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Under 65 Insurance
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Marketplace Insurance
Individuals and families are eligible for Qualified Health Plans through a State or Federal Exchange, commonly referred to as a "Marketplace".
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Pennsylvania, Maryland, New Jersey, and New York are just a few of the 18 states using their own Exchanges. For example, Pennsylvania's Exchange is Pennie. Other states, use HealthCare.gov.
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Customers of exchanges are eligible for Premium Subsidies and Cost-Sharing Reductions to lower the premiums and/or costs of services. Where as purchasing insurance "off the exchange" forfeits one's ability to lower the premium and/or costs.
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The primary factors in determining lower premiums and/or costs is based on income, family size, and age. However, there are different factors which can determine or change eligibility.
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Federal Legislation during COVID-19 raised the income limits significantly, and placed maximums on premiums based on percentage of one's income. The Biden Administration has passed legislation continuing this until 2025. Meaning, individuals who may not have qualified in the past could now otherwise qualify.
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HEALTHFOCUS PARTNERS agents are Certified Pennie Agents, Certified GetCoveredNJ agents, and Certified Federally-Facilitated Marketplace agents. We can help 1) create and submit your account and application for premium subsidies, 2) explain the potential tax implications, 3) provide guidance on the process, and 4) work with you to find your insurance plan with (or without) subsidies.
Commonly asked Questions
How do I know if I reside in a State that has it's own Exchange?
Currently, there are only 18 states with their own Exchange. They are: CA, CO, CT, DC, ID, KY, ME, MY, MA, MN, NV, NJ, NM, NY, PA, RI, VT, WA.
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I applied but did NOT qualify for Subsidies?
It could be how you are filling out the application. While primary factors are age, income, and family size, there are other potential reasons -- or how questions were unintentionally answered -- that you are not qualifying for subsidies. Reach out and we can review your application.
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Is there any other options if I do NOT want to use an Exchange?
Of course! Using Exchanges is not required. However, not using them forfeits any chance of getting financial assistance.
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I did NOT qualify for Subsidies and the costs of my options are too high?
There are other insurance products for those Under 65 (not eligible for Medicare) that exists. Please contact us and we can discuss options which fit your needs and budget.
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Can the income I entered on my application impact my tax return?
YES! Our job is to help you understand which income to report and how to report it. Not reporting enough income could meaning owing some or all of the subsidies back when you file your Federal tax return.
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There are SO MANY plan options on the exchange/Pennie/Etc. how do I pick the "right" one?
This is a common concern we hear often. We work with you to help navigate your plan options based on several factors to help you feel comfortable in your decision and understand the plan's coverage.
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I have so many questions/concerns, I don't know where to begin!
That's OK! Insurance can seem daunting to many. This is why insurance agents get licensed and credentialed to help answer your questions and help it make sense to you.
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