Author Archives: Affordable Care Act

Texas Affordable Care Act

Texas Affordable Care Act Comprehensive Guide

In this article, you will learn about the Affordable Care Act health care reform laws in Texas.  You will get an understanding of how the health care law impacts you as a citizen of the state.  Learn how to sign-up for the Affordable Care Act, learn about the Affordable Care Act penalty and subsidies, and much more.

What is Texas Affordable Care Act?

Affordable Care Act, also known as Obama Care, was signed into law in March 2010.  The goal of the Affordable Care Act is to provide US citizens with affordable health insurance and to reduce the cost of health care spending for families and in America.

The Key Points of the Affordable Care Act / Texas Obamacare:

How to Apply for Texas Affordable Care Act?

Texas Affordable Care Act marketplace is run by the Federal government.  Click on HealthCare.gov to access Texas Affordable Care Marketplace.  You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.

State Federal or State Marketplace  Website Medicaid Expansion?
Texas Federal www.HealthCare.gov No

When can I apply for Texas Affordable Care Act (Texas ACA)?

Texas Affordable Care Act’s Open Enrollment starts on November 1 and ends on December 15.  To have health insurance coverage beginning in the following year, you must apply before the December 15 deadline.

In order to qualify for Tax Credit or Premium Tax Subsidies, you must purchase health insurance from the Affordable Care Act Marketplace during the Open Enrollment period.

If you qualify for Texas Medicaid health insurance, then you can sign-up for Medicaid any time of the year.

When is the deadline for Texas Affordable Care Act (TX ACA)?

Important dates for Texas Affordable Care Act deadlines:  The absolute last day to purchase health insurance from the Marketplace is December 15.

  • November 1: First day to enroll in or change plans for new insurance
  • December 15: Last day to enroll in or change plans for new coverage to start the new year

How much is Texas Affordable Care Act?

There are four different plans within the Texas Affordable Care Act.  The metal plans represent the various levels of coverage you receive and what the plan pays on average.  The plan levels DO NOT represent the quality of the health coverage/doctors you receive.

  • Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
  • Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
  • Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
  • Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost

The cost of the Affordable Care Act in Texas depends on the metal plan you choose and the number of people in the household.   Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.

What are the Texas Affordable Care Act Eligibility Requirements?

In order to get Texas Affordable Care Act, you must meet the following requirements:

  • Must live in Texas
  • Must be a US citizen, national, or lawfully present, immigrant
  • Cannot be currently incarcerated (be in jailed)
  • Have a valid Social Security Number
  • and few other requirements

Do I need to get Texas Affordable Care Act?

Yes, every individual in Texas needs to have health insurance.  The Individual Mandate of Affordable Care Act health care law requires US citizens to enroll in a health insurance plan or pay a penalty.  If you have Medicaid or company-sponsored health insurance, you have met the insurance coverage requirement.

You can choose not to have health insurance, but you have to pay the penalty in addition to the hospitals/doctor’s medical fee if you do get sick.

How much is the Affordable Care Act Penalty in Texas?

The penalty (or also called individual shared responsibility payment) is calculated in two ways.

Starting in the 2019 tax year, there is no longer a penalty for not having health insurance.

From 2016-2018, the ACA penalty is as follows:

  1. By percentage of income (2.5% of household income or a maximum of National Average Bronze plan premium)
  2. By number of people in the household ($695 per adult, $347.50 per child, or maximum $2085)

You’ll pay whichever penalty is higher. 

How much are Texas ACA Subsidies? What are the requirements?

Affordable Care Act Subsidies are also called, “Premium Tax Credits.”

ACA subsidy lowers your premium – the amount you pay each month to your insurance plan. The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.

In order to qualify for the Affordable Care Act Subsidy, your income must be between 100% to 400% of the Federal Poverty Level.

