Plans for Individuals and Families

Individual Healthcare


Choosing the right health insurance for you and your family is an important decision. GUS BATES will work with you to find the right insurance plan to meet your needs.

Learn more about the different types of insurance and how to get the coverage you need.

As individual as you are

Individual Healthcare

There is a specific time period when you can enroll in an individual health insurance policy, this time is called Open Enrollment, and takes place between November 1st through January 31st.

If you enroll between:
November 1st – Enrollment begins
December 15th – Last day to secure coverage effective January 1st.

Special Enrollment Period

Outside of Open Enrollment, you can buy health insurance only if you have an eligible qualifying event, which allows you to purchase a policy for a Special Enrollment Period.

Examples of a qualifying event include:

  • Marriage or divorce
  • Having a baby, adopting, or placing a child for adoption/ foster care
  • Moving your residence, gaining citizenship, leaving incarceration
  • Losing other health coverage due to losing job-based coverage, COBRA expiration, aging off of a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances.

Important: Voluntarily ending coverage is NOT a qualifying event for a Special Enrollment Period. 

If you have any questions about your individual health plan or enrolling in an individual health plan, please contact us.

Penalty

You will not be required to pay a fee for any month you have qualifying health coverage. If you are uncovered for only one or two months, you will not have to pay the fee for either of the two months.

Your fee is calculated one of 2 ways. For 2017 you’ll pay the higher of these amounts:

2.5% of your household income; OR $695 per adult ($347.50 per child; no more than $2,085 per family)

If you have any questions about your current individual health plan or enrolling in an individual health plan, please contact us.

 

Subsidy Information

To qualify for a subsidy you must meet the requirements below.

Subsidies are based on your family size that you claim for tax purposes, counting children under the age of 26 along with modified adjusted household income.

Basic eligibility criteria:

  • You must file a tax return
  • If you’re married, you must file a joint tax return
  • You must not be claimed as a dependent under another taxpayer
  • You must not be able to get health insurance through an employer or spouse’s employer
  • All subsidies paid in error will be sought out by the IRS when you file your taxes

For more facts please visit the IRS website: http://www.irs.gov/pub/irs-pdf/p5120.pdf

If you have any questions about your individual health plan or enrolling in an individual health plan, please contact us.