Questions & Answers

We review the full range of Kaiser Permanente health care offerings in your area. It’s one of the many reasons why you can feel good about coming back to Kaiser Permanente. We’ll help you find the right health care option for today and tomorrow.

Open Enrollment for individual plans begins November 1, 2022 for coverage that becomes effective January 1, 2023 or later. Most people are required to have health insurance and are eligible for it, regardless of health history. Explore the new options that will be available to you.

A household includes you (the tax filer), your spouse if you have one, and your tax dependents.

For more information on who to include in your household, visit who to include in your household.

1. Start with your household’s adjusted gross income (AGI) from your most recent federal income tax return. You’ll find your AGI on line 7 of IRS Form 1040.
2. Add the following kinds of income, if you have any, to your AGI:
   a. Tax-exempt foreign income
   b. Tax-exempt Social Security benefits (including tier 1 railroad retirement benefits)
   c. Tax-exempt interest
   d. Don’t include Supplemental Security Income (SSI)
3. Adjust your estimate for any changes you expect. Consider things like these for all members of your household:
   a. Expected raises
   b. New jobs or other employment changes, including changes to work schedule or self-employment income
   c. Changes to income from other sources, like Social Security or investments
   d. Changes in your household, like gaining or losing dependents. Gaining or losing a dependent can have a big impact on your savings
4. Now you have an estimate of your expected income.

The federal government may provide financial assistance to help you pay for health coverage or care if you can’t afford it. This is usually determined by income level and family size. Find out if you’ll qualify for federal financial assistance. Depending on the state in which you live, you may also qualify for state financial assistance.

The Health Benefit Exchange, sometimes called “Exchange,” is a state- or federally-run place – website, call center, and physical location – where you can buy health care coverage. You are able to compare and choose health plans offered by providers like Kaiser Permanente, get answers to questions, and find out if you’re eligible for federal financial assistance or special programs. The annual open enrollment period through the Health Benefit Exchange begins November 1, 2022. Individual plan coverage purchased through the Health Benefit Exchange will be effective on January 1, 2023, or later.

The term “health care reform” refers to the Affordable Care Act, as well as any state laws passed to put it in place. These laws are intended to help more people get affordable health care coverage and receive better medical care. Learn more about health care reform.

No, not necessarily. The Health Benefit Exchange is just one of the ways you can shop for health care coverage. You can still get coverage through your employer [or directly from a health plan issuer like Kaiser Permanente]. You’ll have to buy coverage through the Health Benefit Exchange to apply for financial assistance; federal financial assistance is not available if health plan coverage is purchased outside of the Exchange.

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Of course. We’re committed to helping you thrive and pinpointing the health care plan that’s right for you. Please call Kaiser Permanente Member Services for your area.