Two ways you may be able to save on your ACA Marketplace plan
If you’re shopping for a low-cost an Affordable Care Act (ACA) Marketplace plan, your premiums could be lower than you expect. Do you know these two ways to pay less for an ACA Marketplace plan?
Under the American Rescue Plan Act of 2021 (ARPA) and Inflation Reduction Act of 2022, you may be able to enroll in ACA Marketplace coverage with lower premiums through subsidies from the government. These subsidies could be tax credits or cost-sharing reductions to help pay for your health care costs. Let’s break down what this means.
Premium tax credit
When you start shopping for an ACA Marketplace plan, you’ll find out if you qualify for a premium tax credit that lowers your monthly premium. It's already part of the UnitedHealthcare plan application, so you don't have to do any additional work to see if you qualify.
Premium tax credits are in place to:
- Reduce monthly payments (premiums) paid to your insurance plan
- Cap the amount an individual or family must pay for health insurance
The size of the premium tax credit is based on a sliding income scale. People who have a lower income will get a larger credit to help cover the cost of their insurance.
Cost-sharing
Cost sharing is literally “sharing” medical costs with your insurance company. You’ll pay some costs out-of-pocket, and your insurance company also pays some costs. Cost-sharing only applies when you pay part of the cost and your insurance company pays the other part. Sometimes your insurance company pays everything, for example, you pay $0 for preventive care because your insurance plan covers it at 100%.1 Sometimes you might be responsible for the full amount, like if a certain service isn’t covered or if you choose an out-of-network provider.
Some examples of cost-sharing are:
- Deductible: The amount you must spend on care covered by your health plan before they begin to pay.
- Copay: A set dollar amount you have to pay when you get care covered by your plan
- Coinsurance: The percentage of costs of a covered health care service you pay after you've paid your deductible.
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What are cost-sharing reductions?
Cost-sharing reductions (also called decreased cost-sharing or “extra savings”) are part of the Affordable Care Act (also called Exchange Plans). It’s there to help people save on out-of-pocket costs when they get care. People who qualify for cost-sharing reductions may have a lower out-of-pocket maximum. They may also have lower copays and deductibles.2 Cost-sharing reductions are in place to help people get the care they need.