ACA Health Insurance Changes Lower Cost For Consumers

If you weren’t aware, the Special Enrollment Period for the Affordable Care Act (ACA) marketplace, which allows consumers to enroll without a qualifying life event, has been extended through August 15, 2021. Plus, new financial help is available through the American Rescue Plan pandemic relief bill.

My colleague Bill Tuthill, vice president of federal markets for Highmark, has answered some frequently asked questions that may help you or your colleagues or loved ones navigate the new ACA subsidies that lower premiums and other out-of-pocket costs.

What kinds of services are covered by ACA health insurance plans?

ACA plans offer comprehensive health coverage, and all must cover certain “essential health benefits” like doctor’s visits, inpatient and outpatient hospital care, prescription drug coverage, mental health services, and pregnancy and childbirth. ACA plans cover a variety of preventive services like vaccinations and annual wellness visits for $0.

Is there financial help available to individuals and families?

The ACA marketplace provides a range of affordable coverage options for individuals and families, and the American Rescue Plan made plans more affordable for more people. Those who make more than 400 percent of the federal poverty level – about $51,000 for an individual; $105,000 for a family of four – are now eligible for subsidies or tax credits. As an example, a 64-year-old married couple making $75,000 (435% FPL) previously had a silver premium of $2,500 per month. With the passage of the American Rescue Plan, this same plan will now cost them $530 per month.

The American Rescue Plan qualifies current ACA consumers for enhanced subsidies and tax credits, expands the availability of plans with $0 premiums after subsidies, and provides financial assistance for those who filed for unemployment in 2021, among other changes that may make ACA plans even more affordable.

Highmark members in Delaware who already receive a tax credit may see additional decreases in their premiums. Highmark also offers ACA plans in Delaware with very low or even $0 deductibles.

What kinds of health plans does Highmark offer to ACA shoppers?

Delaware consumers can select an ACA plan from Highmark that provides in-network access to all acute care hospitals in the state, as well as in-network coverage for services received from more than 95 percent of doctors and hospitals around the country through the BlueCard? program. This includes access to contracted Blues providers in nearby states such as Pennsylvania, New Jersey and Maryland.

We’re pleased to include plans that offer bundled adult dental and vision coverage. We also increased the availability of high-deductible health plans that can be joined with a tax-advantaged Health Savings Account.

What advice do you have for ACA shoppers?

Current ACA marketplace enrollees should update their application online or call a trusted Highmark advisor or their health insurance broker, to see the new savings available through the American Rescue Plan. New consumers should visit healthcare.gov or call a Highmark advisor or broker to shop for plans on the marketplace.

Where can people go to learn more?

To learn more about our ACA plans, you can visit https://www.discoverhighmark.com/plans/aca-plans.html or call 877-959-2563.