In this Beyond the Basics webinar presented on September 14, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, and Jen Wagner, Director of Medicaid Eligibility and Enrollment, detail the rules used to determine household size and explain what counts as income when determining eligibility for premium tax credits and Medicaid.
Most people who enroll in health insurance through the marketplace are eligible for financial help. Premium tax credits lower up-front monthly premiums and cost-sharing reductions lower deductibles, copayments, and other costs when people use their insurance.
Determining household size and accurately calculating income are key to determining whether someone is eligible for Medicaid or financial help in the marketplace. Tools to calculate income and self-employment earnings can help people complete their applications.
Certain circumstances, like having an offer of employer-sponsored insurance, might disqualify someone from financial help.
SEP Reference Charts
Generally, people can only enroll in a marketplace plan or switch plans on HealthCare.gov during the annual open enrollment period, which begins on November 1st each year. But people who experience certain life events during the year (such as getting married, losing job-based insurance, etc.) are able to newly enroll…
Part VIII Tying It All Together
In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on October 12, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, brings together all of the policies covered in our webinar series by walking through the HealthCare.gov application step-by-step. ↓ View Presentation Slides…
Part III Immigrant Eligibility
In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on September 24, 2021, in partnership with the National Immigration Law Center, Shelby Gonzales, Vice President for Immigration Policy, and Gabrielle Lessard, Senior Policy Attorney at the National Immigration Law Center, provide an overview of…
Part II The Premium Tax Credit
In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on September 16, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, provides an in-depth review of eligibility rules for premium tax credits—including how offers of employer-sponsored insurance can affect eligibility—as well as how…
Part I Households & Income
In this Beyond the Basics webinar presented on September 14, 2021, Tara Straw, Director of Health Insurance and Marketplace Policy, and Jen Wagner, Director of Medicaid Eligibility and Enrollment, detail the rules used to determine household size and explain what counts as income when determining eligibility for premium tax credits…
Yearly Income Guidelines and Thresholds
Eligibility for subsidies in the Marketplace is determined in part by using specific percentages and thresholds that are indexed and change each enrollment year. In addition, people who received advance premium tax credits (APTC) in the prior enrollment year will need to complete a tax return for that year and…
Premium Tax Credit Calculator
This calculator provides an estimate of the amount of financial help a person may be eligible for and how much they could expect to pay for health insurance on the marketplace. The information provided is based on premiums for 2022 plans and reflects the increase to premium tax credits in…
Income Calculation Worksheet (Available in 8 Languages)
This worksheet will help individuals add up their current monthly income and estimate their annual income for the following year. It will be particularly useful for people with multiple sources of income. This is a fillable worksheet, which means you can fill it out on your computer and email it…
Health Reimbursement Arrangements
In this Health Reform: Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on November 9, 2020, Tara Straw, Senior Policy Analyst, provides an overview of the various types of health reimbursement arrangements (HRAs) available and how they factor in to the HealthCare.gov application process. ↓…
Part IX Helping People with Disabilities
In this Health Reform: Beyond the Basics webinar presented on October 22, 2020, in partnership with the American Association on Health and Disability, Karl Cooper, Director of Public Health Programs at AAHD, addresses disability etiquette and basic accessibility considerations for anyone doing enrollment work. Karl also provides an overview of…