The Affordable Care Act has offered a practical way for many Americans to access health care for over a decade. However, new regulations and eligibility updates can make it challenging to understand what you qualify for, which is why many people get the assistance of a
health insurance broker in Santa Rosa.
Still, it never hurts to educate yourself about your options before discussing things with a professional. Take a look at this quick breakdown of the ACA guidelines for 2024 and how a broker can help.
How a Health Insurance Broker in Santa Rosa Guides You Through Using Subsidies
This breakdown can only scratch the surface of ACA subsidy essentials. Still, you’ll notice significant updates, some of which could change or expire in the future with new administrations.
Navigating these ever-changing statutes can become confusing, but it doesn’t have to be. Just as you rely on dedicated professionals for guidance in other matters, your broker can help you understand your options for health insurance. Then, you’ll work together with your health insurance broker in Santa Rosa to get the right deal for your family by maximizing the available subsidies.
The General Guidelines for ACA Subsidies
Like many government benefits, your annual household income determines your eligibility. With the ACA, you compare your estimated 2024 income with the “benchmark” plan — that’s the next-to-lowest-cost Silver plan on the Health Insurance Marketplace.
You qualify for a subsidy if that plan exceeds a particular percentage of your modified adjusted gross income. Currently, that percentage
is 8.5%.
That subsidy can initially come to you through reduced insurance premiums. Once you share your projected household income, the government offers a Premium Tax Credit that discounts your rate to no more than 8.5% of your income. However, if you overestimate your income, whatever you paid in excess will be a credit that reduces your tax burden or comes back to you as a refund.
How You Calculate Your Modified Adjusted Gross Income
Remember, the government doesn’t look at the adjusted gross income you put on your tax return. Rather, you calculate
your MAGI, which is a modified value. To get this number, you start with your AGI but add any tax-exempt Social Security benefits. You also add any money you excluded as tax-exempt interest or foreign income.
Understandably, you might worry about calculating this figure correctly. Fortunately, a health insurance broker in Santa Rosa walks you through the process to help you not miss out on the subsidies you are due.
Important Changes to the Law
A few pieces of legislation recently expanded the number of individuals who are eligible for subsidies. Therefore, do not assume that you don’t qualify, even if you weren’t eligible in recent years.
For example, the
American Rescue Plan temporarily removes the restriction for subsidies from higher-income households. Before 2021, you couldn’t get a subsidy if your income was more than 400% of the Federal Poverty Level. Now, you can generally get a subsidy for Silver plans when the cost exceeds 8.5% of your income, no matter how much you earn.
Furthermore, the plan allows those receiving unemployment benefits to get low-cost or even free low-deductible plans. People with lower incomes (below 150% of the FPL) can access no-cost plans.
Also, a member of your household can get plans through the marketplace, even if you have an employer plan. Such flexibility allows you to tailor a solution that fits your family, and a qualified health insurance broker in Santa Rosa will help.
Other Options for Coverage
Your income might be too high or too low to get a plan from the Marketplace. For instance, those with earnings below 100% of the FPL don’t qualify. However, these households typically qualify for free care through Medicaid.
If your income is so high you don’t qualify for a subsidy, you shouldn’t just pick a plan on the exchange. Talk to your broker about private plans that offer the same (or better) benefits for a lower price. Likewise, senior citizens should look at Medicare coverage and determine whether dual coverage with an ACA plan or private insurance would be beneficial.
Get Matched With the Right Plan Using a Health Insurance Broker in Santa Rosa
As you can see, the rules for 2024 vary from previous years. It may be possible for you to get a better deal on health insurance for your family, but you have to understand the regulations and guidelines.
Instead of spending hours agonizing over these rules, let us help. Our team at Sackett Insurance is ready to be your health insurance broker in Santa Rosa. For more information, don’t hesitate to
contact us so we can help you get the subsidies you deserve.