Health insurance is endlessly complicated and is different for each person, so it's important to ask for help. Check out the Frequently Asked Questions below or find some resources here. Don't give up and let us know how we can help.
By using this resource, you understand and agree that the information given is not intended nor implied to be, and will not be used as, a substitute for professional legal, tax, insurance or healthcare advice (but we’re happy to refer you to these professionals). Springboard for the Arts is not a provider, agent/broker, advisor or consultant of healthcare or health insurance.
Health Insurance 101
People get health insurance to help them pay for their everyday healthcare (things like doctor visits, vaccinations, emergency room visits, mental healthcare and prescription drugs) and/or to protect themselves from a big, unexpected medical bill.
Federal law says you have to, but there’s currently no legal punishment for not having it. (People used to pay a penalty for not having insurance, but that went away.) That said, we think insurance is worth getting since it can help pay for everyday healthcare costs and protect you from a big, unexpected medical bill.
Yes! Insurance companies can’t turn you down or charge you more because of your health. It’s the law!
The price of health insurance varies a lot. We’ve seen some health insurance that’s free, and some health insurance that costs as much as $700 a month for one person.
How much you pay depends on things like how old you are, if you use tobacco, how much money that plan typically pays for healthcare, what plans are available where you live, and if you can qualify for free or discounted health insurance. You can’t be charged more or less for your insurance because of your health or gender.
No! There are many kinds of health insurance plans. One plan might help pay more for the same healthcare than another plan will. Some pay for healthcare that other plans won’t.
Check the insurance plan’s “Summary of Benefits,” or click here to find someone to help you understand. The “Summary of Benefits” tells what type of healthcare is paid for and how much of it the insurance company will pay for. Most health insurance plans also come with some free care, things like a yearly doctor check-up and a free flu shot.
Health insurance doesn’t help pay for every type of healthcare or prescription drug that you might need, so it’s best to find out what each plan does and doesn’t include. Most health insurance plans won’t help pay for dental care or eye care, but you can buy other vision or dental insurance for that.
No! The places (doctors offices, clinics, hospitals, etc.) where your insurance can be used are called “in-network.” You can go to go places outside of your insurance plan’s network, but your insurance might not pay for any of it, or may pay less than if you’d gone somewhere in your network.
Call the customer service phone number listed on your health insurance membership card to find out which places are in your health insurance plan’s network.
- What clinics/hospitals/doctors the insurance can be used at (this is called the health insurance plan’s “network.”)
- How much it costs just to have the insurance plan (this is called the “premium” or the monthly payment amount).
- What prescription drugs the insurance will help pay for (the list of drugs an insurance company will help pay for is called a “formulary”).
- How much you will have to pay, and how much the insurance company will have to pay, for healthcare (“copays,” “deductibles” and “coinsurance”).
About Free & Discounted Insurance
Free and discounted insurance is typically for people who aren’t able to get their insurance through an employer, union, school, etc. Most people we talk to can get free or discounted insurance because they are self-employed and because their income makes them eligible, or because they are aged 65 and older.
Medical Assistance is free health insurance that’s typically for people who don’t get their insurance through Medicare or a group (like an employer, union or school).
Medicare is discounted insurance that’s typically for adults age 65 and older, but can also be for certain young people with disabilities or people with end-stage renal disease.
MinnesotaCare is discounted health insurance that’s typically for people who don’t get their insurance through Medicare or group (like an employer, union or school).
A tax credit is another kind of discount you can get on your health insurance that’s typically for people who don’t get their insurance through Medicare or a group (like an employer, union or school).
- How many people are in your family, aka your household (usually, this is who is included on your income tax return)?
- How much money does your household make per month right now?
- How much money does your household plan to make in the year you’re getting insurance for?
- Does anyone in your household have a choice to get insurance through a group (like an employer, union, school) or through Medicare?
- What is the citizenship, or immigration status, of your household members?
- Is anyone in your household under 18 years old, under the age of 2, 65 or over, pregnant, elderly, blind or disabled?
You’ll have to make an educated guess on how much money you’ll make. You can do this by thinking about how much money you already know you’ll make and/or what income you’ve had in the past years that’s likely to happen again. If you discover that your estimate is wrong, call and change it.
For those who qualify for a tax credit, the amount is based on:
1) Where, on federal poverty line (FPL), is your household’s modified adjusted gross income (projected income for the year you’re getting insurance)? Look up where your income falls on the FPL here.
2) The price of the second-lowest cost, silver-level health insurance plan available to you via MNsure. This is called the “Benchmark Plan.”
In a nutshell, the government doesn’t want you paying more than a certain percentage of your income for that Benchmark Plan. The tax credit covers the difference. You can then use that amount to discount any plan available to you via MNsure. See the chart below.
For example, a single person (household of 1) that makes $38,000 has an income about 300% of the Federal Poverty Line (FPL). According to the chart, the government doesn’t want them paying more than 6% of their income, or $2,280/year, for that Benchmark Plan. If the Benchmark Plan costs $4,200 year, their tax credit amount would be about $1920/year or a savings of $160/month. That discount amount can be used for any insurance plan available to them via MNsure.
When Do I Get the Tax Credit? The full tax credit amount can be received as a refund when you file your tax return or you can get an advance on the tax credit to reduce the cost of your health insurance premiums each month. If you get an advance on the tax credit and your income ends up to be less than what you projected it would be, you may get a rebate when you file your tax return; if your income is more than what was projected, you may have to pay some or all of that discount back.
The American Rescue Plan Act provides additional support to help people afford health insurance in 2021 and 2022.
Increased Tax Credit Amounts
Individuals who qualify for a tax credit and buy health insurance via MNsure will likely see a boost in the amount of the tax credit they're eligible for. That means more savings on health insurance premiums in 2021 and 2022.
Expanded Eligibility for Tax Credits
In addition, some people will be newly eligible for a tax credit because there's no income restriction to qualify in 2021 and 2022. The tax credit is only available for plans purchased via MNsure (you may still be able to sign up, though—see “Special Enrollment Period” below).
Unfortunately, there's been no change to the rule that disqualifies many people from tax credits because they have access to group health insurance. This is commonly referred to as "the family glitch."
When Will I See This Extra Money?
While these changes are retroactive, starting back to January 1, 2021, you won't immediately see your health insurance premium cost decrease (though it’s still possible you may later this year). Instead, you’ll likely see this in the form of a refund when you file your tax return for the 2021 tax year.
Special Enrollment Period
Through May 17, 2021, MNsure is allowing Minnesotans who aren't already enrolled in health insurance through MNsure to enroll in a plan. If you’re already enrolled in a plan via MNsure and have become newly eligible for tax credits, you may be able to switch health insurance plans. See more info here.