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Kaiser Family Foundation

I’m divorced and I pay alimony to my ex-spouse. Should I deduct that from my income in determining my eligibility for subsidies?

For divorces after December 31, 2018, alimony payments are no longer deductible for the paying spouse and alimony is not included as income for the recipient spouse. For pre-2019 divorces, old tax rules apply.  The paying spouse can deduct alimony payments from income and the recipient spouse must report alimony…

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Kaiser Family Foundation

Is the value of my house counted in determining my eligibility for premium tax credits in the Marketplace?

No, assets are not counted. So the value of your house, car, retirement savings, etc. will not affect your eligibility for premium tax credits. Only your income is considered.

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Kaiser Family Foundation

Will private enrollment websites sell plans other than qualified health plans?

Yes.  A number of private enrollment websites will also sell short-term health insurance and other products that do not cover all the benefits and provide all the protections of Marketplace plans.  These plans can turn you down or charge you more if you have a pre-existing condition.  Some private sites…

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Kaiser Family Foundation

Can I apply for financial assistance through private websites?

It depends.  Some websites will connect you back to healthcare.gov to complete an application for financial assistance.  Other websites, designated as “full service partners” have features that let you apply for financial assistance on that site. However, experts who have spent time testing these sites online and with ‘secret shoppers’…

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Kaiser Family Foundation

Will private enrollment websites show me all of the plan choices that I would find on healthcare.gov?

Not always.  Private, direct enrollment websites that are run by insurance companies typically only show plans offered by that insurer.  Sites run by web brokers usually show plans offered by multiple insurers, but won’t necessarily display all of the plan options or information that you would find on healthcare.gov.

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Kaiser Family Foundation

I like my Marketplace plan just the way it is. Will it stay the same next year?

It depends.  Insurers are allowed to make changes to policies each year.  Most likely, the premium for your current policy will change next year.  There may be other changes as well, for example, changes in the deductible or copays for some services.  In some cases, an insurer may stop offering a…

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Kaiser Family Foundation

What happens if I need care from a doctor who isn’t in my plan’s network?

Plans are not required to cover any care received from a non-network provider, though some Marketplace plans do, at least to some extent. If you do receive care out of network, it could be costly to you. Generally plans that provide an out-of-network option cover such care at a lower…

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Kaiser Family Foundation

I signed up for a Bronze plan with a high deductible during Open Enrollment. Now, six months later, I need surgery and would rather be in a different plan with a lower deductible. Can I change plans?

No, in general, once you sign up for a plan, you are locked into that coverage for 12 months, or until the next Open Enrollment period. A change in health status doesn’t make you eligible for a special enrollment opportunity.

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Kaiser Family Foundation

Will covered benefits under all Marketplace plans be the same? How can I compare?

Not necessarily. All Marketplace health plans are required to cover the ten categories of essential health benefits. However, insurers in many states will have flexibility to modify coverage for some of the specific services within each category. Any modifications must be approved by the Marketplace before plans can be offered.…

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The Henry J. Kaiser Family Foundation Headquarters: 185 Berry St., Suite 2000, San Francisco, CA 94107 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.