New 2021 Marketplace Plans Selected Midyear, Require You To Satisfy The Plan’s Full Deductible

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Preferred Health Insurance Solutions advises consumers entering the ACA Marketplace midyear that they will still need to meet the full yearly deductible before certain benefits can be paid out.

Preferred Health Insurance Solutions' licensed health insurance agents are available to help consumers enroll in the ACA Marketplace.

Many consumers who enroll in the ACA Marketplace mid-year are not fully aware that they will still need to pay the plan’s entire deductible before certain benefits can be paid.

All ACA Marketplace health insurance plans, purchased on and off the exchange, have a calendar year deductible that runs from January 1 through December 31. The calendar year deductible applies to both Individual or Family plans. Items like deductible, and maximum out-of-pocket expenses, will reset every January 1st.

Robert Dial, Vice President, Preferred Health Insurance Solutions, formally known as ACA Marketplace Enrollment Solutions (ACAEnroll.com), explains, “Many consumers who enroll in the ACA Marketplace mid-year are not fully aware that they will still need to pay the plan’s entire deductible before certain benefits can be paid. The health plan’s deductible is not prorated to half the annual deductible.”

Consumers do have time to take advantage of the American Rescue Plan Act (ARPA) which ends on Aug. 15, 2021. The goal of the new ARPA is to improve access and affordability of health coverage through the ACA Marketplace by increasing eligibility for financial assistance to help pay for ACA Marketplace coverage.

The ARPA will not impact the 2021 Marketplace plan deductible, but it may make having health coverage more affordable. Even those already enrolled through HealthCare.gov will need to reapply to determine if they are eligible for a larger subsidy. When consumers enroll in the ARPA, they can choose a plan that is the same, costs more or costs less than the benchmark plan. The 8.5% cap is used to calculate this increase in premium tax credit amounts, but the cost of the plan a consumer chooses to enroll in may be higher or lower than the benchmark plan.

Dial remarked, “A Preferred Health Insurance Solutions agent can help an individual calculate the new tax credit and help compare plans. This will ensure an individual’s health plan truly fits their individual or family’s healthcare needs. It is vital that all Americans act before the SEP ends on Aug. 15th deadline. If they do not act now, they will miss the opportunity to take advantage of the ARPA and possibly lower their ACA Marketplace plan 2021 health care premium.”

Preferred Health Insurance Solutions has established a Call Center of multilingual, licensed health insurance agents who have been trained to walk a client through the entire process of selecting a healthcare plan and enrolling them for their coverage, as well as responding to any questions they may have regarding their new health insurance policy. Because of their extensive marketplace experience, Preferred Health Insurance Solutions agents can help the determine if the individual qualifies for financial assistance to help pay for their health insurance, as well as go over with them deductibles and other out-of-pocket costs. Consumers can call the Preferred Health Insurance Solutions’ Call Center at 800-342-0631 or access the company’s website at https://www.PHISonline.com.    

About Preferred Health Insurance Solutions    
Headquartered in Bedford Park, Illinois, Preferred Health Insurance Solutions (PHIS) is a national enrollment firm specializing in the Health Insurance Marketplace as well as a variety of other health insurance products including Dental, Critical Illness; Short Term Major Medical; and others. Preferred Health Insurance Solutions, formerly known as ACA Marketplace Enrollment Solutions (ACAEnroll.com) provides enrollment services throughout the country, through national and regional insurance carriers. Consumers can call the PHIS Call Center at 800-342-0631 or access the company’s website at https://www.PHISonline.com.

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