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November 1 marked the primary day of the Marketplace Open Enrollment Period in most states. CHIR up to date its Navigator Resource Guide simply in time for the annual enrollment window. The Navigator Guide, supported by the Robert Wood Johnson Foundation, supplies an easy-to-use on-line useful resource for assisters, together with over 300 searchable steadily requested questions (FAQs), truth sheets for all 50 states and DC, and an “Ask an Expert” function.
During Open Enrollment, we’ll spotlight FAQs from the Navigator Guide about Marketplace eligibility, enrollment, monetary help, and different frequent questions that come up all through the signup course of. This week, we’re having a look at who’s eligible for Marketplace plans.
Who should purchase protection within the Marketplace?
Most folks can store for protection within the Marketplace. To be eligible it’s essential to stay within the state the place your Marketplace is, you should be a citizen of the U.S. or be lawfully current within the U.S., and it’s essential to not at present be incarcerated.
Not everyone who’s eligible to buy protection within the Marketplace might be eligible for subsidies, nonetheless. To qualify for subsidies folks should not be eligible for sure different kinds of protection, similar to Medicare, Medicaid, or an reasonably priced employer plan. (45 C.F.R. § 155.305; 26 U.S.C. § 36B(c).)
I’m eligible for well being advantages at work, however I need to see if I can get a greater deal within the Marketplace. Can I do this?
Assuming you meet different eligibility necessities, you may store for protection on the Marketplace throughout open enrollment or a particular enrollment interval if eligible, however you probably have entry to job-based protection, you may not qualify for premium tax credit.
When persons are eligible for employer-sponsored protection, they will solely qualify for Marketplace premium tax credit if the employer-sponsored protection is unaffordable. The method that is calculated, protection is unaffordable provided that your price for protection for a single individual beneath the employer plan is greater than 8.39 p.c of your family earnings in 2024 (for 2023, it’s 9.12 p.c of family earnings). (IRS Rev. Proc. 2023-29.)
Can I purchase a plan within the Marketplace if I don’t have a inexperienced card?
Potentially, sure. In order to purchase a Marketplace plan, it’s essential to have a qualifying immigration standing, similar to everlasting residency (inexperienced card), sure kinds of visas, or refugee standing. You can discover extra details about qualifying statuses right here.
If you aren’t lawfully current within the U.S., you aren’t eligible to purchase a plan on the medical health insurance Marketplace. However, you may store for particular person medical health insurance exterior of the Marketplace and a few states could give you monetary help, relying in your earnings. To get hold of protection, contact a state-licensed medical health insurance firm or a licensed agent or dealer. Your state Department of Insurance can assist you discover one. (45 C.F.R. § 155.305.)
Open Enrollment runs via January 15 in most states. Stay tuned for added FAQs of the week and take a look at the Navigator Resource Guide for much more FAQs and useful assets.