All ACA-qualified (Obamacare) health insurance policies 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. Click “See The List” below. Be sure to click on “For all Adults”, “For Women” and “For Children” to see entire list.
COVID-19 Special Enrollment period begins on February 15, 2021 and ends on August 15, 2021
On March 23, 2021, C.M.S. extended the COVID-19 Special Enrollment period to 6 months. This Special Enrollment period began on February 15, 2021 and has now been extended to August 15, 2021. During this Special Enrollment period you can purchase ACA-qualified (Obamacare) health insurance on a guaranteed issue basis (no preexisting condition exclusions and no health questions) even though the annual Open Enrollment period ended on December 15, 2020. Advance Premium Tax Credits are increasing significantly on April 1, 2021 due to the passage of the “American Rescue Plan“. Depending on your income, you may find a more affordable plan even if you already have a plan with a subsidy. New improvements for 2021 include the addition of the entire Northwestern Medical Group into the Blue Choice Preferred PPO network. Northwestern will not accept the Blue Cross Individual HMO plans. Please click “Shop for ACA-qualified (Obamacare) plans” below. You will then be able to pick a plan, get your subsidy and finish the entire process much faster than working solely with Healthcare.gov. You can also purchase ACA-qualified plans without a subsidy using the same link.
Determining your eligibility for one or more federal subsidies
Depending on what you expect your 2021 total household MAGI – Modified Adjusted Gross Income (after deductions but before taxes) will be, you may qualify for an APTC – Advance Premium Tax Credit (federal subsidy) to lower your premiums. You may also qualify for CSR – Cost Sharing Reduction – to lower your deductible, if you purchase a Silver plan.
Regulatory update: For the first time ever, the health insurance exchanges are open to all applicants from February 15th until August 15, 2021. Also, from April 1, 2021 until December 31, 2022, health insurance subsidies will be dramatically higher and millions more will qualify due to the passage of The American Rescue Plan. The Traditional “Subsidy Cliff” of 400% of the F.P.L. – Federal Poverty Level (the point where one can no longer qualify for subsidies) has been nearly eliminated, especially for those above the age of 55. To determine your subsidy amount, please click here to use the new calculator provided by the Kaiser Family Foundation. Be sure to enter your state, zip code and county at the top before using the tool. Neither Healthcare.gov nor our state based exchanges have these numbers yet because The American Rescue plan just became a law on March 13, 2021. Hopefully, by April 1, 2021, the exchanges and the insurance company quote portals will be up and running. Those who already have subsidized plans will also be eligible for retroactive adjustments to their existing subsidy amounts back to January 1, 2021.
Basically for a two year period from January 1, 2021 (via retroactive reimbursement for existing policyholders) through December 31, 2022, no one eligible for subsidies will pay more than 8.5% of their M.A.G.I. – Modified Adjusted Gross Income – for health insurance if they choose the second lowest cost Silver plan available in their area. Many will pay much less than 8.5% depending on where their income falls within the F.P.L. – Federal Poverty Level chart below. For example, if your 2021 estimated M.A.G.I. is between 138% and 200% of the F.P.L. you will pay no more than 2% of your income for health insurance. If you’re between 200% and 250% of F.P.L. you will pay no more than 4% of your income. If you’re between 250% and 300% of F.P.L. you will pay no more than 6% if your income. If you’re between 300% and 400% of F.P.L. you will pay no more than 8.5% and (this changes everything) if your income is much higher than 400% of the F.P.L., you will still only pay 8.5% of your income for health insurance. That last part effectively ends the “subsidy cliff” which is the point where one could not qualify for a subsidy back in 2020.
On April 28, 2021 the Biden administration revealed details pertaining to the new “American Families Plan“. This additional spending bill will make the enhanced subsidies under the American Rescue Plan permanent.
All of these percentages are retroactive back to the start of 2021. To see if you qualify click the graphic below:
Please note: If you expect that your M.A.G.I. – Modified Adjusted Gross Income will be lower than 138% of the Federal Poverty Level, you will be eligible for Medicaid and as such will not be able to qualify for subsidized private health insurance. You can purchase private health insurance even if you qualify for Medicaid but you must do so at full price without a Federal subsidy. Click the chart below to determine the current Federal Poverty Level and percentages above it.
Please also note: If you qualify for a federal health insurance subsidy and your state has expanded SCHIP – State Children’s Health Insurance Plan – you may not be able to insure your children on your policy. Healthcare.gov will instead send a referral to your state’s SCHIP program. In Illinois, that program is entitled “All Kids Covered“. You may wish at that juncture to purchase private health insurance at full price for your children instead if you cannot find a Pediatrician who will accept “All Kids Covered”.
On January 28, 2021, C.M.S. announced a 90 day Special Enrollment perioddue to COVID-19 which begins on February 15, 2021 and ends on May 15, 2021. During this Special Enrollment period you can purchase ACA-qualified (Obamacare) health insurance on a guaranteed issue basis (no preexisting condition exclusions and no health questions) even though the annual Open Enrollment period ended on December 15, 2020. Advance Premium Tax Credits are increasing significantly on April 1, 2021 due to the passage of the “American Rescue Plan“. Depending on your income, you may find a more affordable plan even if you already have a plan with a subsidy. New improvements for 2021 include the addition of the entire Northwestern Medical Group. Northwestern will not accept the HMO plans. To shop for 2021 ACA (Obamacare) Individual and Family health insurance policies from Blue Cross Blue Shield of Illinois, click get quotes below.