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Contents tagged with Obamacare

How to Evaluate Your Healthcare Needs + Obtain Enough Insurance Coverage
Posted Nov 21, 2017 by Author

How to Evaluate Your Healthcare Needs + Obtain Enough Insurance Coverage

Open enrollment seems to sneak up on us every year. You're still working through the Halloween candy and suddenly are being asked to make an important and—for most of us—mandatory purchase that will cost potentially hundreds of dollars or more each month.

Continue reading: How to Evaluate Your Healthcare Needs + Obtain Enough Insurance Coverage


How to Evaluate Your Healthcare Needs + Obtain Enough Insurance Coverage
Posted Nov 21, 2017 by Catherine Gudio

How to Evaluate Your Healthcare Needs + Obtain Enough Insurance Coverage

Open enrollment seems to sneak up on us every year. You're still working through the Halloween candy and suddenly are being asked to make an important and—for most of us—mandatory purchase that will cost potentially hundreds of dollars or more each month.

Continue reading: How to Evaluate Your Healthcare Needs + Obtain Enough Insurance Coverage


10 Essential Obamacare Terms to Know When Shopping for Health Insurance
Posted Nov 21, 2017 by Jenifer Dorsey

10 Essential Obamacare Terms to Know When Shopping for Health Insurance

The health insurance lexicon changed a bit when the Affordable Care Act took effect. The healthcare reform law introduced us to concepts such as minimum essential coverage and essential health benefits. We may have a few open-enrollment periods under our belts, but that doesn’t mean we all understand the ins and outs of health insurance and Obamacare.

Understanding how health insurance and the law work is important as you shop for coverage. Learning basic ACA-related terminology can help you compare plans, determine if they meet your healthcare needs, and understand your financial responsibility.

Top 10 ACA (Obamacare) terms + a bonus term

The following terms include 10 ACA essentials that will help you navigate buying health insurance in the age of Obamacare: 

1. Actuarial value (aka, the metal levels)

The percentage of total average health care costs covered by a health insurance plan. Under the Affordable Care Act, health insurance plans sold through the state-based and federally facilitated exchanges as well as in the private market fit into four coverage levels based on their actuarial value. These are known as the metal levels because they are classified as bronze, silver, gold and platinum.

2. Essential health benefits

Ten categories of health insurance items and services for which all Obamacare plans sold on and away from the state-based and federally facilitated exchanges must include coverage. Job-based health insurance plans must also include these benefits. Within these categories, specific essential health benefits may vary dependent on the benchmark plan selected by each sate.

3. Exemption

The allowance of certain, qualifying individuals to go without minimum essential coverage and not owe the shared responsibility payment. You may be exempt from having health insurance due to financial hardship and other circumstances. Application for exemption is required in many cases.  

4. Health insurance exchange

A platform through which individuals may purchase health insurance plans. As a result of the Affordable Care Act, state-based and federally facilitated health insurance exchanges were created. These public exchanges provide consumers with subsidies and tax credits that help lower their premium payments. 

There are also private health insurance exchanges that may be set up by employers and health insurance companies. These exchanges do not provide access to subsidies and tax credits; however, they may offer consumers additional coverage options such as dental insurance.

5. Individual shared responsibility provision

The Affordable Care Act’s requirement that most Americans have minimum essential health insurance coverage unless they qualify for an exemption. This is commonly referred to as the individual mandate

6. Individual shared responsibility payment

The tax penalty owed by those who do not adhere to the individual shared responsibility provision. By law, individuals are allowed a single period of up to three months without health insurance coverage during the year. Beyond that, unless they qualify for an exemption, they will be subject to the shared responsibility payment, which is the greater of a percentage of household income or a flat dollar amount—the percentage and dollar amount change annually. The IRS states that the amount owed is 1/12 of the annual payment for each month consumers and/or their dependents are not insured and are not exempt.1

7. Minimum essential coverage

Plans that meet the ACA’s basic provisions and thereby fulfill the requirement that most Americans have health insurance. These plans include those sold on the state-based and federally facilitated health insurance exchanges as well as some sold in the private market, those that are job-based, Medicare, Medicaid, CHIP and others. 

8. Open enrollment

The annual time period in which Americans can buy exchange-based individual major medical health insurance plans for themselves and their families. 

9. Qualified health plan

A health insurance plan that meets the Affordable Care Act’s minimum requirements and has been certified by the state-based or federally facilitated exchange through which it is sold. 

