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If you don’t have health insurance by 2023, you may still be able to get it through the public marketplace.
Open enrollment for the federal health care exchange ends Sunday and coverage is effective February 1. If your state operates its own exchange, you may have more time.
Most market enrollees (13 million up from 14.5 million in 2022) qualify for federal subsidies (technically tax credits) to help pay premiums. Some people may also be eligible for help with cost sharing, such as deductibles and copays on certain plans, based on their income.
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So far, nearly 15.9 million people have signed up through the exchange during this open enrollment, which began on November 1. Four out of five customers can find 2023 plans for $10 or less a month after accounting for those tax credits, according to the Centers. for Medicare and Medicaid services.
After the enrollment window closes, you will generally need to experience a qualifying life event, ie the birth of a child or marriage, to receive a special enrollment period.
For the most part, people who get insurance through the federal (or their state) marketplace are self-employed or don’t have access to insurance at work, or don’t qualify for Medicare or Medicaid.
Subsidies are still more generous than before the pandemic. The temporarily extended subsidies that were put in place for 2021 and 2022 were extended to 2025 in the Inflation Reduction Act, which was signed into law in August.
This means there is no income limit to qualify for the subsidies, and the amount someone pays in premiums is limited to 8.5% of their income as calculated by the exchange. Before the changes, the aid was generally only available to households with incomes between 100% and 400% of the federal poverty level.
The Marketplace subsidies you’re eligible for are based on factors including income, age, and the second-lowest-cost “silver” plan in your geographic area (which may or may not be the plan you enroll in).