Healthreformbeyondthebasics.org

Income Definitions for Marketplace and Medicaid Coverage

WEBA dependent must file a tax return for 2023 if they received at least $13,850 in earned income; $1,250 in unearned income; or if the earned and unearned income together …

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URL: https://www.healthreformbeyondthebasics.org/key-facts-income-definitions-for-marketplace-and-medicaid-coverage/

The Summary of Benefits and Coverage

WEBThe Summary Benefits and Coverage (SBC) is a standardized document that health insurance issuers must provide for all private health plans they offer, including ACA …

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Determining Households and Income

WEBIncome. In this Beyond the Basics webinar presented on September 12, 2023, Jenny Sullivan, Director of Health Coverage Access, and Allison Orris, Senior Fellow on the …

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How are Medicaid and CHIP eligibility determined

WEBSeptember 2023. Financial eligibility for most categories of Medicaid and the Children’s Health Insurance Program (CHIP) is determined using a tax-based measure of income …

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Determining Eligibility

WEBMost people who enroll in health insurance through the marketplace are eligible for financial help. Premium tax credits lower up-front monthly premiums and cost-sharing reductions …

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Plan Comparison Worksheet (Available in 8 Languages)

WEB8. Languages) This worksheet is designed to help people compare the details of up to four different plans side-by-side. It has space to record annual projected income, …

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American Rescue Plan

WEBThe American Rescue Plan was enacted in 2021 to address the COVID-19 public health and economic crisis. It dramatically reduced premiums for people through additional …

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Marketplace Appeals Process

WEBProcess. This Beyond the Basics webinar was presented in partnership with the National Health Law Program on April 28, 2022. Mara Youdelman, Managing Attorney at the …

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Transitioning from Medicaid to Employer-Sponsored Insurance

WEBEmployer-Sponsored. Insurance. Beginning in April 2023, for the first time since early 2020, states can terminate Medicaid for people they have determined are no longer eligible. …

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Cost-Sharing Charges

WEBA cost-sharing charge is the amount an individual has to pay for a medical item or service (e.g., hospital stay, physician visit, or prescription) covered by their health insurance …

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Upcoming Webinars

WEBThe Beyond the Basics annual 9-part webinar series takes place ahead of open enrollment each fall. The webinars are presented by policy experts who provide in-depth training on …

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Helping Families That Include Immigrants Apply for Health …

WEBWhen this occurs, applicants will be instructed to upload proof of their immigration status to their HealthCare.gov accounts (see list of acceptable proof in Table 3). Applicants can …

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Employer-Sponsored Coverage and Premium Tax Credit Eligibility

WEBEmployer-sponsored coverage is considered to be affordable to the employee if the employee’s share of the premium is less than 8.39 percent of the employee’s household …

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Determining Household Size for the Premium Tax Credit

WEBIncome as a percentage of the federal poverty line also sets the amount of premium tax credit a household is eligible to receive. Families at different income levels are expected …

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Marketplace Casework, Complaints and Appeals

WEBNHeLP | National Health Law Program January 30, 2018 Marketplace Appeals 2 Definitions & Explanations Casework: Issues that the Marketplace Call Center or CMS receives …

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Premium Tax Credit

WEBThe benchmark plan costs $15,000, so the marketplace determines that they are eligible for a premium tax credit of $12,000 for the year ($15,000 – $3,000). Peter and Mary decide …

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