The Affordable Care Act, commonly referred to as Obamacare, makes it easier for people to gain affordable health coverage and protects them against unfair insurance company practices.
Subsidies help lower income Americans purchase health insurance through state exchanges.
Subsidies
The Affordable Care Act (ACA) offers subsidies to assist those purchasing health insurance policies. These subsidies function like tax credits that reduce an individual or family’s monthly premium payment costs.
Subsidies for health insurance plans vary based on two main criteria: income and cost. Subsidies are capped at 8.5% of your income and increase steadily depending on the level of income in your household.
The Affordable Care Act (ACA) offers subsidies to individuals and families earning between 100 percent to 400 percent of the federal poverty level, though Alaska and Hawaii may have higher income limits and thus, their maximum subsidy amounts may differ significantly from other states.
Enrollment
Open enrollment provides you with an opportunity to obtain coverage for the following plan year, or take advantage of special enrollment periods triggered by certain life events.
If you get married or give birth, for instance, enrolling in a new plan with your spouse and/or child can be easy and affordable. Furthermore, Medicaid and Children’s Health Insurance Program (CHIP) eligibility could provide access to additional health coverage options – so be sure to ask about them if applicable!
Of course, the easiest way to secure adequate coverage for yourself is taking advantage of the open enrollment period in October each year – this time when plans can be added during enrollment period.
Since November 1st, record levels of people have selected or automatically reenrolled in an exchange plan, representing an increase of 13 percent year over year. Over 3 million policies were selected or automatically renewed by individuals, including approximately 1.8 million newcomers to Marketplaces for 2023.
Pre-existing conditions
Pre-existing conditions refer to any medical condition, illness or health issue that you or anyone in your family had prior to enrolling in insurance coverage. They can range from severe conditions like asthma or cancer to more subtle ones like high blood pressure or depression – though many people are unaware that such things exist until after enrollment in coverage has taken effect.
Under the Affordable Care Act, all health plans sold on Marketplaces (companies that offer ACA-compliant insurance in states that host a Marketplace) must provide coverage for preexisting conditions without denial, additional cost or waiting periods attached.
Before the Affordable Care Act came into force, those without health coverage due to pre-existing conditions had fewer options than those with coverage through their employers. Without it, those with pre-existing conditions might find themselves forced to shop on the individual market where policies may have higher premiums or even no coverage at all.
Life events
Under the Patient Protection and Affordable Care Act, most people must enroll for health coverage during the annual open enrollment period. However, certain qualifying life events may make you eligible to shop for insurance outside this period.
Losing your job can be one of the most life-altering events. If this occurs and your employer-sponsored health insurance is lost, you have up to 60 days from its cancellation to apply for another plan if proof of loss can be provided.
Marriage can also qualify as a qualifying event. With so many millennials getting married early and the vast changes it brings with it, marriage often necessitates either upgrading your insurance plan to meet the needs of a larger family, or abandoning it completely.
Events that may qualify as qualifying life events include moving to another state, having a child, experiencing injury or illness and receiving special enrollment periods from most carriers. These major changes could alter eligibility to enroll in Obamacare coverage; proof will likely be required during special enrollment periods.
