Temporary Healthcare Cost Assistance may be available if you became eligible for Carewell SEIU 503 benefits outside of Open Enrollment and you’re enrolled in a non-approved plan on a health insurance Marketplace. In this case, you would receive a Benefit Convenience Card to pay covered out-of-pocket expenses. You may also be eligible for temporary reimbursement of your health insurance premiums.

More information can be found in this FAQ.

To continue receiving Healthcare Cost Assistance after the end of the year, you must enroll in a Carewell-approved Marketplace plan as soon as you can and no later than Open Enrollment (generally between November 1 and December 31). Otherwise, your Healthcare Cost Assistance will stop at the end of the calendar year.

To check if you qualify for temporary Healthcare Cost Assistance benefits, call (844) 503-7348.

Your net premium is the monthly amount that you must pay to your insurance company to maintain your insurance. For example, if your gross premium (the full cost of the premium from your insurance carrier) is $500 per month and your advance premium tax credit or APTC (the financial assistance from the federal government) is $200 per month, your net premium would be $300 per month.

Your Benefit Convenience Card works just like a regular credit card, with 2 important differences:

1. Your card is limited in use, meaning you can only use it for the covered medical expenses listed under “What can I use the Benefit Convenience Card to pay for?”
2. You cannot use your card at an ATM or to obtain cash back when making a purchase.

There are 2 accounts on your Benefit Convenience Card. One account is preloaded with funds for paying medical and prescription copays, deductibles, and coinsurance expenses for covered services and prescriptions. In 2027, that amount is $8,500, but this may change from year to year. The other account is preloaded with the amount necessary to pay your net monthly premium: the portion of your net individual health insurance premium that is not covered by your federal advance premium tax credit (APTC).

• Your net monthly individual premium bill for a Carewell-approved Marketplace plan.
• The deductible applicable to your Marketplace plan. A deductible is the amount you must pay for the services that your insurance plan covers before your insurer begins to pay.
• The copayments for medical services and prescriptions covered by your approved Marketplace plan. A copayment (or copay) is a fixed amount your insurance plan may require you to pay and is usually due at the time that you receive the service or prescription.
• The coinsurance for medical services and prescriptions covered by your approved Marketplace plan. Coinsurance is a percentage of the costs you must pay for services your insurance plan covers. Cost sharing may range from 20% to 50% of a covered service, depending on your insurance plan. For example, if your insurance plan has an “80/20” coinsurance arrangement, this means that, after you pay any deductible, your insurance company will pay 80% of the cost of the covered medical expense and you must pay the remaining 20%.

You may be financially responsible for repaying funds to Carewell SEIU 503 if your card is used for expenses that are not covered medical expenses.

The advance premium tax credit (APTC) is a tax credit issued by the federal government that lowers the monthly insurance payment (called your “premium”) when you enroll in a plan through the health insurance Marketplace. Your tax credit is based on the income estimate and household information you put on your Marketplace application. If your estimated income falls between 100% and 400% of the federal poverty level, you qualify for a premium tax credit.

You must apply all tax credits you are eligible for to your premium to receive Healthcare Cost Assistance benefits.

During these in-person events, the Carewell Benefits team review how Healthcare Cost Assistance benefits work when you choose a Carewell-approved plan on the Marketplace.

You can:

• Learn about the Carewell-approved Marketplace health insurance plans for 2027
• See how advance premium tax credits (APTC) work to reduce your premium
• Get support in enrolling in a Carewell-approved health (medical) insurance plan on the Marketplace
• Check your eligibility for Healthcare Cost Assistance benefits that cover your net monthly premiums for an individual health (medical) insurance plan and up to $8,500 in out-of-pocket medical costs in 2027.

Click here for more information! 

• Prescription drugs
• Laboratory services
• Outpatient care you get without being admitted to a hospital
• Preventive and wellness services and chronic disease management
• Emergency services
• Hospitalization (like surgery and overnight stays)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Pregnancy, maternity, and newborn care (both before and after birth)
• Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)