Updated September 2024 ↓ Download PDF In general, an individual must not be eligible for minimum essential coverage (MEC) to be eligible for premium tax credits (PTC) in the marketplace, although there are a few exceptions. Being eligible for MEC means the insurance is available to the individual, even if they…
Updated September 2024 This Employer Coverage & Premium Tax Credit Eligibility Guide explains eligibility rules for individuals with offers of employer-sponsored coverage. It covers how to determine whether employer-sponsored coverage is affordable and minimum value, as well as special rules that reduce an employee’s required contribution. The guide also offers…
In this Beyond the Basics office hours session hosted on September 3, 2024, CBPP’s Jenny Sullivan and Allison Orris were joined by Lynn Cowles, Health and Food Justice Programs Manager at Every Texan and former Navigator program manager. They provided a brief refresher on the rules used to determine household…
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…
Updated August 2024 Eligibility for the premium tax credit is based on certain tax rules determining filing status and who is included in a tax household. This reference guide walks through the following: Who can be claimed as a tax dependent? Tax filing statuses and eligibility for the premium tax…
Updated August 2024 People who enroll in coverage through a health insurance marketplace must pay a monthly premium in order to effectuate and maintain their coverage. The following FAQ explains marketplace policies on premium payments, grace periods for people who do not pay premiums on time, and termination of coverage…
Updated August 2024 Insurers can no longer collect any past-due premiums from the last 12 months before allowing someone to enroll in a plan with the same carrier. The following FAQ explain what happens now if a person misses a premium payment. ↓ Download PDF What is a past-due premium? A…
Updated August 2023 Many non-citizens in the United States are eligible for health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), or subsidized plans in the Affordable Care Act (ACA) Marketplaces. In Healthcare.gov, non-citizens applying for coverage for themselves are asked to select from a drop down list of…
Updated August 2024 It’s possible to view marketplace plan premiums and other details without completing an application. This can be a helpful way for assisters to familiarize themselves with the plans available in their area and to create plan comparison tools to use with marketplace enrollees. This resource provides links to these…
What to Bring to An Appointment Checklist Use this outreach resource to help inform people of the information they will need to bring with them to an enrollment appointment. This will also help people who are enrolling on their own by informing them of the documents they should gather before…
