For the last week and a half, Obamacare has been in the forefront of the media. It started out with its fair share of hiccups, but it seems like now people are able to get on healthcare.gov and shop for coverage.
Did you know, the Obamacare marketplace websites are not your only option. They are an option to all citizens, but they’re not your only option.
Here’s what you need to know about the Affordable Care Act aka Obamacare. And if you didn’t know they were the same thing, you’re not alone. Have you seen the “Which do you like better, Obamacare or the Affordable Care Act” video? Many Americans are confused by the law. Don’t worry – here are 5 things about Obamacare that you need to know, but were too embarrassed to ask.
1. Why do I even need insurance?
The Affordable Care Act, aka Obamacare, includes what is called the “individual mandate.” This means, everyone with a few exceptions, must have qualifying health insurance starting Jan. 1, 2014 or they will pay a penalty. The first year, the penalties will start at $95 for individuals and about $295 per family. The penalties go up each year.
In order to make this coverage available, the government set up Healthcare.gov so people could shop for coverage and enroll. Some states have set up their own websites, but you can get to them through Healthcare.gov.
2. Is Healthcare.gov my only option?
Good question. No, healthcare.gov is not your only option. You actually have at least 6 options. Healthcare.gov is what most people call a public or federal exchange, meaning, it is run by the state or federal government. There are also private exchanges that are run separately from the government. You can also get insurance through a TPA/broker, your employer (if they offer it), or if you’re under 26, you can stay on your parent’s health insurance plan. If you’re over 65, you will use Medicare. If you earn less than $15,000 a year, you may qualify for Medicaid. Get more details about your options.
3. How will Obamacare impact me?
The real answer…nobody fully knows yet. There are rules and regulations that haven’t been completely sorted out. No one will know the full impact until many of the other aspects of the law are implemented in the upcoming years.
Here’s what we do know:
- You can no longer be denied coverage because of a pre-existing condition like pregnancy, asthma, cancer, etc.
- Some companies are dropping the employee coverage because their current healthcare offering is not compatible with Obamacare regulations.
- If you don’t get coverage, you will pay a penalty ($95 for individuals or 1% of your income whichever is higher, or $295 for families or 2.5% of your income, whichever is higher) that goes up each year.
- Starting next year, companies with 50 or more full-time equivalent employees must offer healthcare coverage or they pay a fine.
- All non-grandfathered plans have to include the 10 essential health benefits – things like prescription drugs, emergency services, maternity care, hospital care, and more.
- If you meet the income requirements, you could be eligible for subsidies to purchase insurance on the exchanges.
4. How do I know what kind of plan to buy?
When you’re shopping for a plan, on a marketplace or somewhere else, always think about your total medical cost, which equals premiums + deductibles + out-of-pocket costs. That means, consider all of the possible expenses and whether or not the plan gives you the coverage you need. Read more about what to look for.
5. Can I get a health insurance discount?
Yes, some people will be eligible for a subsidy in the form of tax credits. To see if you qualify, check out the Kaiser Family Foundation Subsidies Calculator.
What Else Do You Want to Know?
For every person, there are probably several questions. We’ve only touched on some of the most commonly asked questions. Ask your questions in the comments below, and we’ll try to help.