This November 1 reopens the federal health insurance market and state markets with more opportunities than ever to receive help paying premiums for medical plans.
It is a historic moment during which people who do not yet have health coverage can buy it cheaply or even for free, thanks to an extension of subsidies, which can now be accessed by families with moderate to medium incomes, to which they still have a hard time paying their monthly insurance premiums.
The market’s open enrollment period on the federal platform healthcare.gov (healthcare.gov) runs from November 1, 2021 to January 15, 2022. Consumers who enroll before midnight on December 15 can get coverage for a full year, beginning January 1 .
This year, the Centers for Medicare & Medicaid Services (CMS) is focusing on increasing access to health care, with strong outreach and education efforts to reach consumers with information about the opportunity to enroll or re-enroll in coverage. From the market.
The CMS have also committed to raising awareness of low-cost plans by 2022, as a result of the American Rescue Plan, the law that the Biden administration enacted to overcome the crisis generated by the pandemic, which left millions unemployed and without health insurance. .
For this, an additional $ 11.5 million fund was established to support the grassroots work of 70 community organizations where navigators work, culturally competent personnel who help consumers, including millions of Latinos, obtain health coverage.
This time frame means 30 days longer than what the Trump administration offered, which had limited the enrollment window to 45 days.
Although millions have obtained health insurance since the ACA was enacted, many of them for the first time in their lives, as of 2021 still 10% of the nation’s population ages 19-64 do not have health coverage.
This percentage is higher among Latino and communities of color, especially young adults, under 50 years of age.
To continue to exceed enrollment goals, CMS will relaunch the “Champions for Coverage” program, which currently includes more than 1,000 community organizations across the country that work with the community, educating about health insurance. and helping with registration. The goal: to connect the community, especially in unprotected, urban and rural areas, with medical coverage, and close health disparities.
For consumers who want to purchase insurance in 2021, there will be more than 1,500 browsers available on the federal platform.
As part of this effort, CMS will also implement a special period each month exclusively for low-income enrollment, who will get free or extremely affordable plans. This alternative has the financial support granted by the American Rescue Plan.
How much does insurance cost in 2021?
With the plan approved by the Biden government to help with the pandemic, the percentage of financial aid or subsidy increases in relation to previous years. For instance:
- Family of 4, living in Jersey City (NJ) with two children (10 and 12 years old). Total household income is $ 106,000 per year, which represents 405% of the poverty level.
This family of 4 now receives an estimated subsidy of $ 614 ($ 7,362 annually) to cover insurance costs.
The cost of a silver plan in NJ for this family will now be $ 751 per month.
Without subsidy, this family would have to pay every month $ 1,364. That is, you are now receiving a subsidy that covers 45% of the total cost of a silver plan, in this example.
In 2020, before the rescue plan approved by President Biden, this family with that income did not qualify for a grant.
If you want to calculate how much you would have to pay for your health insurance and that of your family in the state where you reside, you can use this updated subsidy calculator or call this toll free number: 1-888-553-8283
What is the federal poverty level?
The Federal Poverty Level (FPL) is a measure of income level issued annually by the Department of Health and Human Services (HHS).
Federal poverty levels are used to determine an individual’s eligibility for certain programs and benefits, including insurance market savings and Medicaid and CHIP coverage.
Once the person knows they are eligible for a Marketplace plan, they will have to choose between different Qualified plans such as Metals, Bronze, Silver, Gold, and Platinum, which have different costs and deductibles. In general, the rule is, the higher the monthly premium, the less the deductible (what you pay out of pocket for certain services until the insurer begins to pay).
It’s very important to figure out your options, because depending on the area you live in and your income, your health plan could cost you as much as $ 0.
Another novelty: also as part of this national plan, and so that people have many options to enroll, for the first time, the CMS will offer the states that use the federal platform the possibility of setting their own enrollment dates, as long as when they meet the initial 45 days, and extend beyond December 15. In other words, states cannot establish shorter periods.
Health insurance in your state
There are 36 states that use the federal platform. Are:
- Alabama, Alaska
- Arizona, Arkansas
- North Carolina, South Carolina
- North Dakota, South Dakota
- Delaware, Florida
- Georgia, Hawaii
- Illinois, indiana
- Iowa, Kansas
- Kentucky, Louisiana
- Maine, Michigan
- Mississippi, Missouri
- Montana, Nebraska
- New Hampshire, New Mexico
- Ohio, Oklahoma
- Oregon, Tennessee
- Texas, Utah
- Virginia, West Virginia
- Wisconsin, Wyoming
In addition to the District of Columbia, the 14 states that manage their own health insurance marketplaces are:
- New Jersey
- New York
- Rhode Island
Why you should have health insurance
The following are at least 7 compelling reasons why you should have health coverage:
1) The pandemic. COVID-19 impacts more cruelly on people with pre-existing conditions. Those living with hypertension, heart disease, diabetes, and other chronic conditions are at higher risk of developing a more serious form of covid, and of dying from the infection. Today it is more important than ever to get medical care (not delay) to get pre-existing conditions under control. This is easier with health insurance.
2) Astronomical accounts. Health insurance can be expensive, but not having it can cost a lot more. An accident, a fracture, the diagnosis of a heart condition, high cholesterol, hypertension, a skin rash, an asthma attack, your child’s fall while riding a bike, can trigger unexpected visits to the doctor and a cataract of difficult medical bills. to pay.
3) Help paying. Your health insurance pays for your preventive medical expenses, and for other medical expenses in general when you have already reached the limit of your deductible (what you must pay out of your own pocket before the insurer begins to pay).
4) Family prevention. When all family members have health insurance, they tend to get more preventive care, get yearly checkups, and get the required shots and flu shots. If you have a medical situation or emergency and you do not have health insurance, the person will probably end up in an emergency room, which is much more expensive, either for your own pocket if you have the ability to pay that bill, or for the hospital if it has to absorb that expense.
5) Free care. When you have health insurance, by law you can get vaccinations and preventive checkups at no cost, even before you reach your deductible.
6) Belong to a network. By having insurance, you pay less when you receive care from health providers who are part of your medical plan, even before you reach your deductible.
7) Collective benefit. When a person pays for health insurance, the money from the premiums goes into a kind of pool that the insurer uses to pay for the medical expenses of its members. A healthy person spends less and, obviously, a person with medical conditions, more. That balance, which constantly changes because someone healthy can get sick, helps keep premiums (monthly payments) from increasing, as well as contributing to common health and well-being.
The help you need
Remember that health insurance gives you the peace of mind that in the event of any eventuality, accident or emergency, you and your family will have access to the best health professionals.
There are different ways to enroll in health insurance. The easiest thing to do is contact an agent to help you. You can call HolaInsurance at +1 (888) 258-7476. Help is provided here in Spanish.
You can also ask an agent to contact you.
Enter your information here and an agent or broker registered in the Insurance Market will speak directly with you.