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Marketplace 2020 Plan Information Now Available: On October 25, 2019, CMS launched updates to window shopping (the “See plans & prices” page on HealthCare.gov) that allows consumers and their agents and brokers to preview 2020 plans and prices before Open Enrollment begins. As in previous years, window shopping lets consumers browse plans without logging in, creating an account, or filling out the official application.

Starting November 1, consumers can log in to HealthCare.gov and CuidadodeSalud.gov or call 1-800-318-2596 to fill out an application and enroll in a 2020 Marketplace health plan. Agents and brokers may also work with direct enrollment partners to enroll consumers in Marketplace plans for plan year 2020.

For more information, see these additional plan data resources released today:

2020 Health Insurance Exchange Premium Landscape Issue Brief

To view the Department of Health & Human Services 2020 Health Insurance Exchange Premium Landscape Issue Brief, visit: https://www.cms.gov/CCIIO/Resources/Data-Resources/QHP-Choice-Premiums.html

2020 Plan Landscape Data

For more information on 2020 individual and family health plans available in the Federal Health Insurance Exchange, visit: https://www.healthcare.gov/health-and-dental-plan-datasets-for-researchers-and-issuers/

2020 Health Insurance Exchange Public Use Files

To see the 2020 Health Insurance Exchange Public Use Files, visit:

https://www.cms.gov/cciio/resources/data-resources/marketplace-puf.html

2020 Quality Rating System Public Use Files

To see the Plan Year 2020 Quality Rating System Public Use Files, visit: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/ACA-MQI/ACA-MQI-Landing-Page.html

2020 Issuer Participation County Map

To see the 2020 Issuer Participation County Map, visit: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/Health-Insurance-Exchange-Coverage-Maps.html

To learn more about new quality rating information, the streamlined HealthCare.gov application, and other key updates and enhancements for the 2020 Open Enrollment, follow this link: https://www.cms.gov/newsroom/fact-sheets/federal-health-insurance-exchange-2020-open-enrollment

 

FEDERAL POVERTY LEVEL (FPL): A measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.

The 2019 federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children’s Health Insurance Program (CHIP). 2018 numbers are slightly lower, and are used to calculate savings on Marketplace insurance plans for 2019.

  • $12,490 for individuals
  • $16,910 for a family of 2
  • $21,330 for a family of 3
  • $25,750 for a family of 4
  • $30,170 for a family of 5
  • $34,590 for a family of 6
  • $39,010 for a family of 7
  • $43,430 for a family of 8

 

How federal poverty levels are used to determine eligibility for reduced-cost health coverage.

  • Income between 100undefined FPL: If your income is in this range, in all states you qualify for premium tax credits that lower your monthly premium for a Marketplace health insurance plan.
  • Income below 138undefined FPL and your state has expanded Medicaid coverage, you qualify for Medicaid based only on your income.
  • Income below 100undefined FPL, you probably won’t qualify for savings on a Marketplace health insurance plan or for income-based Medicaid.

“Income” above refers to “modified adjusted gross income” (MAGI). For most people, it’s the same or very similar to “adjusted gross income” (AGI). MAGI isn’t a number on your tax return.

Read More at: https://www.healthcare.gov/glossary/federal-poverty-level-fpl/

2020 COVERAGE FOR LAWFULLY PRESENT IMMIGRANTS: Lawfully present immigrants are eligible for coverage through the Health Insurance Marketplace.

The term “lawfully present” includes immigrants who have: “Qualified non-citizen” immigration status without a waiting period (see details below) Humanitarian statuses or circumstances (including Temporary Protected Status, Special Juvenile Status, asylum applicants, Convention Against Torture, victims of trafficking) Valid non-immigrant visas Legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals) See a full list of immigration statuses eligible for Marketplace coverage.

Lawfully present immigrants and Marketplace savings

If you’re a lawfully present immigrant, you can buy private health insurance on the Marketplace. You may be eligible for lower costs on monthly premiums and lower out-of-pocket costs based on your income.

If your annual income is 400undefined federal poverty level: If you’re not otherwise eligible for Medicaid you’ll be eligible for premium tax credits and other savings on Marketplace insurance, if you meet all other eligibility requirements.

Immigrants and Medicaid & CHIP

Immigrants who are “qualified non-citizens” are generally eligible for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), if they meet their state’s income and residency rules.

In order to get Medicaid and CHIP coverage, many qualified non-citizens (such as many LPRs or green card holders) have a 5-year waiting period. This means they must wait 5 years after receiving “qualified” immigration status before they can get Medicaid and CHIP coverage. There are exceptions. For example, refugees, asylees, or LPRs who used to be refugees or asylees don’t have to wait 5 years.

The term “qualified non-citizen” includes:

* Lawful Permanent Residents (LPR/Green Card Holder)

* Asylees

* Refugees

* Cuban/Haitian entrants

* Paroled into the U.S. for at least one year

* Conditional entrant granted before 1980

* Battered non-citizens, spouses, children, or parents

* Victims of trafficking and his or her spouse, child, sibling, or parent or individuals with a pending application for a victim of trafficking visa

* Granted withholding of deportation

* Member of a federally recognized Indian tribe or American Indian born in Canada

Medicaid & CHIP Coverage for Lawfully Residing Children and Pregnant Women

States have the option to remove the 5-year waiting period and cover lawfully residing children and/or pregnant women in Medicaid or CHIP. A child or pregnant woman is “lawfully residing” if they’re “lawfully present” and otherwise eligible for Medicaid or CHIP in the state. Learn how someone is defined as lawfully present.

Twenty-nine states, plus the District of Columbia and the Commonwealth of the Northern Mariana Islands, have chosen to provide Medicaid coverage to lawfully residing children and/or pregnant women without a 5-year waiting period. Twenty-one of these states also cover lawfully residing children or pregnant women in CHIP. Find out if your state has this option in place.

Getting emergency care

Medicaid provides payment for treatment of an emergency medical condition for people who meet all Medicaid eligibility criteria in the state (such as income and state residency), but don’t have an eligible immigration status.

Medicaid, CHIP, and “public charge” status

Applying for Medicaid or CHIP, or getting savings for health insurance costs in the Marketplace, doesn’t make someone a “public charge.” This means it won’t affect their chances of becoming a Lawful Permanent Resident or U.S. citizen.There’s one exception. People receiving long-term care in an institution at government expense may face barriers getting a green card.

Read More at: https://www.healthcare.gov/immigrants/lawfully-present-immigrants/