Modified Adjusted Gross Income (MAGI)

What is Modified Adjusted Gross Income (MAGI), Adjusted Gross Income (AGI), Gross Income (GI), Family Income, Household Income, Etc? Modified Adjusted Gross Income (MAGI) is Gross Income (GI) Adjusted for deductions (AGI) and then Modified by adding some deductions back in (MAGI). On this page, we cover MAGI as it applies to Medicaid and the Marketplace…. Read More

Should I Get Health Insurance?

Having Health Insurance means you are covered in an emergency. Not getting coverage could result in big fees for those who wait until taxes are due. Obtaining and maintaining health insurance isn’t just about avoiding a fee, it’s about taking responsibility for your health, knowing you have coverage when you need it, and avoiding the devastating… Read More

Factors that Affect Health Insurance Costs

Let’s take a look at factors that affect health insurance costs for premiums and cost sharing under ObamaCare, including Marketplace subsidies and Medicaid. ObamaCare helps ensure fair health insurance premiums (Sec. 2701), helps curb premium growth, and provides Tax Credits to lower premium costs. The ACA also includes measures to reduce out-of-pocket spending and curb national… Read More

Policy Periods and ObamaCare

With ObamaCare deadlines for open enrollment approaching, it’s important to think about health insurance policy periods. Here are some key facts to help you understand why getting covered during open enrollment isn’t just about avoiding the fee, it’s about value. Your health insurance deductible (the amount you have to pay for covered in-network services before coinsurance kicks in)… Read More

Health Insurance Coinsurance

What is Health Insurance Coinsurance? In health insurance, coinsurance is your share of costs of the allowed amount for a covered service after you reach your deductible. Coinsurance is different from a copay which is a fixed dollar amount for services and is not typically dependent on meeting your deductible. How does Coinsurance Work? Each service or drug that is subject… Read More

Health Insurance Copay (Copayment)

What is a Health Insurance Copay? In health insurance a copay (copayment) is a fixed amount you pay for covered services, typically when you get the service. Copays differ from coinsurance (the percentage you pay for covered services, usually after reaching your deductible). Each plan treats copays and coinsurance differently, so it’s important to understand if… Read More

Health Insurance Deductible

What is a Health Insurance Deductible? Your health insurance deductible is the amount you have to pay out-of-pocket for covered services before your insurance begins to pay. It doesn’t include premiums or costs that aren’t covered by your plan. Once you meet your deductible, your plan will pay its share of your coinsurance. TIP: Your maximum deductible… Read More

Health Insurance Premium

What is a Health Insurance Premium? Your health insurance premium is the amount paid to an insurer, typically per month, for a health plan. Tax Credits are available to lower monthly premiums through the Health Insurance Marketplace. If you have coverage through work, your employer typically pays part of your premium. Let’s look a little more… Read More

Premium Tax Credits

ObamaCare’s Premium Tax Credits can be paid to your insurer in advance to lower your monthly premium on a Marketplace plan or adjusted on your tax returns. Tax Credits are based on household income and are available to folks making between 100% and 500% of the Federal Poverty Level FPL. Expanded Premium Tax Credit Cap:… Read More

Cost Sharing Reduction Subsidies (CSR)

How Do Cost Sharing Reduction Subsidies Work? ObamaCare’s Cost Sharing Reduction Subsidies (CSR) lower out-of-pocket costs, based on income, for Silver plans bought on the Health Insurance Marketplace. Along with Premium Tax Credits, ObamaCare’s Cost Sharing Reduction subsidies lower what you pay for out-of-pocket costs like deductibles, copays, and coinsurance, making health insurance coverage more affordable and… Read More

Health Savings Account (HSA)

What is a Health Savings Account? A Health Savings Account (HSA) is a tax-advantaged medical savings account you can contribute to and draw money from for certain medical expenses tax-free. HSAs can be used for out-of-pocket medical, dental, and vision. HSAs can’t be used to pay health insurance premiums. HSA’s can only be used with… Read More

