ObamacarePlans.com Frequently Asked Questions
Below are some of the most common questions people have about Obamacare and this website:
Is ObamacarePlans.com a government site?
No. ObamacarePlans.com is a privately-owned site, and is not affiliated with or endorsed by the government. ObamacarePlans.com connects you to the leading carriers and brokers who offer off-exchange Obamacare plans.
How can I purchase an Obamacare plan?
Depending on your preference, you can purchase an Obamacare plan either through the government or from an insurance company or brokerage. Purchasing through the government or state exchange site is known as buying "on-exchange." Purchasing directly through an insurer or broker is considered buying "off-exchange" or "outside the marketplace."
When shopping off-exchange, you may not see every plan that is available to you. However, many find it faster and easier to find and purchase an Obamacare plan off-exchange, and directly through the insurer or broker. ObamacarePlans.com connects you to many of the leading insurers and brokers, allowing you to compare multiple off-exchange Obamacare plans, all in one place.
Is there government assistance to help me pay for my health care?
Yes. Known as "subsidies", there are two forms of government assistance available for those who meet certain income requirements.
The first is the Premium Tax Credit. The government will help pay for, or subsidize, your monthly insurance rate if your income is at or below 4x the Federal Poverty Line. Learn more about the Premium Tax Credit and how to qualify here.
The second is the Cost Sharing Reduction, or when the government helps pay for your out-of-pocket costs. To qualify, you must choose a Silver plan, and your income must be at or below 2.5x the Federal Poverty Line. Learn more about the Cost Sharing Reductions and how to qualify here.
Can I still get government assistance if I purchase a plan off-exchange?
Yes. As long as you meet the income and eligibility requirements, off-exchange Obamacare plans qualify for subsidies like on-exchange plans.
For those eligible, ObamacarePlans.com displays plans with an estimate of your subsidized rate already factored into your pricing. You can also confirm your subsidy eligibility with federal marketplace or your state’s exchange site.
What is the Affordable Care Act?
The Affordable Care Act is a set of health care reform legislation. It comprises of the Patient Protection and Affordable Care Act and the Health Care and Reconciliation Act, both of which were signed into law in March of 2010. Commonly, the Affordable Care Act is known as "Obamacare."
The purpose of the Affordable Care Act was to provide all Americans, including those with lower incomes, with affordable, accessible, and quality health coverage. It accomplishes these by lowering health care costs and premiums; expanding access to Medicaid; applying stricter regulations to insurers; and ensuring that all reformed plans meet a certain high-standard of quality health care (see next section for more).
Prior to reform, millions of Americans were unable to purchase health insurance because it was either too expensive or unavailable. The costs of premiums were steadily increasing as insurers would either increase rates for those with preexisting conditions or deny them coverage completely. Insurers would also set maximum lifetime benefits, resulting in many Americans losing their coverage once they became too expensive to insure. Now, with health care reform, the government not only helps pay for the monthly premiums of those with lower incomes, but also makes certain that for everyone, insurers can no longer deny coverage for preexisting conditions, or drop your coverage when you become too costly to insure.
With reform, most Americans are required to have coverage or face a Tax Penalty. Requiring most to have coverage helps keep health care costs down for all. The reason is that those who do not need medical care at a given moment are helping pay for those who do.
Only plans that meet the standard of Minimum Essential Coverage exempt you from paying the tax penalty.
What is Minimum Essential Coverage?
Minimum Essential Coverage is when a health plan meets the coverage requirements set forth by the Affordable Care Act. Also known as a "qualifying health plan" or an "Obamacare plan", those who are enrolled in such plans will not face the Tax Penalty for going uninsured.
By law, a qualifying health plan must at minimum meet all of these following Ten Essential Health Benefits:
- Ambulatory care
- Emergency services
- Hospital coverage
- Pregnancy/maternity and newborn care
- Pediatric services (including dental and vision)
- Mental health and addiction treatment
- Prescription drug benefits
- Rehabilitative coverage
- Laboratory services
- Preventative services and chronic disease management
All four types of plans provide the same quality care. The difference among plans is how much you pay per month versus how much you pay when using the insurance. Bronze plans have lower monthly premiums, but higher out-of-pocket costs when needing medical care. Platinum plans are the exact opposite, where you pay more per month, but have a lower out-of-pocket rate. There is also a fifth type, known as a Catastrophic plan, but you must be under the age of 30 or must be facing certain hardships to qualify. Catastrophic plans have the lowest monthly premium, yet have high out-of-pocket costs.
Learn more about the different types of Obamacare plans, and which plan may be right for you here.
Do I have to buy an Obamacare plan?
To avoid paying the Tax Penalty, you must have an Obamacare plan, or a plan that is considered “Minimum Essential Coverage” (see previous section).
If you have employer-provided, please confirm with your plan’s administrator if it is considered Minimum Essential Coverage.
Even if you have coverage through your employer, you are still free to shop around and purchase an Obamacare plan. However, you will not be eligible for a subsidy, unless your employer’s plan costs more than 9.5% of your annual income.
How much is the Tax Penalty?
For 2017, the Tax Penalty is the greater of either a) 2.5% of your income; or b) $2,085 per household ($695 per adult and $347.50 per child).
Learn more about the subsidy eligibility here.
When can I enroll in an Obamacare plan?
To purchase an Obamacare plan, or renew or update an existing one, you must sign up during the Open Enrollment Period. The current Open Enrollment Period is November 1, 2016 to January 31, 2017.
The only way to obtain an Obamacare plan outside of the Open Enrollment period is during the Special Enrollment. Those who have certain life changes, known as "Qualifying Life Events", are eligible for Special Enrollment. The Special Enrollment Period lasts for 60 days following a Qualifying Life Event.
Learn more about the different enrollment periods here.
How come I did not see any plans?
We only show plans if we think you are eligible for an Obamacare plan based on the information you entered. If you did not see any plans, please confirm your eligibility with the federal marketplace or your state’s exchange site.
To start comparing Obamacare plans, please submit your zip code or call (877) 935-9291 to speak with an agent.