Health Insurance Blog - Healthcare.gov
2 steps to 'reconcile' your premium tax credit on 2018 taxes
Thu, 21 Mar 2019 00:00:00 -0400

If you had a Marketplace plan and used advance payments of the premium tax credit (APTC) to lower your monthly payment, you’ll have to "reconcile" when you file your 2018 taxes.

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Step 1: Check Form 1095-A for accuracy

Make sure your coverage and household information on your Form 1095-A is correct. If anything is wrong, contact the Marketplace Call Center.

Also, check your SLCSP by looking at Part III, Column B of your 1095-A, titled “Monthly second lowest-cost Silver Plan (SLCSP) premium.”

The SLCSP premium is incorrect if:

  • Part III, Column B has a “0” or is blank for any month someone in your household had the Marketplace plan.
  • You had changes in your household that you didn’t report on your Marketplace application — like having a baby, moving, getting married or divorced, or losing a dependent.

If either situation applies to you, use our tax tool to get your correct SLCSP premium.

Step 2: “Reconcile” your 2018 taxes

Now that you've made sure your SLCSP premium is correct and your coverage and household information is accurate, you’re ready to file.

How to check your Form 1095-A
Thu, 07 Mar 2019 00:00:00 -0500

If anyone in your household had Marketplace health insurance in 2018, you should have already received Form 1095-A, Health Insurance Marketplace Statement, in the mail.

Image: {Woman reviews Form 1095-A to file taxes at computer}

Before you file: 3 things to know about Form 1095-A

  • If you can’t find your 1095-A, check online. If your form didn’t come by mail or you can’t find it, check your online Marketplace account. When you follow these steps, be sure to choose your 2018 application, not your 2019 application.
  • Before you file, make sure your 1095-A is correct. Check basic health plan and household member information, and verify the premium for your second lowest cost Silver plan (SLCSP). If you find errors, contact the Marketplace Call Center. Don’t file your taxes until you have an accurate form.
  • You’ll use the information from your 1095-A to “reconcile” your premium tax credit. Once you have an accurate 1095-A and second lowest cost Silver plan premium, you’re ready to fill out Form 8962, Premium Tax Credit, and “reconcile.” You’ll compare the amount you used in 2018 to lower your monthly insurance payment with the actual premium tax credit you qualify for based on your final 2018 income. Get a step-by-step guide to reconciling.
Do you qualify for a Special Enrollment Period?
Thu, 21 Feb 2019 00:00:00 -0500

You can now enroll in or change a Health Insurance Marketplace plan only if you have a life event — meaning a change in your situation, like getting married, having a baby, or losing health coverage — that qualifies you for a Special Enrollment Period.

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Life changes that may qualify you for a Special Enrollment Period

  • There are 4 basic types of qualifying life events: loss of health coverage, household changes, residence changes, and other qualifying events, like income changes that may affect your coverage options.
  • See the full list of all qualifying life events.

How to apply with a Special Enrollment Period

Learn more about getting 2019 Marketplace health coverage with a Special Enrollment Period.

Need to submit documents to confirm a life event?
Thu, 07 Feb 2019 00:00:00 -0500

If you’re eligible for a Special Enrollment Period to enroll in or change plans for 2019, you may be asked to provide documents to confirm the event that makes you eligible.

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Do I need to submit documents?

  • You’ll learn if you have to provide documents after you submit your application.
  • Details and instructions appear on your eligibility results screen and in a notice you can download or get in the mail.
  • If your eligibility results don’t say you need to, just pick a plan and enroll.

What document types can I provide?

How long do I have to send documents?

  • After you pick a plan, you have 30 days to send documents.
  • While your coverage start date is based on when you pick a plan, you can’t use your coverage until your eligibility is confirmed and you make your first premium payment.
3 things to know about 2018 taxes & Marketplace insurance
Thu, 31 Jan 2019 00:00:00 -0500

2018 tax filing season starts January 29, 2019. You must report information about your 2018 health coverage when you file. If you had Marketplace health insurance in 2018, check out these 3 tips:

Image: {Woman sits at computer with calculator, prepares to file taxes}

Keep an eye out for Form 1095-A

Make sure your Form 1095-A is correct

  • If anything about your coverage or household is wrong, contact the Marketplace Call Center.
  • Also, make sure the information about the “second lowest cost Silver Plan” (SLCSP) is correct.
  • Don’t file your taxes until you have an accurate 1095-A.

