ACA Insurance Update 2022

ACA Open Enrollment

Open enrollment for ACA Marketplace plans opens November 1 and closes at midnight on December 15 of each year. The dates may vary in states with state-run marketplaces. Plans sold during open enrollment start January 1 of the following year. All plans cover essential health benefits, pre-existing conditions, and preventive services.

A special enrollment period is available for those who have missed open enrollment.

Depending on income, you may qualify for an insurance plan with tax credits or for Medicaid/Children’s Health Insurance Program (CHIP). See where your income falls.

The HealthCare.gov Blog can help you keep up with the latest information. Issues relevant to freelancers are dealt with on the page about Health coverage if you’re self-employed.

Most people in most US states can get coverage through the national marketplace (healthcare.gov). Some states have their own exchanges, and deadlines may differ from those of the national marketplace. Several states have opened their state marketplaces in the past few years.

Note: Updated with premiums for 2022 plans.

The Health Insurance Marketplace Calculator provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter your income, age, and family size to estimate your eligibility for subsidies and how much you could spend on health insurance. You can also use this tool to estimate your eligibility for Medicaid. As eligibility requirements may vary by state, please contact your state’s Medicaid office or Marketplace with enrollment questions.

FAQs on the Healthcare Insurance Marketplace

Medicare and Medicaid 2022

Medicare

Open enrollment begins October 15 and closes at midnight on December 7 each year for Medicare supplemental health plans. Read about Medicare and its supplemental plans, Part D drug plans, and Medicare Advantage plans.

Medicare Part A is free for most people. The monthly Medicare Part B premium is $170.10 in 2022 with an annual deductible of $233. Part C is called Medicare Advantage, and Part D is prescription drug coverage; costs for Parts C and D coverage vary by plan. These costs change only once a year, on January 1.

Beneficiaries with low incomes or certain disabilities are eligible for Extra Help. Beneficiaries with income on their tax returns above $91,000 (individual) or $182,000 (joint) pay higher premiums for Parts B and D in 2022.

Part D prescription drug coverage: In 2022, beneficiaries face a coverage gap in prescription drug coverage . The gap starts when someone reaches the initial coverage limit ($4,430 in 2022), and ends when they have spent $6,550 (and thereby enter what is called catastrophic care, during which they pay only a small co-pay or co-insurance amount). In 2022, enrollees will pay 25 percent of the cost of brand-name and generic drugs. The Medicare Part D maximum deductible is $415 in 2018, up slightly from $480 in 2022.

Enrollment in Medicare Advantage (Part C) is between January 1 and March 31 each year. If you are enrolled in a Medicare Advantage plan, you can leave your plan and return to Original Medicare and buy a Part D prescription drug plan to supplement your Original Medicare. You also have the option to switch to a different Medicare Advantage plan during this time. Only one switch during this time frame is allowed each year—a beneficiary can change their mind multiple times during the enrollment period in the fall, but can only switch to a different Medicare Advantage plan (or back to Original Medicare) once in the first quarter of the new year. But if a beneficiary signs up for a Medicare Advantage plan in the fall and then decides they don’t like it once it takes effect in January, they have until the end of March to make a change.

Medicaid

Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states.

Some states have expanded their Medicaid programs to cover more people. Choose your state and household size to see if your state has expanded and if you may qualify.

Taxes and Health Coverage

For information on your health insurance plan and filing taxes with form 1095-A, visit the healthcare.gov taxes page.