2025 Affordable Care Act (ACA) Health Insurance Updates - Guaranteed to learn at least 1 thing

Hello, this is Kevin Trubenbach with Transition Health Benefits team. I'm going to be going over your 2025 Guide to Buying Health Insurance. The health insurance rates go live for 2025 on November 1st of 2024. When you hear ACA or Marketplace or Healthcare.gov or Obamacare that all means the same thing. Those are the plans with the Affordable Care Act or through Healthcare.gov. Our agency, we work in Wisconsin and several other states. We're here to help. We also handle several Medicare type plans. Here is the team that we have to help assist. And remember, applying from November 1st through December 15th, you get a January 1st start date. December 16th through January 15th, you get a February 1st start date. Okay, so this got signed into law from President Biden back in August of 2022 called the Inflation Reduction Act. And that's going through 2025 where higher income earners can still qualify for a subsidy. So notice there's the 400%. That was the good old days where if you made $1 above $60,240, you did not get any kind of subsidy. You can now make above that amount and it goes off of your age zip code and where you live based on the subsidies amount. Easiest way is to go to Healthcare.gov or our links below and you can click on that and figure out on our links. It's within two minutes you can figure out your subsidy for 2025. Okay, also there are these plans called cost share reduction plans. What that means, the government, if you make lower income, you qualify for these special plans. There's three different cost share levels to lower the income. So for example, if you're a single and you make between $15,000 and $22,000, you'll get a better plan, lower deductibles, lower co-pays, lower max out of pocket. Those cost share plans as they go up the three different levels, then like for example, from $150,000 to $200,000, you'll still qualify for a special plan, but those plans must be purchased in this silver category to get those special lower cost plans. Keep in mind, if you're above 250%, you can still qualify for a subsidy, you just wouldn't qualify for one of the special cost share plans. This income chart here is the 2025 income chart for the new year. On our system that we use, it shows the little CSR. If you're on healthcare.gov, it shows extra savings. And this is a recap 400% or higher. So this is how you figure out the amount of subsidy. Everyone asks, hey, how much is my subsidy for next year? Well, there is no set guide. So the easiest way for us is we rerun the rates with whatever your 2025 estimated income is. And remember, at the end of the year, if you're off by your estimates, you will either owe a few dollars back or get a few dollars back come tax time. Key provisions on the Affordable Care Act, the health insurance marketplace, the majority of plans are network based, you must use in network providers to seek care unless it's an emergency. So that's a question to ask, hey, what providers do these insurance companies work with? And there's these different categories, the bronze, silver, gold and platinum availability based on where you live and the market that you are in. Notice also is the subsidies, it is your estimated 2025 household income, which would determine your rates and plan options. So if you're married, and your husband's on Medicare, and you're under the age of 65, and you need the Affordable Care Act, it is looked at the household income, even only one person's on the plan. Remember, pre existing conditions have to be covered. The essential benefits like emergency care, hospitalizations, mental health also has to be covered. Dependent care through the age 26 can remain on your plan. And preventative services, you must use an in network provider. But when you do it is covered 100%. We made this little guide here, you can download this entire document in the description below. But this is a nice little one page sheet that you can ask the providers on, you know, who do they work with the cost sharing out of pocket maximums, the open enrollment stages. It is our recommendation, you're here, we're here to help you with the 2025 renewal process. If you're currently on a plan now, remember, you're getting a renewal from your insurance carrier, more than likely that renewal letter that you're getting, it is wrong. The reason is when the marketplace sent out those letters, the only subsidy they had available was the 2024 subsidy. So when the lenders letters were printed, the 2025 subsidy wasn't released yet. That starts November 1, when we know the 2025 subsidy. So that's why it's important to see what your subsidy will be in 2025. 99% of the time, it's going to be different from 2024. Our links below, you can figure it out in under two minutes. Also, our links are fully integrated with healthcare.gov. However, you never have to go to the healthcare.gov website. And new rules starting in June of 2024. If you're working with an agent, they must need your consent and attestation to work with you. You can see our consent form here. When you download this document, all of these links are user friendly, you can click on them. Also, if you want, you can work with any in our agency, pick any associates you'd like to work with. Also, some of the other reminders for 2025 tips. As I mentioned, all ACA plans must cover pre-existing conditions, out of pocket maximum is $9,200. There are alternative health plans out there, such as short term plans. But now, due to this, the short term plans are only good for 90 days. So you can no longer do a short term plan for 12 months, it's only 90 days. And then please buyer beware, if you're on social media, and you see some ads that look too good to be true, and you click on them, and you put in your information, you'll notice you'll get a lot of calls. Typically, those entities are selling your information to a bunch of other entities, and now they'll keep calling me. And notice, these are some sample ads that I pulled off on social media. If you're seeing something advertised for a visa gift card, you know, no enroll in no cost health insurance plan, never have to speak to an agent or if you get a three day voucher. That is all buyer beware. You can do your investigation, but please ask this one question. If you have a claim for $100,000, how much will your plan cover? This inquiry will help determine the reliability of their coverage. If they cannot give you an answer, if they cannot email you information, hang up, because more than likely it's a scam, or it's not true insurance. Also, for emergency care, all plans must cover you in and out of network for emergency care due to the No Surprise Act. You can also feel free on our website or click here. We'll walk you through some cool tips on how to use our coding system. As I mentioned, our coding system is fully integrated with healthcare.gov, but you never have to go to the healthcare.gov website. And what to look for in 2025. These plans were available in 2024, but there are multiple companies offering a $0 deductible plan. It's where you have co-pays for services with no deductible. It's those co-pays that go towards your maximum amount of pocket. 2025 maximum amount went down to $9,200 for an individual, $18,400 for a family. That is down from 2024. So keep an eye out for these new plans. Not all insurance companies offer them. Also, when you go through, we're here to help you. This lovely world of insurance. This is our team. Feel free to follow us on Facebook, LinkedIn, social media. These are all of our links that are user active. They will be in the description below. And we have over 600 Google reviews. We're here to help. Please comment below. If you learn something, we're here to help. Good luck. And thank you so much from all of us at Transition Health Benefits.