2025 KFF Marketplace Enrollees Survey
In 2025, about one in three ACA enrollees said they would be “very likely” to look for a lower-premium Marketplace plan If their premium payments doubled.
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In 2025, about one in three ACA enrollees said they would be “very likely” to look for a lower-premium Marketplace plan If their premium payments doubled.
Adults ages 50 to 64 are disproportionately affected by the expiration of ACA enhanced premium tax credits because they make up a large number of Marketplace enrollees and premiums rise with age.
Following the expiration of the enhanced premium tax credits for people with Affordable Care Act (ACA) Marketplace plans, a new KFF follow-up survey of the same Marketplace enrollees KFF surveyed in 2025 finds half (51%) of returning enrollees say their health care costs are “a lot higher” this year compared to last year, including four in 10 who specifically say their premiums are “a lot higher.”
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Los planes "grandfathered" (exentos) son los que existían el 23 de marzo de 2010 y se han mantenido básicamente igual. Los planes de salud "grandfathered" no están obligados a proporcionar todos los beneficios y protecciones al consumidor que se requieren de otros planes de salud.
Puede apelar si cree que su decisión de elegibilidad fue equivocada. La información sobre los derechos de apelación y audiencia imparcial, y cómo presentar una apelación, debe incluirse en el aviso que recibió informándole que su cobertura de Medicaid había terminado.
Debe comunicarse con el mercado de seguros de salud para advertir sobre el error y solicitar un formulario 1095-A corregido. La información sobre el 1095-A también se reporta al IRS, por lo que es importante que obtenga un formulario corregido antes de presentar su declaración de impuestos.
Suponiendo que ninguno de los dos declara dependientes en su declaración de impuestos, se considerará que cada uno forma un hogar individual y sus ingresos se utilizarán para determinar la elegibilidad y el monto de los subsidios para las primas y las reducciones de costos compartidos.
Al solicitar el subsidio para las primas, se le pedirá que calcule sus ingresos esperados para el año siguiente. Un buen punto de partida suele ser considerar sus ingresos de este año o los que declaró en su declaración de impuestos del año anterior.
Todos los mercados de seguros deben ofrecer programas de "Navegadores" para ayudar a los consumidores a revisar sus opciones de planes, completar su solicitud de ayuda asistencia financiera, incluyendo ayuda para solicitar Medicaid o CHIP. Los navegadores también pueden ayudar con otros procesos, por ejemplo, cuando el consumidor quiere apelar las decisiones del mercado.
Many employers, especially large ones, offer workers health coverage that is known as a “self-funded” (also referred to as “self-insured”) arrangement, which is where the employer pays enrollees’ medical claims directly, as opposed to traditional health insurance (known as fully-insured), where the employer buys coverage from a state-regulated insurance company.
Although your husband now qualifies for Medicare, you will not qualify for Medicare until you turn 65. If you do not have health insurance now, you can consider signing up for a Marketplace plan.
If you are not yet enrolled in Medicare, you can buy health insurance coverage through the Marketplace before you turn 65, and if you have a Marketplace plan, you can choose to renew it after you turn 65.
You can request an appeal of any Marketplace decision, including: Your eligibility to buy coverage in the Marketplace Your eligibility for, or the amount of, premium tax credits or cost sharing reductions (for example, a reduction in your premium tax credit amount) Untimely (late) notice from the Marketplace about a decision To start your appeal,…
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