Get help, step-by-step instructions & tax forms

{% box %} IMPORTANT: Didn’t have health insurance in 2018?

If you could have afforded health insurance in 2018 but chose not to buy it, you may have to pay a fee when you file taxes this year. But starting with the 2019 plan year (for which you’ll file taxes in 2020), the fee no longer applies. {% endbox %}

3 ways to use your new Marketplace coverage
Thu, 17 Jan 2019 00:00:00 -0500

Now that you’re enrolled in a health plan for 2019, you can use your new coverage for regular and emergency care, prescription drugs, and preventive care.

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Getting regular & emergency care

  • You usually pay the lowest costs for services when you see a doctor who has a contract with your health plan. Visit your health plan’s website and check their provider directory to see which doctors are covered.
  • In an emergency, you should get care from the closest hospital. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital.

Getting prescription medications

  • Your health plan will help pay the cost of certain prescriptions. Visit your insurer’s website or review your plan’s Summary of Benefits and Coverage to see which prescriptions are covered by your new Marketplace plan.
  • Different health plans allow you to get your medications from different pharmacies. Call your insurance company or visit their website to find out if your regular pharmacy is in-network.

Getting free preventive care

Get more information on using your new coverage.

Ring in the New Year with free preventive services
Thu, 03 Jan 2019 00:00:00 -0500

Starting in 2019, take advantage of the free preventive services — like flu shots and screening tests — available with your Marketplace plan.

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What are preventive services?

  • Preventive services are routine health care procedures that include screenings, check-ups, and counseling to prevent illnesses, disease, and other health problems. These services can help detect illness early when treatment is likely to work best.
  • Preventive services are free when delivered by a doctor or other provider in your plan’s network.
  • Visit your health plan’s website and view their provider directory for a list of the doctors, hospitals, and other health care providers that your plan contracts with.

What services are covered?

Get more information on preventive and wellness services and chronic disease management.

See if you may still qualify for 2019 insurance
Thu, 03 Jan 2019 00:00:00 -0500

For most people, the deadline to enroll in 2019 health insurance has passed. But there are two ways you may still be able to get 2019 coverage:

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Through Medicaid or the Children’s Health Insurance Program (CHIP)

  • Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
  • If eligible, your coverage can start right away, any time of year. Medicaid and CHIP don’t have Open Enrollment Periods.
  • Learn more about Medicaid and CHIP, including how to apply.

Through a Special Enrollment Period

  • Outside Open Enrollment, you may qualify for a Special Enrollment Period if you have certain life events, like losing health coverage, moving, getting married, having a baby, or adopting a child.
  • If you qualify, you usually have up to 60 days following the event to enroll in or change a plan.
  • Not sure your life event makes you eligible? Just answer a few fast questions to find out.
Pay your premium: Make sure your coverage starts January 1
Thu, 20 Dec 2018 00:00:00 -0500

Now that you’ve enrolled in 2019 Marketplace insurance, you must pay your monthly premium for your coverage to start. You pay your premiums directly to the insurance company.

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How to pay your premium

Each insurance company handles premium payments differently. Follow your plan’s instructions about how and when to pay your premium. Make sure you continue your monthly payments. If you don’t, the insurance company could end your coverage.

You may be able to pay your monthly premium online at HealthCare.gov. Follow these steps:

  1. Log in to your Marketplace account.
  2. Click your name in the top right, and select "My Applications & Coverage." Choose your application under "Your Existing Applications."
  3. Click the blue button "Pay Your First Health Insurance Monthly Premium."
  4. If online payment is available, choose the green button "Pay for Health Plan Now" to go to your insurance company’s website to pay.