Catastrophic Health Plans

If you are under 30 or obtained a “hardship exemption” you qualify for a high deductible, low premium, catastrophic plan. Catastrophic health plans are the cheapest plan you can get that counts as minimum essential coverage. Catastrophic plans can be good for those who want cheap, barebones care. Catastrophic plans tend to trade a low… Read More

How to Compare Health Plans

Learn how to compare health plans to get the best deals on health insurance and health care. Compare your health needs with your plans costs and coverage, to find an affordable plan with benefits that are designed to cover you. No matter how you shop, and boy are there a lot of different options under… Read More

How Does Health Insurance Work?

How does health insurance work? You pay a monthly premium and your share of annual out-of-pocket costs, and your insurer pays it’s share of covered costs.  The concept is simple, but getting that perfect health plan takes some brain power and elbow grease.  By taking the time to master and internalize the content of this page,… Read More

Actuarial Value

What is Actuarial Value? Actuarial value is average total of costs for covered benefits covered by a health plan. Let’s look at how ObamaCare’s metal plan actuarial values work and how actuarial value applies to all plans in general. FACT: Actuarial Value (AV) in regards to health insurance was created by the Affordable Care Act to rank ObamaCare’s… Read More

Changing Plans and Verifying Info for Cost Assistance

Everything You Need to Know About Changing Plans During ObamaCare’s Open Enrollment Peroid Each Year The only time you can change health plans under ObamaCare is during open enrollment or a special enrollment period. Verify info or change plans by Dec 15 to ensure you have the right plan and cost assistance starting January 1st. Although you can’t change plans… Read More

Getting Ready For Open Enrollment 2015

ObamaCare open enrollment 2015 deadline

ObamaCare’s open enrollment period for 2015 starts on November 15th, 2014 and ends on February 15th, 2015.  Let’s review the most important things to know about open enrollment in the health insurance marketplace for 2015. • Open enrollment is the only time you can get cost assistance, enroll in a plan, or change plans.  This is true whether you… Read More

Medigap

What is Medigap Insurance? Medigap, or Medicare Supplement Insurance, “covers the gap” between Original Medicare and your medical costs. Supplemental Medigap plans are sold by private companies and make sense for seniors who have costs that aren’t covered under traditional Medicare Part A and B. If Original Medicare isn’t covering your medical needs, you’ll want… Read More

Medicare Part D (Drug Coverage)

What is Medicare Prescription Drug Coverage Medicare Part D, or Medicare Prescription Drug Coverage, covers the gap between your prescription drug needs and Original Medicare. Original Medicare (Parts A and B) includes basic drug coverage. However, many Medicare beneficiaries have prescription drug needs outside of what parts A and B covers. Medicare Part D is… Read More

Medicare Advantage Plans

What is Medicare Advantage? Medicare Advantage, or Medicare Part C, is a health plan that offers Medicare Part A, B, and typically D benefits through a private company. Medicare Advantage offers everything Original Medicare Part A and Part B offers but with better benefits and coverage options. Typically however this comes at a higher upfront… Read More

Washington Health Insurance Exchange

How “Washington Healthplanfinder”, The Official Washington Website for Health Insurance, Works The Washington Health Insurance Exchange, Washington Healthplanfinder, is the official Washington State marketplace for health insurance under Obamacare. You can use Washington Healthplanfinder to apply for cost-assistance, compare prices of plans, change plans and enroll in a plan that best suits you, your family… Read More

Washington, D.C. Health Insurance Exchange

How “DC Health Link”, The Official Washington, D.C. Website for Health Insurance, Works The Washington, D.C. Health Insurance Exchange, DC Health Link, is the official Washington, D.C. State marketplace for health insurance under Obamacare. You can use DC Health Link to apply for cost-assistance, compare prices of plans, change plans, and enroll in a plan… Read More

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