The following is a helpful video for everyone interested in how the tax credit (APTC) is applied to any plan. Share with your friends, family, coworkers, and anyone who is a little (or a lot) confused as to how the Advance Premium Tax Credit works.
Remember, based on their applications, consumers may be eligible for:
A QHP without premium tax credit and/or cost-sharing reductions
A QHP with premium tax credit and/or cost-sharing reductions
QHP = Quality Health Plan
How the Advance Premium Tax Credit works:
Where can I get low-cost care in my community?
If you can't afford any health plan, you can get low-cost health care at a nearby community health center.Locate a community center near you using the following link:
How much you pay depends on your income. Community health centers are located in both urban and rural areas and provide:
general primary care
referrals to specialized care, including mental health, substance abuse, and HIV/AIDS
If the employer DOES offer coverage to part-timers
If you’re offered coverage through an employer, you may buy insurance through the Marketplace instead. But in most cases you won’t be able to get lower costs based on your income.
You would be eligible for lower costs only if the coverage your employer offers isn’t considered affordable to you or doesn’t meet certain minimum standards.
You can find out if your employer’s coverage is affordable and meets minimum standards by completing an Employer Coverage Tool.
Questions? Call 1-800-318-2596, 24 hours a day, 7 days a week. (TTY: 1-855-889-4325)
CATASTROPHIC PLANS for people 30 and over
People 30 and over who have received a hardship exemption may be able to buy a catastrophic plan. A catastrophic plan generally requires you to pay all of your medical costs up to a certain amount, usually several thousand dollars. Costs for essential health benefits over that are generally paid by the insurance company.To see the list of free preventive services go to: https://www.healthcare.gov/...
These policies usually have lower premiums than a comprehensive plan, but cover you only if you need a lot of care. They basically protect you from worst-case scenarios.
Marketplace catastrophic plans cover prevention
All Marketplace plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. This applies only when these services are delivered by a network provider.
In the Marketplace, catastrophic policies cover 3 primary care visits per year at no cost. They also cover free preventive benefits.
If consumer's income is under a specific amount, the following two options will help them afford coverage through the Marketplace:
Option 1 • Premium tax creditThere are rumors floating around claiming a spouse who is losing "her" healthcare from her employer cannot be added to "her husband's" healthcare from his employer because she is not a "dependent". The omission of the word "spouse" in the healthcare law is being interpreted as "children only" by many anti-Obamacare haters, and they are using it to scare people and generate additional anger within their followers. At this point I'm not sure how red states are taking advantage of this wording "glitch". So far California, who recognized the omission, has the following response:
Consumers must be aware that choosing to take more or less premium tax credit may impact the amount that is owed or refunded when they file federal income taxes.
Option 2 • Cost-sharing reductions
A discount that lowers the amount you have to pay out-of-pocket for deductibles, coinsurance, and co-payments. If consumers receive an eligibility determination and are eligible for cost-sharing reductions, they’ll need to select a Silver-level plan to receive the reductions.
I heard that CalPERS will be deleting spouses from members' health plans because of the Affordable Care Act (ACA). Is that true?
No. Although the ACA does not include a spouse in the definition of dependent, CalPERS currently allows a legally married spouse to be enrolled on a member's health plan. We do not plan to change that. http://www.calpers.ca.gov/...