Affordable Care Act - Federal Poverty Level
Federal Poverty Level Insurance Premium After PTC Subsidy
Up to 133% FPL 2% of income
133-150% FPL 3%-4% of income
150-2000% FPL 4%-6.3% of income
200-250% FPL 6.3%-8.05% of income
250-300% FPL 8.05%-9.5% of income
300-400% FPL 9.5 of income
Over 400% FPL No Government Subsidy

Medicaid Expansion under the Affordable Care Act

With the new health care reform, the Federal government offered incentives for states to expand the Medicaid program.  30 states out of the 50 states expanded Medicaid program while 20 states decided not to expand Medicaid due to expected future cutbacks from the Federal government.

Texas did not expand the Medicaid program.

State Medicaid Expansion
Texas No

Insurance Companies that offer Affordable Care Act Health Insurance Plans in Texas:

The following insurance companies are offering Affordable Care Act Plans in the Marketplace.

  • Aetna (5 plans)
  • Assurant Health (6)
  • Blue Cross and Blue Shield of Texas (17)
  • Cigna Healthcare (9)
  • Molina Marketplace (5)
  • Scott and White Health Plan

Frequently Asked Questions (FAQ) on Texas Affordable Care Act:

  1. Who runs the Texas Affordable Care Act? Federal
  2. Where can I sign up for Texas Affordable Care Act? Click here
  3. Do I need to get health insurance or the Affordable Care Act? Yes, if not, you have to pay a penalty.
  4. How much is Texas Affordable Care Act? Click here for the average ACA premium
  5. Did Texas expand Medicaid under the Affordable Care Act? No

Click here for more Frequently Asked Questions on Obamacare / Affordable Care Act.

For more information on Texas Obamacare / Affordable Care Act:

Federal HealthGov Marketplace
Toll-Free: 1-800-318-2596
Website: HealthCare.gov

Texas Department of Insurance
333 Guadalupe
Austin, TX 78701
(800) 578-4677
http://www.tdi.texas.gov/index.html

Texas’s five largest cities in terms of population: Houston, San Antonio, Dallas, Austin and Fort Worth.  You can apply for Affordable Care Act Health Insurance in any location in Texas.

Tennessee Affordable Care Act

Tennessee Affordable Care Act Comprehensive Guide

In this article, you will learn about the Affordable Care Act health care reform laws in Tennessee.  You will get an understanding of how the health care law impacts you as a citizen of the state.  Learn how to sign-up for the Affordable Care Act, learn about the Affordable Care Act penalty and subsidies, and much more.

What is Tennessee’s Affordable Care Act?

Affordable Care Act, also known as Obama Care, was signed into law in March 2010.  The goal of the Affordable Care Act is to provide US citizens with affordable health insurance and to reduce the cost of health care spending for families and in America.

The Key Points of the Affordable Care Act / Tennessee Obamacare:

How to Apply for Tennessee Affordable Care Act?

Tennessee’s Affordable Care Act marketplace is run by the Federal government.  Click on HealthCare.gov to access Tennessee Affordable Care Marketplace.  You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.

State Federal or State Marketplace  Website Medicaid Expansion?
Tennessee Federal www.HealthCare.gov No

When can I apply for Tennessee Affordable Care Act (Tennessee ACA)?

Tennessee Affordable Care Act’s Open Enrollment starts on November 1 and ends on December 15.  To have health insurance coverage beginning in the following year, you must apply before the December 15 deadline.

In order to qualify for Tax Credit or Premium Tax Subsidies, you must purchase health insurance from the Affordable Care Act Marketplace during the Open Enrollment period.

If you qualify for Tennessee Medicaid health insurance, then you can sign-up for Medicaid any time of the year.

When is the deadline for Tennessee Affordable Care Act (TN ACA)?

Important dates for Tennessee Affordable Care Act deadlines:  The absolute last day to purchase health insurance from the Marketplace is December 15.

  • November 1: First day to enroll in or change plans for new insurance
  • December 15: Last day to enroll in or change plans for new coverage to start the new year

How much is Tennessee Affordable Care Act?

There are four different plans within the Tennessee Affordable Care Act.  The metal plans represent the various levels of coverage you receive and what the plan pays on average.  The plan levels DO NOT represent the quality of the health coverage/doctors you receive.

  • Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
  • Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
  • Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
  • Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost

The cost of the Affordable Care Act in Tennessee depends on the metal plan you choose and the number of people in the household.   Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.

What are the Tennessee Affordable Care Act Eligibility Requirements?

In order to get Tennessee Affordable Care Act, you must meet the following requirements:

  • Must live in Tennessee
  • Must be a US citizen, national, or lawfully present, immigrant
  • Cannot be currently incarcerated (be in jailed)
  • Have a valid Social Security Number
  • and few other requirements

Do I need to get Tennessee Affordable Care Act?

Yes, every individual in Tennessee needs to have health insurance.  The Individual Mandate of Affordable Care Act health care law requires US citizens to enroll in a health insurance plan or pay a penalty.  If you have Medicaid or company-sponsored health insurance, you have met the insurance coverage requirement.

You can choose not to have health insurance, but you have to pay the penalty in addition to the hospitals/doctor’s medical fee if you do get sick.

How much is the Affordable Care Act Penalty in Tennessee?

The penalty (or also called individual shared responsibility payment) is calculated in two ways.

Starting in the 2019 tax year, there is no longer a penalty for not having health insurance.

From 2016-2018, the ACA penalty is as follows:

  1. By percentage of income (2.5% of household income or maximum of National Average Bronze plan premium)
  2. By number of people in the household ($695 per adult, $347.50 per child, or maximum $2085)

You’ll pay whichever penalty is higher. 

How much are Tennessee ACA Subsidies? What are the requirements?

Affordable Care Act Subsidies are also called, “Premium Tax Credits.”

ACA subsidy lowers your premium – the amount you pay each month to your insurance plan. The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.

In order to qualify for Affordable Care Act Subsidy, your income must be between 100% to 400% of the Federal Poverty Level.

Affordable Care Act - Federal Poverty Level
Federal Poverty Level Insurance Premium After PTC Subsidy
Up to 133% FPL 2% of income
133-150% FPL 3%-4% of income
150-2000% FPL 4%-6.3% of income
200-250% FPL 6.3%-8.05% of income
250-300% FPL 8.05%-9.5% of income
300-400% FPL 9.5 of income
Over 400% FPL No Government Subsidy

Medicaid Expansion under the Affordable Care Act

With the new health care reform, the Federal government offered incentives for states to expand the Medicaid program.  30 states out of the 50 states plus Washington DC expanded Medicaid program while 20 states decided not to expand Medicaid due to expected future cut back funding from the Federal government.

Tennessee did not expand the Medicaid program under the Affordable Care Act Health Care Reform as of 2015/2016.

State Medicaid Expansion
Tennessee No

Insurance Companies that offer Affordable Care Act Health Insurance Plans in Tennessee:

The following insurance companies are offering Affordable Care Act Plans in the Marketplace.

  • Assurant Health
  • BEST Life and Health Insurance Company
  • BlueCross BlueShield of Tennessee
  • Cigna Health & Life Insurance Company
  • Community Health Alliance

Frequently Asked Questions (FAQ) on Tennessee Affordable Care Act:

  1. Who runs the Tennessee Affordable Care Act? Federal
  2. Where can I sign up for Tennessee Affordable Care Act? Click here
  3. Do I need to get health insurance or Affordable Care Act? Yes, if not, you have to pay a penalty.
  4. How much is Tennessee Affordable Care Act? Click here for the average ACA premium
  5. Did Tennessee expand Medicaid under the Affordable Care Act? No

Click here for more Frequently Asked Questions on Obamacare / Affordable Care Act.

