En español | Most Minnesotans are eligible to buy health insurance through MNsure, the state’s Affordable Care Act (ACA) marketplace, with open enrollment running through Jan. 15. And you might be able to save money on premiums, thanks to expanded federal tax credits in the March coronavirus relief bill.
Most people already enrolled in ACA marketplace plans have seen their premiums go down this year because the recently enacted American Rescue Plan increases tax credits for insurance premiums and expands the number of households who qualify for them. Every household that pays more than 8.5 percent of their household income now qualifies for federal tax credits to help it afford health insurance. Prior to the new law, such tax credits were available only to people making up to 400 percent of the federal poverty level (around $51,000 for one person).
The average American with a marketplace plan can save $50 per month with the new assistance, the federal government says. As of now, this additional federal financial assistance will only be available in 2021 and 2022.
You apply for coverage and choose your plan at the same time. As soon as you submit an application with MNsure, you'll learn what coverage you're eligible for. If you qualify for private coverage, you can shop for plans and continue the enrollment process immediately. If you're eligible for a public plan, Medical Assistance or MinnesotaCare, information about next steps will come from the Minnesota Department of Human Services, your county or your tribal agency.
If you enroll in a private plan or for MinnesotaCare, your coverage will not begin until you've paid your first monthly premium. There is no monthly premium for Medical Assistance.
To apply and enroll:
Certified brokers, for private plans, and navigators, for public plans, offer free help exploring plans and answering questions and are available virtually, by phone or in person. MNsure's website makes it easy to find help near you.
All MNsure health coverage plans cover basic dental services for children, but adults who want dental insurance must add it to their policy. Deductibles and out-of-pocket costs vary between plans; enrolling in a family plan can cut costs.
Coverage and cost depend on where you live, the type of plan you choose, your household income, use of tobacco and the age and disability status of you and your members of your family.
If you qualify for Medical Assistance or MinnesotaCare, you will be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income.
All MNsure plans cover 10 “essential” benefits, including:
Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family.
Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income now qualifies for federal tax credits for insurance premiums.
For example, a single 64-year-old filer earning $51,000 per year could potentially save more than $8,000 with the new tax credits, according to the Kaiser Family Foundation.
Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a Silver-level plan to get this assistance.
If you’ve collected unemployment benefits this year, even for just one week, you may qualify for a $0/month premium health coverage option, thanks to the American Rescue Plan. Minnesotans who received unemployment in 2021 may qualify for a new 60-day special enrollment period to shop for coverage through MNsure and take advantage of these new low-cost options. If you’re already enrolled in a plan through MNsure this subsidy will show up on your August invoice for the first time if your account is up to date. You may even be able to change plans to access benefits that greatly reduce out-of-pocket costs for in-network services.
If you’ve already received unemployment benefits this year while enrolled in a marketplace plan, you’ll be able to claim the additional subsidies for the months prior to August when you file your 2021 tax returns. The extra financial help for those who have received unemployment income will expire at the end of 2021. The marketplace’s website provides further information about unemployment income benefits through MNsure and the American Rescue Plan.
Most MNsure plans are organized into four categories:
Minnesotans under 30, and others who qualify for a hardship exemption, can also apply for a catastrophic health plan which offers a low monthly premium and a very high deductible and exists to protect customers in worst-case scenarios.
MNsure’s Shop and Compare tool helps you estimate costs and benefits of various plans and check whether you might qualify for financial assistance.
If you already have coverage through your employer or directly through an insurance provider but are eligible for lower premiums, you can switch to MNsure. But you may need to wait until open enrollment, and you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.83 percent of your household income for individual coverage.
If you get coverage through the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) because you were terminated from a job or were put on reduced hours before Oct. 1, you may be able to save money by switching to a MNsure plan during a 60-day special enrollment window. Be sure to apply and select your plan through MNsure before your COBRA coverage ends to make sure there’s no gap in coverage. If you're not sure if this switch makes sense for you, you can ask for free advice from a certified insurance broker.
If you already have a marketplace plan and want to adjust your coverage, you’ll need to wait until the renewal period opens this fall. If you don’t take action during the renewal period, you’ll automatically be reenrolled in your existing plan if it’s still available. And if it’s not available through MNsure but is available outside MNsure, you’ll be enrolled but will not receive financial help. For this reason, you should be sure to shop and compare MNsure plans during open enrollment to secure the best option and savings for you and your family.
That depends. Major insurance providers — including BlueCross BlueShield Minnesota, Health Partners, Medica, Quarts and UCare — offer MNsure plans, but not all doctors accept them. Before you select a plan, you may want to check to see if your doctor is in the insurance company's network or contact the insurance company to learn more about in-network vs. out-of-network providers and what that means for you and your costs.
Most families can enroll in the same plan. But in some cases, the needs of family members may vary — and so might their access to subsidies. If you're not sure what makes the most sense for your family, MNsure encourages you to contact a broker for guidance.
This guide, originally published on May 25, was updated on Nov. 1 to include information about open enrollment.
This story is provided by AARP Minnesota. Visit the AARP Minnesota page for more news, events, and programs affecting retirement, health care, and more.
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