A new federal law was passed in March 2021, the American Rescue Plan Act, and it changed the way we calculate financial help for customers for this year and 2022. Starting May 1, many more customers will now qualify for financial help to make plans more affordable. We will update this article soon with more information on how to qualify.
Complete One Application to See Your Options
Access Health CT is the only place where you can qualify for financial help to lower your health insurance costs or, if eligible, enroll into free or low-cost coverage through HUSKY Health (Medicaid/Children’s Health Insurance Program). Before you begin an application, you can use the Compare Plans tool to enter some basic information about your household – like your tax household size, home address, and household income - to understand your coverage and financial help options.
Your Coverage & Financial Help Options
1. HUSKY Health Programs: Medicaid and the Children’s Health Insurance Program (CHIP)
You may be eligible for HUSKY Health Programs (Medicaid/CHIP) - which offer free or low-cost healthcare coverage if your household meets the income requirements, and you are:
A single Connecticut resident who has no children, or who has children age 19 or older
Parents or caregivers of Medicaid-eligible children
A Medicaid-eligible child (under 19)
For more information about Husky Health Programs, click here.
2. Financial Help Available Only For Qualified Health Plans Offered Through Access Health CT
If you do not qualify for a free or low-cost program through Medicaid or HUSKY Health Programs, you may be able to enroll in a health insurance plan with financial help to lower your healthcare costs.
If you enroll in a Qualified Health Plan (QHP) through Access Health CT, there are two types of financial help you may qualify for:
Premium Tax Credits (PTC) which you can take in advance (APTC) or claim on your federal income tax return
Cost-Sharing Reductions (CSR)
|Financial Help Options for QHPs||What It Does...|
|Premium Tax Credits (PTC), also called Advanced Premium Tax Credits (APTC)||
Reduces your monthly payments (premium) or claim when you file your federal income taxes
|Cost-Sharing Reductions (CSR)||
Reduces what you pay out of your own pocket when you use your plan
More About Financial Help Available Only Through Access Health CT
1. (Advanced) Premium Tax Credits
What is it? Premium Tax Credits (PTC), also called Advanced Premium Tax Credits (APTC), can be distributed monthly or when you file your federal income taxes. When used in advance, Premium Tax Credits can help lower your monthly payments (known as premiums) when you enroll through Access Health CT. To qualify for a Premium Tax Credit, you:
Cannot be eligible for other affordable healthcare coverage through your employer or a government-sponsored program, such as Medicaid, Tricare, Medicare, or VA benefits
Must be a Connecticut resident and a citizen or lawful resident of the United States, and not in prison (other than pending final disposition of charges)
Must enroll in a Qualified Health Plan (QHP) offered through Access Health CT
If you are married, you must file a joint tax return (unless you are a victim of domestic abuse or spousal abandonment)
You must not be claimed as a dependent on anyone else's return
You must file a Form 1040 income tax return at least for the year that you got APTCs and must file IRS Form 8962 to make sure that you got the correct amount of APTCs during the year.
How does financial help work? When you apply through Access Health CT and we determine that you are eligible for Premium Tax Credits, you will be given the option to take the credits in advance (that’s the A in APTC), or you can wait until your annual federal income tax filing to reconcile your household income and Premium Tax Credits. When enrolling online, you can use the sliding scale (on the Advanced Premium Tax Credit selection page) in your application to choose how much of the tax credit to take in advance - you can take all, some, or none of the Premium Tax Credits.
In general, there are two ways you can take advantage of Premium Tax Credits:
In Advance: When you choose to take Advance Premium Tax Credits, the tax credit is paid directly from the federal government to your insurance company to help lower your monthly payments (known as premiums). It’s important that you estimate your annual household income accurately and contact Access Health CT if your income changes significantly from the amount you provided in your application. When you file your federal income taxes (IRS Form 1040) and Form 8962, the IRS will compare your actual household income for the tax year with the estimated income you reported in your application. If the details do not match, then you could owe the IRS for overpayments of APTC.
When You File Federal Income Tax Return (IRS Form 1040): You may be able to claim the Premium Tax Credit (PTC) that you didn't take in advance when you file your tax return. It's important to remember that your ability to claim the PTC depends on providing us an accurate estimate of your household income when you complete your application. When you file your taxes, the IRS will compare what you told us in your application to what your return shows for income, which can impact how much PTC you can claim.
What else is important to know?
Your family's modified adjusted gross income (also known as MAGI), will determine whether you received too much or too little financial help throughout the year. It is important that your MAGI estimate is accurate on your application to avoid owing the IRS, so it is important that you update your MAGI estimate anytime it changes during the year.
2. Cost-Sharing Reductions (CSR)
What is it? Cost-Sharing Reductions (CSR) lower the amount you pay out-of-pocket for deductibles, co-insurance, and co-payments when you get medical services. If you qualify for CSR, you must enroll in a Silver level plan to get these lower costs. Cost Sharing Reductions (CSR) are only available to individuals and families who have a MAGI is between 0% and 250% of the Federal Poverty Level.
CSR plans only exist at the Silver level of plans. For more information about plan types and metal levels, click here.
How does it work?
During your enrollment process you will provide basic information – like estimated MAGI, address and age to determine if you qualify for financial help or are eligible for low-cost or free coverage. If you are eligible for Cost Sharing Reductions, you will need to select a plan at the Silver level to take advantage of this type of financial help. Once you enroll, you will have access to reduced out-of-pocket costs for services when you use your plan.