Health Insurance for 2023: A Guide to Getting Coverage

Picture of Ty Bernicke, CFP® | President & CEO

Ty Bernicke, CFP® | President & CEO

Do you still need health insurance for 2023? If you missed the December 15, 2022 deadline to apply for Marketplace coverage, fear not! There is still time to get health insurance.

Important Dates

Open Enrollment ends on January 15, 2023, to apply for and enroll in health insurance for coverage beginning February 1. Following Open Enrollment, participants may only establish or adjust health plans by qualifying for a Special Enrollment Period through certain life events. For those approaching retirement, these may include:

  • Losing health coverage
  • Moving
  • Maintaining household income below a certain level

How do I apply for coverage?

Visit the Marketplace website online at www.healthcare.gov to explore coverage options or to find contact information for an agent in your area.

What information will I need in my application?

During the application process, Marketplace collects the following information while finding plans that may suit your needs:

  • Personal information
  • Household information
  • Home address
  • Basic information for everyone needing coverage
  • Information about a professional helping you apply for coverage (if applicable)
  • Immigration document information (if applicable)
  • Tax filing information
  • Current health coverage information
  • Health Reimbursement Arrangement notice (if applicable)

What is the Affordable Care Act?

The Affordable Care Act (ACA), otherwise known as the Patient Protection and Affordable Care Act (PPACA) or “Obamacare,” was enacted in 2010 to provide comprehensive reform for health care in the United States. Currently, 30 states have ACA insurance available, while 20 states and the District of Columbia have state-run health insurance. The federal ACA Marketplace and other state-run insurance programs provide health insurance to those who do not have access to coverage through their employer or do not wish to use a work-sponsored plan. Participants’ monthly insurance premiums are calculated as a percentage of their estimated annual Modified Adjusted Gross Income (MAGI).

Enrollees may be eligible for tax subsidies if premiums exceed a certain percentage of MAGI for a benchmark plan, which is the second lowest-cost silver plan on Marketplace for a specific area. These subsidies, known as premium tax credits, lower monthly insurance premiums for households that maintain a certain level of income. The lower a household’s MAGI, the greater the amount of tax credits received. Participants in ACA or state-run insurance programs will not pay more than 8.5% of MAGI in premiums for a benchmark plan. The Inflation Reduction Act passed in August of 2022 extended these tax subsidies through 2025.

Marketplace sends the tax credit directly to the insurance plan, which allows participants to save on monthly premiums. When household income changes, the premium tax credit also changes. Participants may have to pay money back while filing federal income tax returns if their actual income is greater than their projected income at the end of the year.

Where can I get more information?

We recognize that every individual’s insurance needs are unique. Contact us to discuss obtaining health insurance through the ACA Marketplace or a state-run insurance program and determine the best strategy to optimize your tax credits.

References

Securities offered through LPL Financial, Member FINRA/SIPC. Investment advice offered through Great Valley Advisor Group, a registered investment advisor. Great Valley Advisor Group and Bernicke Wealth Management are separate entities from LPL Financial. Content in this material is for general information only and is not intended to provide specific financial or tax advice recommendations for any individual.

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