If your health insurance company doesn't accept online payment, they should have contacted you with next steps. Reach out to them if you haven’t received details on how to pay or aren’t sure if you paid.

Learn more about completing your enrollment by paying your premium.

2019 Open Enrollment is over, but you may still have options
Sun, 16 Dec 2018 00:00:00 -0500

If you missed the Open Enrollment deadline and didn’t enroll in 2019 Marketplace health insurance, you may still be able to get coverage for 2019 two ways:

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Enroll in or change 2019 plans with a Special Enrollment Period

  • If you experience certain life changes, like losing health coverage, getting married, or having a baby, you may be eligible for a Special Enrollment Period. This means you may be able to sign up for health insurance at other times during the year.
  • See the full list of life events that may qualify you for a Special Enrollment Period.
  • Not sure whether your life event qualifies? Answer a few questions to find out.

Apply for Medicaid or the Children’s Health Insurance Program (CHIP) any time of year

  • Medicaid and CHIP provide free or low-cost health coverage to millions of Americans, including some people with limited income, families and children, pregnant women, the elderly, and people with disabilities.
  • If you qualify, your coverage can start right away, any time of year.
  • Learn how to apply for Medicaid and CHIP.
Time’s running out for 2019 Marketplace insurance
Thu, 06 Dec 2018 00:00:00 -0500

Open Enrollment for 2019 Marketplace insurance ends next Saturday, December 15. This means you have just over one week to enroll in, re-enroll in, or change a 2019 Marketplace plan.

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Beat the December 15 deadline

  • First time applying at HealthCare.gov? Create an account.
  • Have 2018 Marketplace insurance? Log in to update your application and compare plans for 2019. If you don’t, you may be automatically re-enrolled for January 1, but you'll miss out on other options. New plans may be available, and your financial assistance may not be correct.

Questions? Help is available

Important: Update & compare plans by December 15
Thu, 29 Nov 2018 00:00:00 -0500

You can renew, change, or update your Marketplace plan for 2019 until December 15, 2018. That’s about 2 weeks away! If you don't update your application and enroll in a plan by the deadline, you may be automatically enrolled in a 2019 plan. While automatic enrollment is a good fallback, you may want to choose another option.

Image: {Man uses computer to update his application and compare plans online}

Log in, update & compare

  • Log in to your HealthCare.gov account to update your application with your expected 2019 income and household information.
  • Compare your current plan with other available 2019 plans. You may find a new 2019 plan with coverage and features that better meet your needs — especially if you’re expecting income or household changes.
  • Even if you want to keep your same plan, we strongly recommend that you update your information and check out all the plans available to you. If you don’t, you could miss out on savings and a plan better suited for your lifestyle.
  • Learn more about changing and renewing coverage for 2019.
3 reasons to enroll in 2019 Marketplace coverage
Wed, 21 Nov 2018 00:00:00 -0500

Staying healthy is important. This Thanksgiving, give yourself the peace of mind that comes with having health insurance. You have until December 15, 2018 to enroll in or change health insurance for 2019.

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Why bother with health insurance?

  • Health insurance provides financial protection in case you have a serious accident or illness. For example, a broken leg can cost up to $7,500. Health coverage can help protect you from high, unexpected costs.
  • With Marketplace coverage, you’ll get access to preventive services — like shots and screening tests — at no cost to you. Getting recommended preventive services is a key step to good health and well-being.
  • When you apply for insurance using the Health Insurance Marketplace, you’ll find out if you qualify for savings that can make insurance less expensive. Before you apply, select your household size, state, and income range to see if you may qualify for financial help.

Ready to apply? See the different ways to apply for 2019 health insurance.

2019 Open Enrollment ends in one month!
Thu, 15 Nov 2018 00:00:00 -0500

Attention: Open Enrollment ends December 15, 2018. You have just one month to enroll in or change Marketplace health insurance for 2019.

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Take action & apply

Questions? Help is available

Get a quick idea of 2019 savings and costs
Wed, 07 Nov 2018 00:00:00 -0500

You have until December 15, 2018 to enroll in or change 2019 Marketplace health insurance. Before you apply, get a quick idea of what your costs may be.

