We’ve translated some of the confusing terminology around health insurance into plain English so you can better understand your health plan options.
Cost Sharing Reduction (CSR):
Cost Sharing Reduction provides a discount that lowers the amount you have to pay for deductibles, coinsurance, and copayments. This is based on your income and can only be applied to Silver plans.
Financial assistance or Savings:
There may be ways for those with low or middle incomes to get help paying for their health insurance by signing up for a plan through the Health Insurance Marketplace. If you qualify for financial assistance, the government will pay a portion of your health insurance premiums directly to your health insurance company every month. This will lower the amount of money you have to pay for your health insurance premium every month.
Health insurance requirement or Individual mandate:
As part of the new health care law, most Americans will need to have health insurance. If you do not have health insurance, you may have to pay a fine. You won’t have to pay a fine if you have a very low income and coverage is unaffordable for you, or for other reasons including your religious beliefs. You can also apply for a waiver asking not to pay a fine if you aren’t automatically exempt.
Open enrollment period:
The period of time when you can sign up for health coverage through the Health Insurance Marketplace. The next open enrollment period is from November 1, 2015 to January 31, 2016.
Premium tax credit or Subsidy:
A type of financial help that you may qualify for that reduces your monthly payment (or premium) as soon as your coverage begins. For example, if your premium is $200, and you qualify for a $180 a month premium tax credit, you will pay $20 a month for your insurance plan. The amount of your premium tax credit is based on your estimated yearly income.