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For individuals or families who obtain or may obtain health insurance through the public market, the opportunity to choose coverage for 2023 is approaching.
Open enrollment for next year’s health insurance options will run from November 1 through January 15 for federal markets. HealthCare.gov and most state exchanges. Generally, people who are insured in this way are self-employed or are unable or ineligible for workplace insurance. Medicaid Also Medicare.
About 13 million out of 14.5 million People who purchase private health insurance through the public market, authorized by the Affordable Care Act of 2010, receive a subsidy (technically a tax credit) that reduces the amount they pay for insurance. Some people may also be eligible for cost-sharing assistance, such as deductibles and copays, on certain plans, depending on their income.
Here’s what you need to know for 2023.
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Insurance premiums have increased by an average of 4% to 5%
Cynthia Cox, director of the Kaiser Family Foundation’s Affordable Care Act program, noted that insurance premiums will rise by an average of about 4% to 5% nationwide next year.
But she said there are many differences from state to state. In Virginia, for example, premiums are down an average of 18%, while in New Mexico she’s up 14%, Cox said.
“Most of the time it’s an increase of 1% to 7%,” she said.
If you have marketplace coverage and are facing a significant price hike, you can always check to see if more affordable options are available, Cox said.
More generous subsidies still in effect
However, more generous financial support will continue to be implemented.
In other words, the temporary increased subsidies introduced in 2021 and 2022 have been extended to 2025. Inflation control lawbecame law in August.
This means there is no cap on income eligible for subsidies, and premium payments are capped at 8.5% of exchange-calculated income. Before the change, aid was generally only available to households with incomes between 100% and 400%. federal poverty level.
Eligible market subsidies are based on factors such as income, age, and the second lowest cost “silver” plan in the area (which may or may not be the plan you are enrolled in). increase.
Properly estimate your income for 2023.
Since the amount of the subsidy is based at least in part on your income, you should: estimate in 2023 in the signup process.
Getting a good estimate is important. If he earns more than he reported at registration, it may mean he is not entitled to as much assistance as he is receiving, and the excess will be due in his 2024 tax returns. must be accounted for. This will either reduce your refund amount or increase the amount of tax you owe.
“I don’t want any nasty surprises when I pay my taxes next year,” Cox said.
Similarly, if you are entitled to more than you received, the difference will either increase your refund or reduce the amount of tax you owe.
At any time during the year, adjust income estimates Or, be aware of relevant life changes (birth of a child, marriage, etc.) that may affect the amount of grant you are eligible to receive.
“Family Glitch” will usually be fixed from 2023
Workers without employer-sponsored health insurance deemed “affordable” (9.61% or less of their income this year) are allowed to sign up for plans through the marketplace. Pricing measurements are based on employee-only coverage costs.
This is true even if the employee wishes to cover dependents as well. That means the actual cost of family cover can well exceed that threshold.
Here’s how it works as of 2023: If family workplace coverage is out of reach, employees will have to stay on their employer plan, while spouses and children will be covered in the market and eligible for subsidies, Cox said.
“This means that families are split between two or more health plans, and have multiple premiums and deductibles,” she said. It’s not that people are actually better off moving to subsidized coverage.”
