Category Archives: Affordable Act Care Questions

What is Minimum Essential Coverage?

Question: What is Affordable Care Act’s Minimum Essential Coverage (MEC)?

Answer: Minimum Essential Coverage or MEC, is a type of insurance coverage an individual needs to have to meet the individual mandate requirement under the Affordable Care Act.

The following type of insurance DOES NOT COVER the Affordable Care Act’s Minimum Essential Coverage:

  • Employer-sponsored insurance plans (private insurance)
    Insurance plans purchased under the Affordable Care Act’s Health Insurance
  • Medicare Part A coverage and Medicare Advantage (MA) plans
  • Medicaid coverage
  • Children’s Health Insurance Program (CHIP) coverage
  • Certain types of veterans health coverage administered by the Veterans Administration
  • TRICARE

If you have any one of the plans above, you are the essential insurance and will not have to pay any penalties.

The following insurance coverage does not cover the Minimum Essential Coverage of the Affordable Care Act:

  • Coverage only for dental care
  • Coverage only for vision care
  • Workers’ compensation
  • Disability Insurance
  • Auto Insurance
  • Coverage only for a specific disease or condition
  • Plans that offer only discounts on medical services

Do I have to pay a penalty if I have no insurance?

Question: Do I have to pay a penalty if I have no insurance (No Obamacare or No Affordable Care Act?)

Answer: If you do not qualify for an exemption from Affordable Care Act and decide not to buy insurance, you will have to pay a penalty.

In 2014, the penalty is 1 percent of your annual household income or a fee of $95, whichever is greater.  There is a cap of the 1 percent penalty.  Imagine Bill Gates not having insurance and penalty a 1% penalty on his income.  The maximum penalty is the premium for your household size for the national average of the Bronze plan.  For 2014, the maximum annual penalty was $2,448 per individual up to $12,240 for families of five or more.

Who is Eligible for Affordable Care Act?

Question: Who is eligible for Affordable Care Act?

Answer: To be eligible for health insurance coverage through the Marketplace, you:

  • Must reside in United States
  • Must be a US Citizen or have legal status (Green Card, Asylee, Refugee, etc.)
  • Not Incarcerated or Jailed
  • Have a Social Security Number

Residents of a US Territory (eg. Guam, Puerto Rico, etc) are not eligible to apply for health insurance coverage using the Federal or State Marketplace unless they also qualify as a resident within the service area of the Marketplace.

 

What is a State Exchange?

Question: What is a State Exchange?

Answer:  Eighteen states have the marketplaces. The Affordable Care Act helped develop these marketplace exchanges where people can go to find out about the different health care plans, use the calculators, and ultimately apply for reasonable, yet complete health care programs, The health care programs were developed in order to get coverage for those uninsured and underinsured in the United States.

States Which Currently have 100% Approved Marketplaces

California- http://www.coveredca.com/

Colorado- http://connectforhealthco.com/

Connecticut- http://www.ct.gov/hix/site/default.asp

District of Columbia- http://healthreform.dc.gov/DC/Health+Reform

Hawaii- http://www.hawaiihealthconnector.com/

Idaho- http://idahomarketplace.org/

Kentucky- https://kynect.ky.gov/

Maryland- https://www.marylandhealthconnection.gov/

Massachusetts- https://www.mahealthconnector.org/

Minnesota- https://www.mnsure.org/

Mississippi- https://www.onemississippi.com/

Nevada- https://www.nevadahealthlink.com/

New Mexico- http://www.nmhix.com/

New York- http://healthbenefitexchange.ny.gov/

Oregon- https://www.coveroregon.com//

Rhode Island- http://www.healthsourceri.com/

Utah- http://www.avenueh.com/

Vermont- https://portal.healthconnect.vermont.gov/VTHBELand/welcome.action

Washington- http://www.wahealthplanfinder.org/

When is Affordable Care Act Open Enrollment?

Question: When is Affordable Care Act Open Enrollment?

Answer:  The open enrollment period for Affordable Care Act for 2014 starts on November 15, 2014 and ends on February 15, 2015.  It is only during the open enrollment period, you can get health care insurance from the marketplace that qualifies for tax credits.  If you miss the open enrollment, you have to wait for 9 months until they open again in late 2015 to get health insurance.

If you experience Qualifying Life Experiences, you can enroll for Affordable Care Act during special enrollment within 60 days of the qualifying event.

Medicaid and CHIP health care plans are available year round, 365 days.

Can I Switch from Company Insurance to Medicaid?

Question:)  Currently I’m enrolled in company’s insurance but want to switch to Medicaid.  Is it possible?

A Medicaid-eligible individual can always choose to leave the employer’s coverage and enroll in Medicaid, and an employer is not required to pay a penalty for any employees enrolled in Medicaid.

If your income decreased to the Medicaid eligible level, you can stop your company insurance and immediately switch to Medicaid.

What is Obamacare – Glossay – Affordable Care Act

Obamacare is the term most commonly used by conservative critics to refer to the Patient Protection and Affordable Care Act.  In reality, President Obama only outlined general principals to guide Congress and did not offer a particular legislative proposal.  Obamacare was model after the health reform in  Massachusetts.

In short summary, Obamacare is Affordable Care Act.

When Can I buy Affordable Care Act Obamacare health insurance?

Question: When Can I buy Affordable Care Act Obamacare health insurance?

The Affordable Care Act / Obamacare Marketplace open enrollment is from October 1, 2013 to March 31, 2014.  For future years, the open enrollment will be from October 15 to December 7.

Most people will only be able to use the Affordable Care Act Marketplace during Open Enrollment. But, if you experience certain qualifying events at other times during the year, you may be able to buy health insurance through the Marketplace at that time. This is called a Special Enrollment Period.