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Medicare & Medicaid

Medicare & Medicaid

Featured

Featured
ACA open enrollment: what’s new for 2025
Open enrollment for 2025 ACA (Affordable Care Act)-compliant health insurance is just around the corner. Let’s take a look at the various changes that consumers should be aware of this fall.

Featured

Featured
Fact check: Is the $6,400 subsidy real or a scam?
Ads on social media – promising a $6,400 subsidy – have been flagged as misleading. Here's what you need to know about the $6,400 subsidy scam.

Frequently-asked questions by tag

Who’s getting zero-premium health insurance plans? photo

Who’s getting zero-premium health insurance plans?

November 11, 2024 – You don't have to be poor to get an ACA-compliant health plan with $0 premiums. See who's getting no-premium coverage and why – and…

If I get an Obamacare subsidy in the exchange, is the subsidy amount considered income? photo

If I get an Obamacare subsidy in the exchange, is the subsidy amount considered income?

November 5, 2024 – ACA health insurance subsidies (both premium assistance tax credits and cost-sharing reductions) are not considered income and are not…

What is the Medicaid ‘coverage gap’ and who does it affect? photo

What is the Medicaid ‘coverage gap’ and who does it affect?

November 5, 2024 – According to Kaiser Family Foundation data, there are about 1.9 million people in the coverage gap across nine states (this does not…

We claim our son, but not our daughter, on our taxes. How are premium subsidies calculated for families like ours? photo

We claim our son, but not our daughter, on our taxes. How are premium subsidies calculated for families like ours?

September 29, 2024 – Subsidy eligibility is based on modified adjusted gross income (MAGI). For your family, your MAGI will include income for yourself and your…

My employer offers insurance, but I think it’s too expensive. Can I apply for a subsidy to help me buy my own insurance? photo

My employer offers insurance, but I think it’s too expensive. Can I apply for a subsidy to help me buy my own insurance?

August 23, 2024 – You cannot qualify for a health insurance premium subsidy unless the insurance your employer offers would force you to kick in more than…

If your income last year was higher than expected, do you have to pay back some of the advance premium tax credits that you received for Marketplace coverage? photo

If your income last year was higher than expected, do you have to pay back some of the advance premium tax credits that you received for Marketplace coverage?

August 22, 2024 – If you received advance payments of the premium tax credit for health insurance that you purchased last year on HealthCare.gov (or a…

I earn too much to qualify for a subsidy. Why should I buy through the exchange? photo

I earn too much to qualify for a subsidy. Why should I buy through the exchange?

August 21, 2024 – The American Rescue Plan (ARP), enacted in March 2021, makes health insurance coverage more affordable for millions of people who buy their…

Should I let my individual health insurance plan automatically renew? photo

Should I let my individual health insurance plan automatically renew?

July 26, 2024 – If you have a health plan in the individual market, on-exchange or off-exchange, you can probably just let it renew for the coming year…

Do plans sold in the health insurance exchanges cover abortion? photo

Do plans sold in the health insurance exchanges cover abortion?

July 23, 2024 – In more than half the states, ACA-compliant health insurance plans are not allowed to cover abortions except for circumstances involving…

Should I buy the health plan my college offers? or buy through an ACA exchange? photo

Should I buy the health plan my college offers? or buy through an ACA exchange?

March 23, 2024 – Most student health plans offered by colleges and universities are fully compliant with the ACA, with just a few exceptions that don't…

How might my tax deductions affect the size of my ACA premium subsidy? photo

How might my tax deductions affect the size of my ACA premium subsidy?

March 22, 2024 – Learn how you might be missing out on deductions and tax breaks that would lower your income for ACA purposes, which could result in larger…

Should I take my ACA premium subsidy during the plan year – or claim it at tax time? photo

Should I take my ACA premium subsidy during the plan year – or claim it at tax time?

February 14, 2024 – The Affordable Care Act’s premium subsidies are tax credits that can be taken in advance and paid to your health insurer throughout the…

Can health insurance policies still have lifetime or annual benefit maximums? photo

Can health insurance policies still have lifetime or annual benefit maximums?

January 19, 2024 – All new individual and small-group plans have covered essential health benefits (EHBs) since 2014, and there cannot be dollar limits on…

How does my access to employer-sponsored coverage impact my eligibility for subsidized coverage through the exchanges? photo

How does my access to employer-sponsored coverage impact my eligibility for subsidized coverage through the exchanges?

