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Health Insurance for Low-Income Adults

If you are under 30, you can get health coverage a few different ways; some designed specifically for you. Here are some different ways to get a health insurance plan.

Getting or Staying on a Parent’s Health Insurance Plan.

• Under 26? You may be able to get on a parent’s health insurance plan
• Purchasing your insurance plan
• Depending on your state, you may be eligible for savings based on your income. You can pick a “Catastrophic” health plan to protect yourself mainly from worst-case situations.
• One catch: If somebody claims you are tax-dependent, you can purchase a plan through the Marketplace but won’t qualify for savings based on your income.

Student Health Insurance Plans

• If you are in school, you may be able to enroll in a student health insurance plan — and meet the requirement for having coverage under the health care law.

Medicaid and CHIP

• If your income is low or you have certain life situations, you could be eligible for free or low-cost coverage through Medicaid.
• If your state has expanded Medicaid coverage, you can qualify depending on your income alone — in many states that have expanded, that’s around $17,236 or less for a single individual, about $23,335 or less for couples without children.
• In all states, you can be eligible based on factors including income, some family situations such as pregnancy and having young children, and disability.
• If you have children, they might be eligible for coverage under the Children’s Health Insurance Program (CHIP) — even if you do not qualify for Medicaid.

Cost-Sharing Reductions

After you fill out an application with the Health Insurance Marketplace and offer household and income information, you will find out if you are eligible for a premium tax credit that lowers your monthly health insurance bill.

You will also find out if, in addition, your income qualifies you for additional savings known as “cost-sharing reductions.” If it does, you can save money a second way: by paying less out of pocket every time you get medical services.

Qualifying for Cost-Sharing Reductions

• If it does fall in the range, the amount you will save on out-of-pocket costs depends on your specific income estimation. The lower your income within the range, the more you will save.
• You will find out exactly how much you will save only after applying and shopping for Silver plans in the Health Insurance Marketplace.

How Cost-Sharing Reductions Work

If you are eligible for savings on out-of-pocket costs and enroll in a Silver plan:

• You will have a lower deductible. This means the insurance plan begins to pay its share of your medical costs sooner. For instance, if a particular Silver plan has a $750 deductible, you have to pay the first $750 of medical care yourself before theinsurance carrier pays anything (other than for free preventive services). But if you are eligible for cost-sharing reductions, your deductible for a Silver plan could be $300 or $500, depending on your income.
• You will have lower copayments or coinsurance. These are the payments you make every time you get care — like $30 for a physician visit. If a Silver plan’s copay is $30 for a doctor’s visit, if you enroll in the plan and qualify for additional savings, you may pay $20 or $15 instead.
• You will have a lower “out-of-pocket maximum.”This means the total amount you’d have to pay in a year if you utilized a lot of care like if you got very sick or had an accident, would be lower. Instead of $5,000, your out-of-pocket maximum for a particular Silver plan could be $3,000.

Resources and References:

• Cost-Sharing Reductions
• Free or Low-cost Health Insurance