If you’re employed, your employer will likely offer you the option to add health insurance to your benefits package at little or no cost to you (the employee).
This can be a great perk of working for an employer who cares about its employees.
However, many employees and employers alike don’t understand how the health insurance enrollment process works and what it means if your company offers subsidized health insurance.
Here are some tips on how to apply for subsidized health insurance that will help you get signed up with affordable coverage quickly and efficiently.
Step 1) Understand what Obamacare is
Most people don’t know that there are two options when it comes to Obamacare: subsidies and no subsidies.
Most people won’t qualify for subsidies, which is actually what most people in America have.
In order to qualify for a subsidy, you must make between 100-400% of the poverty line (ie less than $28,725/year) and not be eligible for an employer sponsored health insurance plan (if you are offered insurance through your job).
If you meet these criteria, then sign up at healthcare.gov. If you don’t meet these criteria, or want more information about health care plans in general, consult a doctor and they will help you choose a plan based on your needs.
Step 2) Find out if you qualify for Obamacare
Under Obamacare, everyone is eligible for health insurance subsidies (with some exceptions), whether you have a job or not.
If you’re a low-income American and buy health insurance on your own, you may be eligible for financial assistance that can lower your monthly premiums and out-of-pocket costs.
The government will determine whether you qualify based on how much money you make each year, how many people are in your household, and where you live.
First thing’s first: Check out our comprehensive guide to find out if Obamacare is right for you.
Step 3) Apply for Obamacare through the Marketplace
The health insurance exchanges, a.k.a. Marketplaces, opened October 1, 2013 and went live November 1, 2013 as an online marketplace where you can purchase and compare your options before selecting a plan that best suits your needs and budget.
The Healthcare Marketplace is for those individuals who are not covered by health insurance or have been dropped from their current coverage because of pre-existing conditions.
You may also shop on the Marketplace if you do not get coverage from your employer or from a government program like Medicare or Medicaid .
If you are working full-time at least 30 hours per week and an average of 30 hours per week in 12 months out of any consecutive 12 month period, then your employer must offer affordable health insurance coverage.
Step 4) Decide which plan fits your needs
When you apply for subsidized health insurance, you’ll be asked a series of questions about your health and family status.
You’ll have four basic plans (Bronze, Silver, Gold and Platinum) from which to choose, each with varying levels of coverage.
For example, Bronze plans cover 60 percent of expected medical costs while Gold plans cover 80 percent.
Your plan selection will depend on your age, income level and current health status: Platinum is recommended only if you are currently in excellent health without any major ongoing issues or illnesses.
Step 5) Receive the confirmation by mail
When you receive a notice of eligibility, you must sign and return it by mail within 60 days.
Your subsidized health insurance will start on January 1 if you meet all these requirements: You live in California.
You are not already enrolled in Medicaid or Covered California. If you do not return your application, your coverage may be delayed until mid-March, which is a 30-day extension.
The deadline to apply for subsidized health insurance is December 15th at 11:59 p.m., but if there is any possibility that you may qualify, make sure you apply before then!
Step 6) Pay your first month’s premium on time
Federal subsidies are available only when you pay your first month’s premium by a specific date each year.
If you do not pay your premium by that date, then coverage will start on January 1 and there will be no retroactive subsidies.
Although penalties or fees may apply if you don’t comply with nonpayment rules, these cannot be paid with a federal subsidy.
Paying your first month’s premium in advance can help prevent coverage gaps and lapses, which could lead to missing an opportunity for future tax credits.
What are the income limits for healthcare subsidies 2021
The ACA’s exchange subsidies are only available to individuals and families whose income falls between 100 percent and 400 percent of poverty level.
In 2018, that ranges from $12,060 a year ($1,021 per month) for an individual up to $48,240 ($4,376 per month) for a family of eight.
The 2019 poverty level guidelines have not yet been published. If you’re considering subsidies, expect them to go down as incomes rise above 400 percent of poverty level.
And expect fewer people to qualify as income rises above 400 percent of poverty level or health insurance premiums rise in general — or both.
Free medical insurance for adults
The Children’s Health Insurance Program (CHIP) provides free or low-cost health insurance coverage to eligible children in working families.
The Affordable Care Act extended CHIP coverage for three years through 2019.
Adults with incomes up to 133 percent of poverty are also eligible if they don’t have access to affordable health insurance through their employer.
Both programs use Medicaid funding, so a state can offer both adult and child beneficiaries either Medicaid or CHIP.
If you are already enrolled in Medicaid, you do not need to fill out another application; your eligibility will be verified automatically.
What is the maximum income to qualify for free health care
Families with income below a certain level qualify for free or reduced cost health insurance coverage through Medicaid.
The Medicaid program operates in all 50 states, but each state sets its own rules.
There are no federal guidelines on how much you must earn per year to qualify.
However, in general, having an income that is less than 138% of the Federal Poverty Level (FPL) will likely result in your eligibility for some sort of assistance with health insurance costs.
Most states determine eligibility based on Modified Adjusted Gross Income (MAGI), which accounts for deductions such as child support and taxes.
How to get health insurance
The first step is to determine if you are eligible for subsidized health insurance.
The Affordable Care Act (ACA) provides tax credits and subsidies on a sliding scale based on your income and household size.
To see if you qualify, visit healthcare.gov/marketplace-enrollment/questions/.
If you do not qualify, use their subsidy calculator to determine how much it will cost per month based on your income.
You may also be eligible if your employer offers affordable coverage but it does not meet minimum standards of affordability as defined by regulations adopted by your state’s Department of Insurance.