Introduction:
You're probably used to buying health insurance through the Marketplace. You know it's there, but you may not have thought about how it works or where to go for help with your health coverage. If you are new to the individual market, or if you've been uninsured for a long time, this guide is for you! We'll walk through all of the options and explain what they mean so that you can make an informed decision about whether or not it's right for your family.
You can purchase health insurance through the Marketplace at any time of the year.
You can purchase health insurance through the Marketplace at any time of the year. You’re able to qualify for a Special Enrollment Period if you have a life event like losing your job, moving, or getting married. If you do not have qualifying life events, you can still purchase coverage during open enrollment by calling 1-800-318-2596 or visiting HealthCare.gov directly at www.healthcare.gov/getinsurance/.
If you lose your employer-sponsored coverage, you can buy a Marketplace plan; however, outside of Open Enrollment, you must qualify for a Special Enrollment Period.
If you lose your employer-sponsored coverage, you can buy a Marketplace plan; however, outside of Open Enrollment, you must qualify for a Special Enrollment Period. You cannot buy a Marketplace plan outside of Open Enrollment unless you have had a qualifying life event (e.g., losing your job) that makes it necessary for you to enroll in the program at any time during its duration—even if only temporarily and pending verification by the insurance company that your eligibility remains valid.
If you have a life event that qualifies you for a Special Enrollment Period, you will be notified by your state’s Marketplace and given the opportunity to enroll in a plan. You can also use this time to change or update your existing coverage if necessary.
If you lose your job, you may qualify for a Special Enrollment Period. If you lose your job and have employer-sponsored health insurance, you can enroll in a Marketplace plan or Medicaid if you have been without coverage for less than 60 days since losing your job. If you are eligible for COBRA continuation coverage through your former employer, it must be paid in full before the end of the month following the month in which it was first offered to you by that employer.
Certain types of health insurance do not qualify as minimum essential coverage under the Affordable Care Act. These include short-term plans, workers' compensation plans, and dental or vision plans.
· Short-term plans. Short-term insurance is not considered minimum essential coverage under the Affordable Care Act and may not be eligible for tax credits to help pay for your health care expenses.
· Workers' compensation plans. Workers' compensation plans, which are typically offered by employers as part of their group benefits package, do not qualify as minimum essential coverage under the ACA because they cover only work-related injuries or illness (not everyday healthcare). If you have access to this type of coverage through your employer, you're better off keeping it rather than enrolling in an individual plan on the exchange (see below).
· Dental or vision plans. Even if these types of medical expenses aren't covered by insurance—and there's no guarantee that they will be—you could still opt out of getting health insurance via an Obamacare exchange without penalty if 1) You're over age 65; 2) You earn $15k/year ($30k/year married); 3) You live in one state with high premiums among those who buy individual market policies outside open enrollment periods (for example New Hampshire).
You may be required to pay a fee if you don't have some form of health insurance that qualifies as minimum essential coverage. The fee is 2.5 percent of your household income or $695 per uninsured adult (whichever is higher).
You may be required to pay a fee if you don't have some form of health insurance that qualifies as minimum essential coverage. The fee is 2.5 percent of your household income or $695 per uninsured adult (whichever is higher). This applies to each adult in your household who doesn't have minimum essential coverage, even if it's only one person in your family who does not meet this requirement.
The fee for those without minimum essential coverage is calculated based on their household income:
If your household income is less than $20,800 for a single person or $32,500 for a family of two, you won't be charged the fee. If your household income is between $20,800 and $23,850 for a single person or between $32,500 and $34,550 for a family of two, then the fee will be 1 percent of income.
Unlike the individual mandate penalty, there is no maximum penalty that you would have to pay under the employer mandate penalty.
The individual mandate penalty for not having health insurance is $695 per uninsured adult. The employer mandate penalty for not offering affordable coverage to employees is 2,085 per employee who does not have affordable coverage.
Unlike the individual mandate penalty, there is no maximum penalty that you would have to pay under the employer mandate penalty and it's not capped at any particular amount.
The penalty for not offering affordable coverage is $2,085 per employee who does not have affordable coverage. This penalty will be phased in over three years, with the first year being $166 per employee and increasing to $3,000 in later years. The penalty can be avoided if you offer affordable coverage that meets certain minimum value standards or qualify for a waiver due to certain hardships.
There are several routes to buying health insurance, but only some will give you a Special Enrollment Period if you miss Open Enrollment and haven't had qualifying life events recently.
There are several routes to buying health insurance, but only some will give you a Special Enrollment Period if you miss Open Enrollment and haven't had qualifying life events recently.
· You can buy coverage through the Health Insurance Marketplace at any time of the year. If you lose employer-sponsored coverage, however, it will usually take six months before you can enroll in a Marketplace plan again.
· If your income is below 138 percent of the federal poverty level (FPL), then you may qualify for Medicaid or CHIP even if your state doesn't participate in those programs right now. However, these programs are not designed as replacements for private health insurance plans; they're intended for people who don't have access to affordable options at work or elsewhere due to financial hardship or other reasons beyond their control like immigration status or incarceration history—and therefore shouldn't be considered substitutes for regular medical care like doctor visits when appropriate!
Conclusion:
Now that you know all about buying health insurance, it's time to get started. If you're looking for help with shopping for a plan or just want more information about your options, please visit HealthCare.gov. You can also connect with us on Facebook and Twitter!
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