For more information on Tennessee Obamacare / Affordable Care Act:

Federal HealthCare.Gov Marketplace
Toll-Free: 1-800-318-2596
Website: HealthCare.gov

Tennessee Department of Commerce and Insurance
Consumer Insurance Services
500 James Robertson Parkway, 4th Floor
Nashville, Tennessee 37243
(800) 342-4029
(615) 741-2218
Fax: (615) 532-7389

If you have a hard time affording health coverage and you have questions about eligibility or current Medicaid benefits, go to:  

Tennessee Department of Human Services
Commissioner’s Office
400 Deaderick Street, 15th Floor
Nashville, TN 37243
(866) 311-4287
(615) 313-4700
Fax: (615) 741-4165
http://www.tn.gov/humanserv/adfam/afs_med.html

Tennessee’s five largest cities in terms of population: Memphis, Nashville, Knoxville, Chattanooga, and Clarksville.  You can apply for Affordable Care Act Health Insurance in any city in Tennessee.

Does Affordable Care Act cover Tobacco Use screening?

Question:  Does Affordable Care Act cover Tobacco Use screening?

Answer:  Yes, Affordable Care Act health insurance plans cover Tobacco Use screening.  Free Tobacco Use screening for all adults and cessation interventions for tobacco users.

One of the major benefits of the Affordable Care Act is that all Marketplace health plans, company health insurance plans, and many other health plans must cover the following list of preventive services without charging you a copayment or coinsurance.  Lung Cancer screening is one of the preventive care benefits of Obamacare.

Quitting smoking is one of the most important things you can do for your health. The sooner you quit, the sooner your body can start to heal.  Smoking causes lung cancer, heart diseases, stroke, pregnancy problems, gum diseases and many more.

Preventive Care Name Covered under ACA Health Insurance?
Tobacco Use screening Yes

For more information Affordable Care Act / Obamacare, click here.

Learn how to Sign up for Affordable Care Act and get free preventive care benefits.

For Frequently Asked Questions on Affordable Care Act ACA.

Does Affordable Care Act cover Syphilis screening?

Question:  Does Affordable Care Act cover Syphilis screening?

Answer:  Yes, Affordable Care Act health insurance plans cover Syphilis screening.  Free Syphilis screening for adults at higher risk.

What is Syphilis?
Syphilis is a sexually transmitted disease, or STD, that you can get during vaginal, anal, or oral sex. If a pregnant woman has syphilis, her baby may get it from her before or during birth.

Get tested for syphilis if you:

  • Are pregnant
  • Are a man who has sex with men
  • Have sex for drugs or money

One of the major benefits of the Affordable Care Act is that all Marketplace health plans, company health insurance plans, and many other health plans must cover the following list of preventive services without charging you a copayment or coinsurance.  Syphilis screening is one of the preventive care benefits of Obamacare.

Preventive Care Name Covered under ACA Health Insurance?
Syphilis screening Yes

For more information Affordable Care Act / Obamacare, click here.

Learn how to Sign up for Affordable Care Act and get free preventive care benefits.

For Frequently Asked Questions on Affordable Care Act ACA.

Does Affordable Care Act cover STD screening?

Question:  Does Affordable Care Act cover STD screening?

Answer:  Yes, Affordable Care Act health insurance plans cover STDs screening.  Free Sexually transmitted infection (STI) prevention counseling for adults at higher risk

Most common Sexually Transmitted Diseases (STDs)

  • Chlamydia
  • Genital Herpes
  • Gonorrhea
  • HPV Infection
  • Syphilis
  • and many more

One of the major benefits of the Affordable Care Act is that all Marketplace health plans, company health insurance plans, and many other health plans must cover the following list of preventive services without charging you a copayment or coinsurance.  Free Sexually Transmitted Disease screening is one of the preventive care benefits of Obamacare.

Preventive Care Name Covered under ACA Health Insurance?
Sexually Transmitted Disease screening Yes

For more information Affordable Care Act / Obamacare, click here.

Learn how to Sign up for Affordable Care Act and get free preventive care benefits.

For Frequently Asked Questions on Affordable Care Act ACA.

Does Affordable Care Act cover Obesity screening?

Question:  Does Affordable Care Act cover Obesity screening?

Answer:  Yes, Affordable Care Act health insurance plans cover Obesity screening.  Obesity is the main cause for serious health conditions such as:

  • Type 2 diabetes
  • Heart disease
  • High blood pressure
  • Early death

One of the major benefits of the Affordable Care Act is that all Marketplace health plans, company health insurance plans, and many other health plans must cover the following list of preventive services without charging you a copayment or coinsurance.  Obesity screening is one of the preventive care benefits of Obamacare.

