Financial assistance now available to millions on the Individual & Family Marketplace Exchanges

Recent changes from the Biden administration have made insurance options more affordable and more available – making it easier for more people to get covered. However, finding the right insurance for your needs may be still confusing. You might have heard about Affordable Care Act Plans, but perhaps like many other uninsured Americans, you assumed coverage would be too expensive. The fact is, millions remain uninsured, despite qualifying for assistance. With the American Rescue Plan Act, even more people are eligible for financial assistance, with more coverage options.

A young woman wearing headphones reads a computer screen A young woman wearing headphones reads a computer screen

To help explain these changes, and what it could mean for you, Marcus Robinson, national vice president of sales for Individual & Family Exchange Plans at UnitedHealthcare, answers a few questions about these types of plans and who may now qualify for financial assistance.

How does the American Rescue Plan Act change the health care exchanges?

A couple of things. First, subsidies have increased and millions of consumers are now eligible for coverage with a $0 premium or eligible for lower premiums. There used to be a cut-off for subsidies at 400 percent of the federal poverty level. That has been removed, and instead capped at 8.5% of one’s income. Additionally, if you were unemployed at any point in time in 2021 or 2022, you get the benefit for the full subsidy amount on the American Rescue Plan. Even if you were on unemployment for just a week.

Can you explain what the exchanges are?

The health care exchanges on healthcare.gov or certain state-based sites provide access to shop and enroll in insurance plans for individuals and families through the Affordable Care Act. Depending on the state, the exchange might be run by the federal government, the state itself, or a combination of the two. Over 80 percent of plans are available with some form of subsidy. With the American Rescue Plan, those subsidies have been increased.

Plans on the exchange have tiers such as gold, silver and bronze. Can you break down the difference between the “metallic” levels?

The “metal” indicates the richness of the insurance coverage. For example, the bronze level is going to have the most cost-effective plans—lower premiums, but fewer benefits. The gold level, on the other hand, is higher-premium but provides richer benefits (think lower deductibles and lower out-of-pocket amounts).

Which levels of plans are the subsidies good for?

You get to choose. Once you have qualified for and locked in a subsidy amount, you can take that subsidy and shop for any type of plan design you choose. For example, you could use your subsidy with a bronze plan and potentially have a plan with zero premium depending on your income level.

What do you recommend for those who might be new to this? 

Health care is personal. You want to look at how frequently you use health care, what medications you take and what the cost of them might be — and keep that in mind while shopping. You also might want to look at what physicians and hospitals are in network. Many products now offer virtual visits at no cost, or offer wellness and value-added benefits. You can always learn more at UHCExchange.com or contact 1-800-806-0451 TTY 711 to get help with finding the best plan for you.

When can people shop for a plan? Is there a specific enrollment period?

With the American Rescue Plan, the special enrollment period runs through August 15, 2021. You can either change your plan or sign up for a new one without a qualifying life event. What’s also really important is that the increased subsidies went into effect April 1, 2021. If you were already on a plan prior to April 1, you can re-enroll in order to get the subsidy increase or you can assume the tax credit next year.

How do you enroll in a plan? What if someone has barriers to access a computer?

You can learn more about this type of coverage at UHCExchange.com or you can call 1-800-806-0451 TTY 711 to speak with enrollment specialists about the plans UnitedHealthcare offers in your area.

Most areas have navigators and assistors available in multiple languages or you can find agents at Health Markets, who can help people enroll in all types of plans.

To find out more about affordable and reliable individual and family plans from UnitedHealthcare, click here.