10. Special enrollment period

A limited time outside of the standard open-enrollment period in which consumers may be eligible to enroll in a health insurance plan. Special enrollment becomes available due to qualifying life events such as getting married, having a baby or moving and lasts for a limited time—typically within 60 days of the event. This applies to individual health insurance sold on and away from the state-based and federally facilitated health insurance exchanges. 

11. Subsidy

Income-based financial assistance available to those who buy health insurance from state-based and federally facilitated exchanges. These may come in the form of premium tax credits for those whose incomes fall between 100 and 400 percent of the federal poverty level and/or cost-sharing subsidies for those who earn up to 250 percent of the federal poverty level and buy a silver plan. 

Estimate your subsidy using the Health Care Reform Calculator

These are only a few key terms you will encounter when buying Obamacare health insurance, but they are some of the most common and essential. Check out our 10 essential insurance terms, which explains deductible, coinsurance, copay and more.

If you need further explanation or guidance in selecting the right health insurance plan, call the number on your screen to speak with a licensed health insurance producer.

Looking for temporary coverage? Explore your short term health insurance options.

 

Originally posted July 17, 2015. Reviewed and updated Nov. 20, 2017. 


Legal Disclaimers

1IRS. “The Individual Shared Responsibility Payment – An Overview.” March 20, 2014. http://www.irs.gov/Affordable-Care-Act/The-Individual-Shared-Responsibility-Payment-An-Overview

 

Continue reading: 10 Essential Obamacare Terms to Know When Shopping for Health Insurance


An Obamacare Mistake the Government Wants You to Ignore
Posted Nov 21, 2017 by Jenifer Dorsey

An Obamacare Mistake the Government Wants You to Ignore

The words "glitch" and "Obamacare" were commonly associated with one another during the Affordable Care Act’s first open enrollment period. While the technological problems that plagued state-based and federally facilitated health insurance exchanges may be more or less fixed, there is one Obamacare glitch that’s been there from the beginning and hasn’t gone away.

Continue reading: An Obamacare Mistake the Government Wants You to Ignore


3 Alternatives to Buying Health Insurance from Public Exchanges
Posted Nov 21, 2017 by Jenifer Dorsey

3 Alternatives to Buying Health Insurance from Public Exchanges

Under the Affordable Care Act, the health insurance plans that qualify as minimum essential coverage may be purchased on the state-based and federally facilitated exchanges. But did you know you can shop elsewhere?

Continue reading: 3 Alternatives to Buying Health Insurance from Public Exchanges


Complete Guide to the Federal Poverty Level
Posted Nov 21, 2017 by Jenifer Dorsey

Complete Guide to the Federal Poverty Level

You likely know that the Affordable Care Act’s subsidies—both tax credits and cost-sharing reductions alike—are based on your income in relation to the federal poverty level.  

Continue reading: Complete Guide to the Federal Poverty Level


The Best Health Insurance If You’re Healthy and Not Subsidy-Eligible
Posted Nov 21, 2017 by Jenifer Dorsey

The Best Health Insurance If You’re Healthy and Not Subsidy-Eligible

Open enrollment for Obamacare plans runs from Nov. 1, 2017, through Dec. 15, 2017. Even if you consider yourself healthy, not taking the time to compare options and select the right health plan can be costly.

Continue reading: The Best Health Insurance If You’re Healthy and Not Subsidy-Eligible


How to Choose the Right ACA Health Insurance Plan
Posted Nov 21, 2017 by Jenifer Dorsey

How to Choose the Right ACA Health Insurance Plan

Choosing health insurance coverage for you and your family is no small decision. Even though the Affordable Care Act requires that all qualified major medical insurance plans cover certain preventive services and include essential health benefits at no additional cost, there are nuances.

Continue reading: How to Choose the Right ACA Health Insurance Plan


Health Insurance Plans: Automatically Re-enroll or Shop Around?
Posted Nov 20, 2017 by Jenifer Dorsey

Health Insurance Plans: Automatically Re-enroll or Shop Around?

Open enrollment for 2018 health insurance plans goes from Nov. 1, 2017, to Dec. 15, 2017 — just six short weeks!

Continue reading: Health Insurance Plans: Automatically Re-enroll or Shop Around?


Does Obamacare Require You to Buy Insurance or Are You Exempt?
Posted Nov 20, 2017 by Jenifer Dorsey

Does Obamacare Require You to Buy Insurance or Are You Exempt?

Dec. 15 is the deadline for enrolling in an ACA plan that begins Jan. 1, and this year it also marks the end of 2018 open enrollment. Maybe you haven’t enrolled because you aren’t sure which plan to buy or feel like you can’t afford coverage

Continue reading: Does Obamacare Require You to Buy Insurance or Are You Exempt?

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