Healthcare coverage is a vital thing that can also be pricey. Low-income individuals may find themselves struggling to pay monthly premiums if they get private insurance and/or do not qualify for programs like Medicare and Medicaid. With few options to protect themselves and their families, it can cause tremendous anxiety. 

However, the Affordable Care Act (ACA) subsidy can help by lowering the cost of monthly premiums for those who qualify. These subsidies work as financial aid, similar to how tuition grants and scholarships work for college students. 

In this case, the government picks up the amount that cannot be paid by an individual or household.

How Do I Qualify?

To qualify for an ACA subsidy, your or your household’s net income must be between 100% and 400% of the Federal Poverty Level. The amount you may qualify for will depend on the insurance plans available in your coverage area. Look into the different ACA levels to see how much monthly premiums cost in your zip code.

Also note that if your or your household’s income ends up being higher than the Federal Poverty Level, once taxes have been filed, you may be subject to back pay for the medical costs covered throughout the previous year.

How Do I Apply for an ACA Subsidy?

To apply for an ACA subsidy, you must first meet the requirements. If you’re not sure if you or your household does, you can check your eligibility through the online marketplace, and it will calculate your net income for you — letting you know if you’re within the Federal Poverty Level range.

Once you know that you qualify for an ACA subsidy, you have two choices: 1) You can apply the subsidy in advance, to lower your monthly premiums as you pay them throughout the year, or 2) you can wait and claim the money that you would’ve saved during the year on your next tax return.

If you don’t apply for an ACA subsidy or just don’t think you qualify but later realize that you do, you’ll be refunded once you’ve filed your taxes.

What Will Disqualify Me?

In order for you or your household to qualify for an ACA subsidy, those of you applying must be either U.S. citizens or legal residents currently residing in the United States.

If you’re concerned about your ability to afford healthcare insurance, look into whether or not you meet the qualifications listed above, and see if you can alleviate some of your financial stress by receiving an ACA subsidy.

Get Coverage Today

If you’re in the market for affordable health insurance, iHealthcare Direct can help. iHealthcare Direct is an expert in the healthcare field and our agents can help you navigate through dozens of options. Call iHealthcare Direct and see how you can get insured today!

While most health insurance plans do not include coverage for routine dental, vision, and hearing care, these are important areas that affect your overall health. How, then, can you get the coverage you need to maintain your quality of life? And how do dental, vision, and hearing insurance plans work when you’re covered under the Affordable Care Act (ACA)?

How to Get Dental Coverage

In the insurance Marketplace, created by the Affordable Care Act, you can get dental coverage in two ways: as part of a health plan, or by itself through a stand-alone plan.

  • Some Marketplace health plans include dental coverage. You can see which plans do when you compare them. If the plan includes dental, the premium covers BOTH health and dental benefits.
  • In some cases, separate, stand-alone dental plans are offered. You can view them when you shop in the Marketplace. If you select a separate dental plan, you’ll pay an additional premium.

For children up to the age of 19, dental coverage is considered an essential need and must be available through the marketplace. This doesn’t mean that every dental procedure is covered. For example, preventative cleanings may be covered, whereas braces may not. Deductibles and copays may also be required.

For adults, dental coverage is not considered to be essential, meaning that your insurer isn’t required to offer a dental plan for you if you’re over the age of 19. If you’re able to enroll in a dental plan, you can choose between a high premium plan, which will lower the costs of your copays and deductibles, or a low premium plan, which will do the opposite.

How to Get Vision Coverage

Like with dental coverage, vision screenings and necessary corrections to vision are considered essential and required for those under the age of 19. Vision coverage for children is considered to be preventative care under the ACA, and won’t cost you extra.

Unfortunately, also as with dental, vision coverage is not “essential” for adults, meaning an ACA plan is not required to make a vision plan available. It’s possible that certain plans will offer a vision plan, but don’t bank on it.

If no plans in your area cover vision, and you’re in need of vision coverage, there are a couple of ways to go about obtaining it. If you’re employed and receive benefits, vision insurance is often offered. You can also purchase a private, separate vision plan. Depending on your needs, you’ll want to explore what exactly these stand-alone plans include and how high their premiums are.

How to Get Hearing Coverage

For children, hearing coverage is generally considered essential and preventative. However, if a child has hearing loss past the point of 19, they can continue to receive hearing benefits under their parents’ insurance until the age of 26.

For those who are considered deaf or hard-of-hearing, cochlear implants are often covered. This is not a guarantee.

While having insurance through the Marketplace doesn’t guarantee access to comprehensive hearing coverage, there are still parts of hearing health that may be covered. For example, your plan may cover a trip to an ENT, but not necessarily cover a pair of hearing aids.

If you already have chronic hearing problems, you cannot be denied coverage, but it’s important for you to look at plans carefully to see if they offer the benefits you need.

Call iHealthcare Direct

If you’re exploring your health insurance options, you’ve come to the right place. iHealthcare Direct is an expert in the healthcare field and our experts can help you navigate through hundreds of plans to find the best fit for your situation. Call today!

Helping individuals and families access affordable healthcare. iHealthcare offers personalized services to our clients, helping them find the best possible healthcare solutions for their needs.
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