What is an Health Care Exchange?
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Public health insurance exchanges are used to buy individual and family health insurance plans that are compliant with the ACA-Affordable Care Act a.k.a obamacare (“individual and family” or “individual market” means health insurance that people buy on their own, as opposed to coverage that’s obtained through an employer or via a government-run program like Medicare or Medicaid).
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People who are eligible for Medicaid based on their income can enroll in Medicaid via the exchange in their state. Depending on the state, this can either be done entirely through the exchange, or the exchange will direct them to the state Medicaid office once a preliminary eligibility determination indicates that they’re likely eligible for Medicaid.
Who Qualifies?
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All U.S. citizens and legally present residents who are not imprisoned and not enrolled in Medicare are eligible to purchase a health plan in the exchange in the state in which they live. Illegal immigrants CANNOT enroll in coverage through the exchanges, even without premium subsidies.
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In some states, small businesses can also purchase coverage in the exchange (in most states, this is limited to businesses with up to 50 employees). Note that in states that use HealthCare.gov’s small business exchange, the exchange is no longer handling enrollment, and is having businesses enroll directly with insurers instead. Some of the state-run exchanges are also using this approach, so on-exchange availability of small group health coverage is fairly limited.
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Even if you think you might be eligible for a premium subsidy but aren’t sure due to fluctuations in your income, you’ll want to consider buying a plan through the exchange. You can pay full price and then go back later and claim the subsidy (since it’s really just a tax credit) on your tax return. But you can’t do that if you bought your plan off-exchange.
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Most plans DO NOT offer additional benefits which should be purchased individually (e.g. dental, hearing and vision.)
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Eligibility for enrollment is not affected by medical history or pre-existing condition
Why choose Basta Executive Services, LLC:
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Using a broker gives you the power to compare and freedom to choose a plan that fits your individual needs.
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As licensed agents, we shop around for the best plan that will cover you and your loved ones, but most important keep you within your budget.
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With so many choices it is much easier to have one point of contact that can help you review all that is available.
Our team of highly skilled licensed insurance specialists will work with you to set you up with the right plan, or whether you qualify, please fill out the form below today and one of our licensed agents in your area will contact you.