Can I get a health insurance subsidy for out-of-pocket costs?

Asked November 25, 2013, 10:57 AM EST

I have CIDP and I receive IVIGS monthly. On our old plan, there was a $3,000 out-of-pocket maximum, but the new plans are $12,000 and more. I am guaranteed to hit the out-of-pocket maximum every year. We are a family of three with an income of $42,000 gross. We cannot afford another $1,000 a month.

Sanilac County Michigan insurance health insurance affordable care act

1 Response

Tax credits and cost-sharing subsidies are only available for health insurance plans chosen through the Marketplace at www.healthcare.gov. I am not familiar with the acronyms you used in your question, to know if your old plan was provided by an employer or you purchased it from a private insurer directly. If your employer provides health insurance coverage and you decide to instead purchase a plan in the Marketplace, you may be responsible to pay for the entire cost Marketplace plan. If you purchased your old plan directly from a private insurance company, I suggest you explore www.healthcare.gov for 2014 coverage.
If you set up an account in www.healthcare.gov, your personal information will be reviewed to see if you are eligible for tax credits and/or cost-sharing reductions based on your income and family size. (Cost-sharing reductions are for deductibles, coinsurance and copayments, and only if you choose a Silver plan). Visit https://www.healthcare.gov/will-i-qualify-to-save-on-monthly-premiums/ and https://www.healthcare.gov/will-i-qualify-to-save-on-out-of-pocket-costs/ to learn more. You may also want to check out the online calculators at Online calculators https://www.healthcare.gov/find-premium-estimates/ and http://kff.org/interactive/subsidy-calculator/ to help estimate your family health insurance premiums and subsidies in the Marketplace as you comparison shop.
Michigan State University Extension is providing education about health insurance basics this fall, including the why, what and how for making a smart decision. Find out about Smart Choice: Health Insurance workshops and factual information at http://aca.msue.msu.edu. I know some workshops are being offered in Lapeer County during the next few weeks. We also have free online webinars you can join every Monday at 9 am, 3 pm, or 6 pm at http://connect.msu.edu/healthinsurance to learn more.