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Is your income in the range to save?

Ready to apply?

Open Enrollment for 2019 Marketplace coverage is here!
Thu, 01 Nov 2018 00:00:00 -0400

Starting today, you can apply for new 2019 health insurance — or renew, change, or update your 2018 health plan for 2019.

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Important dates

Before you apply: Preview plans & get ready

Ready to apply now? See the different ways to apply for 2019 health insurance.

Preview 2019 plans & prices today
Thu, 25 Oct 2018 00:00:00 -0400

November 1–December 15, 2018, is when you can enroll in or renew a 2019 plan. Get a head start, and preview 2019 plans with personalized price estimates right now.

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How to preview 2019 plans and prices

  • Answer a few brief questions about your estimated 2019 income and household to see available health insurance plans and estimated prices.
  • Not sure how to estimate your income? Learn how.
  • You’ll see exact prices later when you fill out or update your Marketplace application.

More on 2019 Open Enrollment & plan shopping

Find out what Marketplace health plans cover
Thu, 11 Oct 2018 00:00:00 -0400

All Marketplace plans cover the same set of essential health benefits, preventive care, and pre-existing conditions. Starting November 1 you can enroll in or renew a plan for 2019, so you’ll continue to have access to these benefits.

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What are essential health benefits?

  • Essential health benefits are a set of 10 categories of services — including doctor's visits, inpatient and outpatient hospital care, prescription drugs, pregnancy and childbirth, mental health, and more — that health insurance plans must cover.
  • Plans must also offer birth control and breastfeeding coverage.
  • These are the minimum requirements for all Marketplace plans. Plans may offer more benefits. You’ll see exactly what’s covered when you compare plans.

What’s preventive care?

  • Most health plans must cover a set of preventive services — like shots and screening tests — at no cost to you.
  • Preventive services are used to prevent illnesses, disease, and other health problems, or to detect illness at an early stage when treatment is likely to work best.
  • These services are free only when delivered by a doctor or other provider in your plan’s network.

What’s coverage for pre-existing conditions?

  • All Marketplace plans must cover treatment for pre-existing medical conditions, like asthma, diabetes, or cancer.
  • Marketplace plans can’t deny you coverage or raise your rates based only on your health.
  • Pregnancy is also covered from the day your plan starts.
Open Enrollment is less than one month away!
Thu, 04 Oct 2018 00:00:00 -0400

You have less than one month until you can start enrolling in a 2019 Marketplace health insurance plan. See important dates to remember, and learn things you can do now to prepare.

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Important dates to know

  • The 2019 Open Enrollment Period runs from November 1 to December 15, 2018. This means you have six weeks to enroll in or renew a plan.
  • Plan coverage starts January 1, 2019.

Get ready today to apply November 1

  • Gather everything you need to apply by using this checklist (PDF).
  • Review quick tips about the Health Insurance Marketplace.
  • Return to HealthCare.gov shortly before Open Enrollment starts to preview 2019 health plans and prices before you apply.
Stay healthy with your free flu shot this fall
Thu, 27 Sep 2018 00:00:00 -0400

The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months and older get a flu shot every year. With your Marketplace health plan, your flu shot is free from a provider in your plan's network.

Image: {Sick woman sneezing in bed}

Quick answers about the flu shot

  • Why get vaccinated: The flu shot helps keep you and the people around you healthy. According to the CDC, getting the flu shot lowers the risk of flu illnesses, doctor's visits, hospitalizations, and missed work and school.
  • When to get vaccinated: It’s best to get the shot before the flu starts spreading in your community, so try to get it by the end of October. Flu viruses are most common in the fall and winter.
  • Where to go: Getting the flu shot may be more convenient than you think. Enter your ZIP code to find a clinic near you.
  • How much it costs: Most health plans cover a set of preventive services — including the flu shot — at no cost to you when delivered by a doctor or provider in the plan’s network.

Get more flu information from the CDC.


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