of upholding the Affordable Care Act (ACA) for the third time.

This decision is wonderful news for Charlotte Center of Legal Advocacy and the people it serves as the ACA has helped make health care accessible to millions of uninsured Americans since 2010. 

More than 31 million Americans rely on the ACA for affordable coverage that provides free preventive care, protection for pre-existing conditions and a ban on lifetime caps for insurance benefits, along with the peace of mind that comes with being insured.  

Access to health care is essential for all people as efforts to fight the COVID-19 pandemic continue. This decision ensures that access without disrupting our healthcare system at a time when care is needed most.  

For those who have coverage through the ACA, this decision does not change current plans. Those who are uninsured or interested in changing their health plan can still sign up for 2021 coverage through August 15 using the Special Open Enrollment Period. Financial assistance to pay for coverage is still available.  

The Charlotte Center for Legal Advocacy’s health insurance navigators provide free, unbiased assistance to anyone who needs help signing up for coverage or understanding their options. For more information, visit charlottelegaladvocacy.org/getcovered

What Is Included in Every Healthcare.gov Plan?

Need to enroll in a health insurance policy or update the one you have?

Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2022, to Jan. 15, 2023.

All Healthcare.gov plans are required to cover preventive health services 100%. Additionally, these plans are required to include 10 types of health services—called Essential Health Benefits. Keep reading to learn more about these services below.

Preventive Health Services

Preventive health services are routine health care procedures, like screenings, check-ups and counseling to prevent illness, disease and other health problems.

This means that insurance companies cannot charge you a copay or coinsurance to get this type of medical attention. For example, immunizations, children’s vision screenings, contraception and well-woman visits are free. Get specific lists of preventive services for adults, women and children.

Preventive services are free only when you get them from a doctor or other provider in your plan’s network. (A network is the facilities, providers and suppliers your health insurance company has contracted with to provide health care services.) Talk to your doctor about taking advantage of these free services to keep you and your family healthy. 

Essential Health Benefits

While most of these services won’t be free, plans will pay for at least a portion of the costs of these services.

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization (like surgery and overnight stays)
  • Pregnancy, maternity, and newborn care (both before and after birth)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities or chronic conditions gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services, as well as chronic disease management
  • Children’s oral and vision care

Learn more here: https://www.healthcare.gov/coverage/what-marketplace-plans-cover/ 

Learn more about how to get covered on Healthcare.gov, or call 980-256-3782 to reach a Health Insurance Navigator for free assistance. You can leave a message with a quick question or schedule a longer phone appointment.

Mental Health and the ACA

Need to enroll in a health insurance policy or update the one you have?

Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2021, to Jan. 15, 2022.

Healthcare.gov plans are required to help pay for mental health services like counseling and psychotherapy. Healthcare.gov plans can’t put yearly or lifetime dollar limits on coverage of mental health services.

Additionally, some mental health services are completely free. For example, alcohol abuse screening and counseling, as well as depression screening, are free for adults. And behavioral health assessments are free for children at no cost. You can find more free preventive services for adults and children on Healthcare.gov.

To find out how much of the cost of mental health services is covered by your health insurance plan, look at the Summary of Benefits and Coverage. This document is available in your Healthcare.gov account, or you can call your health insurance company to get a copy. When you’re shopping for a health insurance plan and know that you will want to use mental health services, make sure you compare the Summary of Benefits and Coverage documents of each plan.

To find a therapist or other mental health professional in the Charlotte area, you can use the Bright Health provider search tool or the Blue Cross Blue Shield provider search tool (tip: search “psychology” or “psychiatry”).

If you need health insurance coverage, a Special Open Enrollment Period is open through Aug. 15, 2021. 

Learn more about how to get covered, or call 980-256-3782 to reach a Health Insurance Navigator for free assistance. You can leave a message with a quick question or schedule a longer phone appointment.

National Suicide Prevention Hotline: 1-800-273-8255

What does the American Rescue Plan (third stimulus package) mean for the Affordable Care Act?

This blog content applies to health care coverage for 2021 and 2022.

Need to enroll in a health insurance policy or update the one you have? Open Enrollment for the Health Insurance Marketplace (Healthcare.gov) is Nov. 1, 2022, to Jan. 15, 2023.

Get Covered

What people need to know about the relief bill and its changes to the ACA: 

1. Lower monthly premiums: federal government subsidies will reduce the amount you have to pay for health insurance each month. 

The plan significantly increases premium tax credits for 2021 and 2022. These increased subsidies will substantially reduce or even eliminate monthly premiums for millions of people with Marketplace plans.  

On average, premiums will decrease by $50 per month. No one will have to spend more than 8.5% of their income on premiums. People with income below 150% of the poverty line (about $19,000 for a single person, $25,800 for a couple, and $39,000 for a family of four) will pay no premiums for some plans, including Silver plans with cost sharing reductions. 

Current enrollees, including those who recently enrolled through the 2021 Special Enrollment Period, will need to update their Healthcare.gov applications to get the new subsidies. These subsidies will be visible on Healthcare.gov starting April 1, and you will start receiving them on May 1. You will need to reselect your current plan for the changes to take effect to reduce your premiums for the remainder of the year. If you do nothing, you do not lose access to the tax credits, but you’ll get them as a refund when you file your taxes next year. When you file your taxes in 2022, you will get a reimbursement of the additional tax credits you would have qualified for from January through April 2021.  

Due to the SOEP, you may be able to change plans until August 15. If you qualify for these additional benefits, the new tax credits will be applied to your policy starting on May 1.  

If you purchase a plan now, you will get a refund if you go back into your Healthcare.gov application after April 1. 

2. Increase Subsidies for Those Who Have Lost Their Jobs 

The plan expands premium tax credits for people who receive unemployment benefits in 2021. This means that individuals currently unemployed are guaranteed to get the most generous subsidies on Healthcare.gov. It doesn’t matter what their actual year-end income is.  

These additional tax credits will be available starting this summer. 

3Protect Families from Having to Pay Back Subsidies 

In 2020 some people lost their jobs early in the year but later got new ones with higher earnings than they had expected. Others worked additional hours or received bonus pay as essential workers. The American Rescue Plan exempts low- and moderate-income families from having to repay the premium tax credit they received in 2020.  

4. Government will pay the cost of COBRA coverage 

If you lost your job and your job’s health insurance, you can use COBRA to keep your same health insurance plan. But instead of losing your employer’s contribution for your premiums, the government will pick up the bill. The government will pay the entire COBRA premium from April 1 through September 30, 2021. 

If you get a new job that offers health insurance before Sept. 30, you will lose eligibility for this no-cost COBRA coverage. And someone who left a job voluntarily would not be eligible, either. 

We encourage you to review your options with the Marketplace before signing up for COBRA, since plan options may be more attractive to you, depending on your particular situation.  

Healthcare.gov Knocked For Glitches, Inaccurate Info By Advocacy Group

If you’re shopping for an insurance plan on healthcare.gov, the online marketplace created by the Affordable Care Act, there’s an important feature that doesn’t always work, an advocacy group says. It sometimes gives misinformation about which doctors are in the network for each plan.

Read more at www.wfae.org