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What Are The Minimum Requirements To Obtain Coverage Through The Health Insurance Marketplace?
The Marketplace was created to be very accessible to millions of people who might not have had easy access to health insurance coverage in the past. However, there are certain requirements to be met in order to purchase a plan.
- You must be a U.S. citizen or “lawfully present” immigrant.
- You must live in the United States.
- And you can’t be currently incarcerated serving time in a jail or prison.
What Is Minimum Essential Coverage?
To avoid being charged the individual mandate (also referred to as fee, fine, penalty, or responsibility payment), employees are obligated to obtain an insurance plan that meets the requirements of “minimum essential coverage” which include the new benefits, rights, and protections laid out in the legislation, and must remain covered throughout the year, or procure and exemption.
How Are My Premium Costs Calculated?
Insurance companies are prohibited to discriminate when offering health coverage, and there have been new restrictive measures put in place to prevent this .However, there are 5 factors that may be considered when figuring out premium costs.
- Individual vs. Family – A plan covering an individual will generally cost less than a plan covering a family. Size of the family may also factor into the cost.
- Location – Where you reside may affect your coverage cost as an insurance company will consider factors such as competition, local regulations, price of living, etc.
- Tobacco users vs. non-users – There are many health-risks associated with tobacco use, and health insurance companies will definitely factor this into their calculations. Tobacco users will generally expect to pay a higher premium.
- Age – Due to health complications of aging, a younger enrollee will typically pay less than an older enrollee.
- Plan Category – The four metal categories in a Marketplace plan are Bronze, Silver, Gold, and Platinum. Although they offer similar coverage, they differ in premiums and deductible costs depending on the plan you go with.