What if you can’t afford a health plan?

When it comes to deciding to sign up for a health plan, you probably have many questions, especially about how you are going to pay for it. You’re not alone in wondering how to afford a health plan. As you check out your options, here’s some information about the resources available for you and your family to help pay for your coverage.

Prices of Health Plans
One of the first questions you may ask when shopping for anything is, “How much will this cost?”  You now have more choices when choosing health coverage under the Affordable Care Act.

The health care law helps many people pay for a health plan who may not have been able to before the law was put in place. Based on your income, family size and the health plan you choose, you may qualify for federal financial assistance. This could reduce – or even eliminate – your monthly premium. When you enroll, you’ll have a variety of plans to choose from based on your budget and health care needs. You will be able to see what your health plan will cost before you make a final decision to enroll.

The four levels of plans available during open enrollment: bronze, silver, gold and platinum, differ in the monthly premiums, the deductibles and other out-of-pocket costs, and the percent of services your plan covers. This chart shows the differences among the plans.

Affordable Health Insurance Plans

Paying Less for A Health Plan
Before you throw your hands in the air and say, “I cannot afford a health plan,” know that you might be eligible for financial assistance and you may be able to get lower monthly premiums and out-of-pocket costs based on your income, family size and the health plan you choose.

There are two ways you may get help paying for coverage: a premium tax credit and cost-sharing assistance.

  • How to afford health insuranceTax Credits: The premium tax credit, also referred to as a subsidy,  helps eligible people pay for their premiums, or the monthly cost of coverage. If you qualify, the credit can be paid in advance directly to your insurance company to lower your premium each month. If your income is lower than what is listed on the chart below, you may be eligible for a tax credit.
  • Cost-Sharing Assistance: If you qualify for a premium tax credit and your income is below $28,725, you may also be eligible for cost-sharing assistance. Most health plans have out-of-pocket costs that you pay when you get health care: a doctor visit, medical procedure, or test, for example. Cost-sharing assistance helps lower these costs. Depending on how much money you make, your health plan will pay a greater amount of health care costs, reducing what you pay out-of-pocket.

Penalties for Not Getting or Keeping A Basic Health Plan
Remember that the law requires most U.S. citizens and legal residents to get and keep a basic health plan.* If you don’t have a health plan in 2017, you may pay a fee of either 2.5% of your income or $695 per person, whichever is greater, on your 2017 income taxes.

If you have a plan, but do not pay your plan premium, you may lose coverage and may also have to pay penalties.

*A few groups/individuals are exempt, such as certain religious groups, American Indians and people who are incarcerated or in financial hardship.

Signing Up for Health Insurance
Open enrollment for you to have coverage in 2018 is November 1, 2017, through December 15, 2017. You have to sign up by December 15 if you want a plan that starts January 1, 2018.  Signing up for a health plan after this enrollment period will require qualifying for a special enrollment period. Otherwise, you will need to wait until the next open enrollment period to sign up for coverage starting in 2019.

Most recent update: 12/1/2017

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