QUESTION

What happens if I don’t return to the marketplace to update my application?

Individuals with coverage | Individual and Marketplace Health Coverage
ANSWER

In most states and if eligible, the marketplace will automatically re-enroll you into the same or a similar marketplace health plan with a re-determination of premium tax credit eligibility based on the latest information they have through their federal sources. However, the price of the benchmark plan may have changed, meaning that your premium tax credit amount has changed. If your premium tax credit amount turns out to be less than what you’re actually eligible for, you will have to pay more in premiums than you should have to. Conversely, if your premium tax credit turns out to be more than what you’re actually eligible for, you will have to repay all or part of the difference when you file your tax return. It’s important to contact the marketplace to update your application so that you’re receiving the correct amount of subsidy and the best coverage for your premium tax credit dollar. (CMS, Guidance on Reenrollments and Redetermination for Exchange Coverage for 2018, July 13, 2017; CMS, Guidance on Reenrollments and Redetermination for Exchange Coverage for 2019 and Later Years).

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