January 18, 2024 – Fortunately, the IRS issued new rules, effective in 2023, to allow some families to take advantage of premium subsidies in the exchange if…

Does the Affordable Care Act make it easier to get individual health insurance? photo

Does the Affordable Care Act make it easier to get individual health insurance?

January 11, 2024 – It's easier to get individual health insurance under the Affordable Care Act, but consumers in the individual market need to be aware that…

Does every business with 50 or more employees pay a penalty if it doesn’t offer ‘affordable, comprehensive’ insurance? photo

Does every business with 50 or more employees pay a penalty if it doesn’t offer ‘affordable, comprehensive’ insurance?

January 10, 2024 – Businesses with 50 or more full-time equivalent (FTE) employees are required to offer comprehensive, affordable health insurance coverage…

Who ISN’T eligible for Obamacare’s premium subsidies? photo

Who ISN’T eligible for Obamacare’s premium subsidies?

January 3, 2024 – If your income is just a little over the subsidy-eligibility threshold, you can talk with a tax advisor about strategies for lowering your…

My wife and I each make about $40,000 a year. If we file our taxes separately, can we each qualify for an exchange subsidy? photo

My wife and I each make about $40,000 a year. If we file our taxes separately, can we each qualify for an exchange subsidy?

July 6, 2023 – The guidelines for eligibility are determined by total household income and the number of people in the household.…

We’re a family of four with an income of $50,000 a year. What kinds of subsidies are available to help us purchase insurance through the exchanges? photo

We’re a family of four with an income of $50,000 a year. What kinds of subsidies are available to help us purchase insurance through the exchanges?

February 28, 2023 – The government offers two types of subsidies for people who buy their own insurance in the state’s marketplaces (a.k.a. health insurance…

If an individual pays for an exchange plan, how do they pay for the premium pre-tax as would someone with an employer plan? photo

If an individual pays for an exchange plan, how do they pay for the premium pre-tax as would someone with an employer plan?

January 11, 2023 – If you’re self-employed, you can generally deduct the full amount you pay in premiums without having to itemize your deduction.…

I’m self-employed and am hiring employees. Under Obamacare, am I obligated to provide health insurance for them? photo

I’m self-employed and am hiring employees. Under Obamacare, am I obligated to provide health insurance for them?

December 16, 2022 – No, unless you're hiring at least 50 full-time equivalent (FTE) employees. Businesses with fewer than 50 FTE employees (that's 96% of…

Can I purchase a Platinum policy and also get a premium subsidy? photo

Can I purchase a Platinum policy and also get a premium subsidy?

July 12, 2022 – You can buy a Platinum plan and also get a premium subsidy. The size of the subsidy is based on the cost of a Silver plan, but you can…

If I qualify for Medicaid, should I worry about the deadline for open enrollment? photo

If I qualify for Medicaid, should I worry about the deadline for open enrollment?

December 23, 2021 – It's true that Medicaid and CHIP enrollment are year-round. But that doesn’t mean that you should disregard the end of open enrollment…

We’re in a same-sex civil union. Should we calculate our subsidy as a household of two, or apply separately? photo

We’re in a same-sex civil union. Should we calculate our subsidy as a household of two, or apply separately?

August 30, 2021 – Since you're not legally married, your premium tax credits will be calculated separately, based on each partner's individual income. For…

Were individual-market health plans less expensive before Obamacare? photo

Were individual-market health plans less expensive before Obamacare?

July 31, 2021 – A 35-year-old says that before the ACA, his health insurance premiums were $150 a month with a $50 deductible. But did he have a true major…

I understand that subsidies come in the form of tax credits. But I’m unemployed and probably won’t owe any taxes. How would the subsidy help me? photo

I understand that subsidies come in the form of tax credits. But I’m unemployed and probably won’t owe any taxes. How would the subsidy help me?

June 7, 2021 – The premium subsidy offered through the exchanges is a tax credit, but it differs from some other tax credits in two important ways. First…

I work part-time. Am I eligible for a premium subsidy to help me buy insurance? photo

I work part-time. Am I eligible for a premium subsidy to help me buy insurance?

May 27, 2021 – Your eligibility for a premium subsidy isn't tied to how many hours you work. As long as you meet the income requirements for the premium…

Who is keeping track of whether I buy health insurance through the exchanges? photo

Who is keeping track of whether I buy health insurance through the exchanges?

May 25, 2021 – Regardless of where you get your health insurance, you (and the IRS) will get a tax form from your employer, insurance company, or exchange…