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TAX YEAR 2021 Health Care Reform Health Insurance Marketplace Norman M. Golden, EA 1900 South Norfolk Street, Suite 218 San Mateo, CA 94403-1172 (650) 212-1040 [email protected] Health Insurance Marketplace • Mental health and substance use disorder services, in- cluding behavioral health treatment (this includes coun- The Health Insurance Marketplace helps uninsured people seling and psychotherapy). find health coverage. When you fill out the Marketplace ap- • Prescription drugs. plication online the website will tell you if you qualify for: • Rehabilitative and habilitative services and devices (ser- • Private health insurance plans. The site will tell you vices and devices to help people with injuries, disabili- whether you qualify for lower costs based on your house- ties, or chronic conditions gain or recover mental and hold size and income. Plans cover essential health ben- physical skills). efits, pre-existing conditions, and preventive care. If you • Laboratory services. do not qualify for lower costs, you can still use the Mar- • Preventive and wellness services and chronic disease ketplace to buy insurance at the standard price. management. • Medicaid and the Children’s Health Insurance Pro- • Pediatric services, including oral and vision care. gram (CHIP). These programs provide coverage to mil- lions of families with limited income. If it looks like you Essential health benefits are minimum requirements for all qualify, the exchange will share information with your Marketplace plans. Specific services covered in each broad state agency and they’ll contact you. Many but not all benefit category can vary based on your state’s require- states have expanded Medicaid to cover more people. ments. Plans may offer additional benefits that are not in- cluded in essential health benefits, such as dental and vi- If you are eligible for job-based insurance, you can consid- sion coverage. er switching to a Marketplace plan, but you will not qualify for lower costs based on your income unless the job-based Benefits are generally the same in each state. However, insurance is unaffordable or does not meet minimum re- some states require insurers to cover additional services quirements. You also may lose any contribution your em- and procedures. When you compare plans in the Market- ployer makes to your premiums. place, you will be able to see the specific benefits each plan offers. What is Covered? All private health insurance plans offered in the Market- How to Apply for Marketplace Coverage place offer the same set of essential health benefits. The es- Open Enrollment sential health benefits include at least the following items An open enrollment period is a yearly time when you can and services. enroll in a health insurance plan. The open enrollment pe- • Ambulatory patient services (outpatient care you get riod is generally November 1 through December 15. Some without being admitted to a hospital). states have longer open enrollment periods that start soon- • Emergency services. er and/or end later. • Hospitalization (such as surgery). • Maternity and newborn care (care before and after your baby is born). continued Health Care Reform State Marketplace Health Insurance Minnesota MNsure Marketplace https://www.mnsure.org/ Nevada Nevada Health Link Outside the open enrollment period, you can only enroll in https://www.nevadahealthlink.com/ or change a Marketplace plan if you have a life event that New Jersey Get Covered NJ qualifies you for a Special Enrollment Period. You may qual- https://nj.gov/getcoverednj/ ify for special enrollment if you or anyone in your house- New York New York State of Health hold in the past 60 days: https://nystateofhealth.ny.gov/ • Got married. Pennsylvania Pennie • Had a baby, adopted a child, or placed a child for foster https://pennie.com/ care. Rhode Island HealthSource RI • Got divorced or legally separated and lost health https://healthsourceri.com/ insurance. Vermont Vermont Health Connect • Died. https://portal.healthconnect.vermont.gov/ • Moved to a new ZIP code or county. Washington Washington Healthplanfinder • Lost qualifying health coverage (including through your https://www.wahealthplanfinder.org/ job or a family member). • Lost eligibility for Medicaid or CHIP. Other Ways to Apply Note: There is no limited enrollment period for Medicaid • Find and contact an agent, broker, or assister to help you. or CHIP. If you qualify, coverage can begin immediately. Some offer help in languages other than English and in-person assistance. Apply Online • Apply through the website of an approved enrollment Most states do not have their own Marketplace. Individu- partner, such as an insurance company or online health als in those states can use HealthCare.gov to apply for and insurance seller. enroll in health coverage online. If you live in a state that • Contact the Marketplace Call Center at 1-800-318-2596 operates its own Marketplace, you will go to your state’s (TTY 1-855-889-4325) to enroll by phone. Marketplace website to apply and enroll. See the following • Print an application obtained online at HealthCare.gov and chart. mail it to the Marketplace. You will get eligibility results in the mail within two weeks. State Marketplace California Covered California https://www.coveredca.com/ Colorado Connect for Health Colorado https://connectforhealthco.com/ Connecticut Access Health CT https://www.accesshealthct.com/ District of DC Health Link Columbia https://dchealthlink.com/ Idaho Your Health Idaho https://www.yourhealthidaho.org/ Contact Us Maryland Maryland Health Connection There are many events that occur during the year that can affect your tax situation. Preparation of your tax return involves sum- https://www.marylandhealthconnection.gov/ marizing transactions and events that occurred during the prior Massachusetts Health Connector year. In most situations, treatment is firmly established at the https://www.mahealthconnector.org/ time the transaction occurs. However, negative tax effects can be avoided by proper planning. Please contact us in advance continued in next column if you have questions about the tax effects of a transaction or event, including the following: • Pension or IRA distributions. • Retirement. • Significant change in income or • Notice from IRS or other deductions. revenue department. • Job change. • Divorce or separation. This brochure contains general information for taxpayers and • Marriage. • Self-employment. should not be relied upon as the only source of authority. • Attainment of age 59½ or 72. • Charitable contributions Taxpayers should seek professional tax advice for more information. • Sale or purchase of a business. of property in excess of • Sale or purchase of a residence $5,000. Copyright © 2021 Tax Materials, Inc. or other real estate. All Rights Reserved Powered by TCPDF (www.tcpdf.org).
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