The Affordable Care Act (ACA) has arrived: there are no health questions or preexisting condition restrictions, and most people are eligible to receive subsidies and cost-sharing plans, but what does this mean for you? These terms and regulations directly relate to the ACA and affect those who are eligible to get help paying the required premiums, but also those who choose not to obtain insurance.
For low-income families, the ACA has some helpful provisions. Any family whose income falls within 100-400% of the federal poverty line is allowed a tax credit (also known as a subsidy) that will help offset some of the premium costs. Families who are 250% below the poverty line are eligible to receive an additional cost-sharing benefit, which will contribute to reducing the out-of-pocket expenses (such as deductibles and copays).
Off Exchange Individual Family Health Insurance Policy
Off-Exchange health insurance policies typically are not qualified for financial assistance. Under Obamacare, individuals who are not eligible for or want a subsidy, but who want to steer clear of the tax penalty, can purchase major medical health policies that meet ACA policy requirements on or off of government-run state exchanges.
An off-exchange plan is merely a health insurance plan that is obtained straight from the company or by an agent or broker, outside of the state health insurance exchange. Still, if you know that you won’t receive financial assistance in the exchange, you’ll want to contemplate exchange options as well as off-exchange plans to find the policy that best suits you. The ACA has enhanced the standard of coverage in the individual market and has also broadened the choices widely available for many people, thanks to guaranteed issue health insurance policy and subsidies.
On Exchange Individual Family Health Insurance Policy
The primary distinction between an on-exchange and off-exchange health plan is where the consumer carries out his or her application. If the enrollment for the medical plan is done within a government-run marketplace for insurance, it is called an on-exchange health plan.
If the enrollment does not occur within the government-run marketplace for insurance, it is known as an off-exchange health plan. If one makes less than 400% of the National Poverty level (and don’t have access to employer-based insurance coverage) than it is an easy decision, using the Health Insurance Marketplace may well lead to massive reductions in premium and cost sharing.