Navigator Information FAQs of the Week: Who’s Eligible for Market Protection?

November 1 marked the primary day of the Market Open Enrollment Interval in most states. CHIR up to date its Navigator Useful resource Information simply in time for the annual enrollment window. The Navigator Information, supported by the Robert Wooden Johnson Basis, supplies an easy-to-use on-line useful resource for assisters, together with over 300 searchable often requested questions (FAQs), truth sheets for all 50 states and DC, and an “Ask an Knowledgeable” function.

Throughout Open Enrollment, we’ll spotlight FAQs from the Navigator Information about Market eligibility, enrollment, monetary help, and different frequent questions that come up all through the signup course of. This week, we’re having a look at who’s eligible for Market plans.

Who should buy protection within the Market?

Most individuals can store for protection within the Market. To be eligible it’s essential to stay within the state the place your Market is, you have to be a citizen of the U.S. or be lawfully current within the U.S., and it’s essential to not presently be incarcerated.

Not everyone who’s eligible to buy protection within the Market will likely be eligible for subsidies, nonetheless. To qualify for subsidies individuals should not be eligible for sure different kinds of protection, similar to Medicare, Medicaid, or an inexpensive employer plan. (45 C.F.R. § 155.305; 26 U.S.C. § 36B(c).)

I’m eligible for well being advantages at work, however I need to see if I can get a greater deal within the Market. Can I do this?

Assuming you meet different eligibility necessities, you may store for protection on the Market throughout open enrollment or a particular enrollment interval if eligible, however when you have entry to job-based protection, you may not qualify for premium tax credit.

When persons are eligible for employer-sponsored protection, they will solely qualify for Market premium tax credit if the employer-sponsored protection is unaffordable. The best way that is calculated, protection is unaffordable provided that your price for protection for a single particular person underneath the employer plan is greater than 8.39 p.c of your family revenue in 2024 (for 2023, it’s 9.12 p.c of family revenue). (IRS Rev. Proc. 2023-29.)

Can I purchase a plan within the Market if I don’t have a inexperienced card?

Doubtlessly, sure. With the intention to purchase a Market plan, it’s essential to have a qualifying immigration standing, similar to everlasting residency (inexperienced card), sure kinds of visas, or refugee standing. You will discover extra details about qualifying statuses right here.

If you’re not lawfully current within the U.S., you aren’t eligible to purchase a plan on the medical health insurance Market. Nevertheless, you may store for particular person medical health insurance outdoors of the Market and a few states could give you monetary help, relying in your revenue. To acquire protection, contact a state-licensed medical health insurance firm or a licensed agent or dealer. Your state Division of Insurance coverage will help you discover one. (45 C.F.R. § 155.305.)

Open Enrollment runs via January 15 in most states. Keep tuned for extra FAQs of the week and take a look at the Navigator Useful resource Information for much more FAQs and useful assets.