QUESTION

I am not eligible for premium tax credits. What are my options to find affordable coverage?

Individuals with no coverage | Individual Responsibility Requirement (Individual Mandate) Coverage Outside the Marketplace
ANSWER

There are many options for people who do not qualify for premium tax credits. It is still worth looking for coverage on HealthCare.gov, even if you do not currently qualify for premium tax credits; there, you can shop for coverage that provides the Affordable Care Act’s protections, including a comprehensive set of benefits and limits on cost-sharing that can save you money when you access health services. Also, if your income fluctuates and you become eligible for premium tax credits mid-year, you will be able to get a special enrollment period to shop for coverage and enroll in tax credits or claim them as a tax refund when you file your taxes for the year.

If you do not expect your income to change mid-year, you may want to shop outside the marketplace for similar coverage that still provides the Affordable Care Act’s protections. To access these plans, contact your state’s Department of Insurance for a list of reputable brokers that can help you shop for Minimum Essential Coverage.

There may be other coverage options available outside of the marketplace that do not provide the Affordable Care Act’s protections. These include plans that are not traditional health insurance products, including short-term, limited duration insurance, association health plans, health care sharing ministries, and Farm Bureau plans. If an insurer or entity cannot provide a Summary of Benefits and Coverage that indicates coverage is Minimum Essential Coverage, be aware that the plan may have coverage limitations, particularly for pre-existing health conditions or for basic medical care. Always insist on getting plan documents to review prior to buying a plan.

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues