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Answers to Frequently Asked Questions: Learn More and Compare Your Options Now!

HealthInsuranceUSA.org Frequently Asked Questions

Below are some of the most common questions people have about health insurance, Obamacare, and this website:

Is HealthInsuranceUSA.org a government site?

No. HealthInsuranceUSA.org is not affiliated with or endorsed by the government. Rather, it is a privately-owned website whose purpose is to connect you to top carriers and brokers who offer plans that range from off-exchange Obamacare plans, and alternative plans like short-term, limited indemnity, and critical illness plans.

How can I purchase a health plan?

There are a few different types of health plans that you can choose from, depending on the type of coverage that you’re looking for. The type of plan most people are familiar with is an Obamacare plan, or a health insurance plan that offers the ten essential benefits as outlined by the Affordable Care Act (learn more about these essential benefits here).

You have a couple of options of how you can purchase an Obamacare plan; one is through a government-owned entity (like Healthcare.gov, or a state-specific website, like CoveredCalifornia.org), or through an insurance company or brokerage. When you purchase a plan through a government or state exchange site, you’re buying a plan that is "on-exchange." If you purchase a plan through an insurer or broker, you’re buying a plan that is considered "off-exchange" or "outside the marketplace."

One thing to keep in mind is that on-exchange plans and off-exchange plans differ, in that some plans that are listed on HealthInsuranceUSA.org are not listed on Healthcare.gov, and vice-versa.

Other types of plans you may choose from that do not meet the ten essential benefits are short-term, limited indemnity, and critical illness plans. These plans typically do not cover preventative medical care, and while they generally have lower premiums than traditional plans, also have high out-of-pocket costs when medical care is needed. You can enroll in an alternative plan from an insurer or broker. You can start finding plans available to you on HealthInsuranceUSA.org.

Is there government assistance to help me pay for my health care?

Yes, but only for plans that cover the ten essential benefits as outlined in the Affordable Care Act. There are two types of government assistance (called subsidies) that may be available for people who meet certain income requirements.

One type of subsidy is the Premium Tax Credit. This means the government will give you a discount on 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 (any costs you might incur that do not include your monthly premium). To qualify for the Cost-Sharing Reduction, you must choose a Silver-level metal 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.

There is currently no form of government assistance available with any alternative plan choices.

Can I still get government assistance if I purchase a plan off-exchange?

Yes. As long as it is an Obamacare plan and you meet the income and eligibility requirements that are described above, people who purchase an off-exchange Obamacare plan may qualify for help paying for their plans as they would with on-exchange plans.

For those who may be eligible for government assistance, HealthInsuranceUSA.org provides an estimate of your subsidized premium rate already factored into your pricing for your convenience.

What is the Affordable Care Act?

The Affordable Care Act is a set of health care reform legislation. It is comprised of the Patient Protection and Affordable Care Act, and the Health Care and Reconciliation Act. These were both signed into law in March of 2010. The Affordable Care Act (ACA) is commonly known as "Obamacare."

The purpose of the ACA was to provide all Americans, including those with lower incomes, with access to affordable and quality health coverage. The ACA assists people with health care costs and premiums, expands access to Medicaid, applies stricter regulations to insurers, and ensures that all health plans meet a certain standard of health care coverage and benefits.

Before the ACA was passed, millions of Americans were unable to purchase health insurance because it was either too expensive or not available to them in their area. Premium prices were steadily increasing for many, and insurers would either increase rates for people who had pre-existing 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 the ACA, the government provides financial assistance for lower-income individuals and mandates that insurers can no longer deny coverage for preexisting conditions, or cancel coverage when a certain limit is reached.

The ACA also says that every American is required to have insurance or pay a tax penalty. This is because having more people pay into the system helps keep health care costs down for all, since those who do not need medical care at a given moment are helping pay for those who do.

Only plans that meet the ten minimum essential coverage benefits 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 plans that meet these standards 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

The difference among plans is how much you pay per month versus how much you pay when using the insurance. Learn more about different types of Obamacare plans, and which plan may be right for you here.

Short-term, critical illness, and limited indemnity plans do not meet these minimum essential standards, and therefore will not exempt you from having to pay the tax penalty.

Do I have to buy an Obamacare plan?

If you want 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 your employer provides your coverage for you, please confirm with your plan’s administrator or with the insurer directly to confirm that 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 2018, 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?

You can enroll in an alternative plan – including short-term, limited indemnity, and critical illness plans – at any time.

If you would like to enroll in an Obamacare or ACA plan, or renew or update an existing one, you must enroll during the Open Enrollment Period. The current Open Enrollment Period is November 1, 2017 to December 15, 2017.

The only way you can enroll in an Obamacare plan outside of the Open Enrollment period is during the Special Enrollment period. You may be eligible for the Special Enrollment Period if you experience a "Qualifying Life Event", which includes moving to a new state, getting married or divorced, having a baby, losing your job, and other experiences. The Special Enrollment Period lasts for 60 days following a Qualifying Life Event.

Learn more about the different enrollment periods here.

Why did I not see any plans?

We only show plans if we think you are eligible for a plan based on the information you entered. If you did not see any Obamacare plans in particular, 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.

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