Preventive Care Name Covered under ACA Health Insurance?
Abdominal Aortic Aneurysm Yes

For more information Affordable Care Act / Obamacare, click here.

Learn how to Sign up for Affordable Care Act and get free preventive care benefits.

For Frequently Asked Questions on Affordable Care Act ACA.

Does Affordable Care Act cover Lung Cancer screening?

Question:  Does Affordable Care Act cover Lung Cancer screening?

Answer:  Yes, Affordable Care Act health insurance plans cover Lung Cancer screening.  Free Lung cancer screening for adults 55 – 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years.

One of the major benefits of the Affordable Care Act is that all Marketplace health plans, company health insurance plans, and many other health plans must cover the following list of preventive services without charging you a copayment or coinsurance.  Lung Cancer screening is one of the preventive care benefits of Obamacare.

Preventive Care Name Covered under ACA Health Insurance?
Lung Cancer screening Yes

For more information Affordable Care Act / Obamacare, click here.

Learn how to Sign up for Affordable Care Act and get free preventive care benefits.

For Frequently Asked Questions on Affordable Care Act ACA.

Does Affordable Care Act cover Immunization Vaccines?

Question:  Does Affordable Care Act cover Immunization Vaccines?

Answer:  Yes, Affordable Care Act health insurance plans cover Immunization Vaccines.  Immunization vaccines for adults, women, children are all part of the Preventive Care benefits.

The following immunization vaccines are included.  (Partial list)

One of the major benefits of the Affordable Care Act is that all Marketplace health plans, company health insurance plans, and many other health plans must cover the following list of preventive services without charging you a copayment or coinsurance.  Immunization vaccines are one of the preventive care benefits of Obamacare.

Preventive Care Name Covered under ACA Health Insurance?
Immunization vaccines Yes

For more information Affordable Care Act / Obamacare, click here.

Learn how to Sign up for Affordable Care Act and get free preventive care benefits.

For Frequently Asked Questions on Affordable Care Act ACA.

Does Affordable Care Act cover AIDS screening?

Question:  Does Affordable Care Act cover AIDS screening?

Answer:  Yes, Affordable Care Act health insurance plans cover AIDS screening.

What is AIDS?
AIDS is a syndrome caused by the HIV virus.  It is when a person’s immune system is too weak to fight off many infections.  There is currently no cure for HIV or AIDS.

One of the major benefits of the Affordable Care Act is that all Marketplace health plans, company health insurance plans, and many other health plans must cover the following list of preventive services without charging you a copayment or coinsurance.  AIDS screening is one of the preventive care benefits of Obamacare.

Preventive Care Name Covered under ACA Health Insurance?
AIDS screening Yes

For more information Affordable Care Act / Obamacare, click here.

Learn how to Sign up for Affordable Care Act and get free preventive care benefits.

For Frequently Asked Questions on Affordable Care Act ACA.

Does Affordable Care Act cover HIV screening?

Question:  Does Affordable Care Act cover HIV screening?

Answer:  Yes, Affordable Care Act health insurance plans cover HIV screening.  Free HIV screening for everyone ages 15 to 65, and other ages for people with increased risk

What is HIV?
HIV stands for human immunodeficiency virus. This is the virus that causes AIDS. There is no cure yet for HIV/AIDS, but there are treatments that can help people live longer, healthier lives.

One of the major benefits of the Affordable Care Act is that all Marketplace health plans, company health insurance plans, and many other health plans must cover the following list of preventive services without charging you a copayment or coinsurance.  HIV screening is one of the preventive care benefits of Obamacare.

Preventive Care Name Covered under ACA Health Insurance?
HIV screening Yes

For more information Affordable Care Act / Obamacare, click here.

Learn how to Sign up for Affordable Care Act and get free preventive care benefits.

For Frequently Asked Questions on Affordable Care Act ACA.