Obamacare requires most Americans to obtain health insurance and provides subsidies that enable many to afford plans.
Those without health insurance can apply for an Affordable Care Act Marketplace plan either during open enrollment or following a qualifying life event.
Individuals and families whose income falls between 100% to 400% of poverty level may qualify for assistance with premium payments and out-of-pocket costs.
Open Enrollment Period
The Affordable Care Act makes health insurance available to everyone through the marketplace. Each year, people can apply for health coverage during the open enrollment period from November 1 through January 15 with free assistance available if needed. In addition, this legislation included an individual mandate which required everyone to obtain health insurance by law; though its requirement has now been lifted for most states; penalties still exist in some cases for not complying.
Consumers will have access to plans that best meet their needs and budget during the 2023 open enrollment period, thanks to new premium assistance options; four out of five returning marketplace enrollees should find plans with monthly premiums of $10 or less per month.
Additionally to online resources, hundreds of Certified Enrollment Assistors are available across the state to offer one-on-one help in their communities. They will assist with the application process, review program eligibility criteria, provide cost estimates and comparisons and answer questions regarding applications or enrollment processes. They can be found at events or by calling 1-800-318-3724.
Special Enrollment Period
If you or any family members lose coverage or anticipate losing coverage within 60 days, a special enrollment period (SEP) may apply to you and should apply during this window to avoid gaps in health insurance. In order to apply during an SEP window and apply without gaps, documents proving this situation are needed – MNsure Marketplace will let you know which documents they require as part of this application process.
Use this special enrollment period to change plans or health status; however, carriers often impose strict criteria regarding what constitutes evidence of qualifying events.
Make use of the special enrollment period to register for Medicaid, which is a government-run health insurance plan offering free or low-cost health coverage to those whose income falls below poverty line. The program is accessible in every state, District of Columbia and five U.S. territories with permanent populations (American Samoa, Guam, Northern Mariana Islands Puerto Rico and U.S. Virgin Islands).
Medicaid
The Affordable Care Act (ACA) created a health insurance marketplace where individuals could shop for private coverage and receive financial assistance to pay their monthly premium. In addition, Medicaid coverage was expanded, restrictions against insurers refusing policies to people with preexisting conditions were put in place and Medicare was strengthened further.
To enroll in an Affordable Care Act health plan, it’s essential that you gather several pieces of information. This includes your household details (name, birthdate and Social Security number); current income estimates including tips; any existing insurance you might possess and where you live.
The federal government now covers most of the cost for benchmark silver plans purchased by consumers earning up to 150% FPL, due to the Inflation Reduction Act’s decreased cost-sharing burden from reduced deductibles and copays for low-income enrollees. You can use New York State of Health to compare plans and monthly costs.
Marketplace
The Marketplace is at the core of Affordable Care Act (ACA). Individuals or families without employer-sponsored health coverage can use it to shop, compare and enroll in health coverage – either directly through it or via an authorized web broker such as eHealth. Both offer plans certified as meeting ACA guidelines; if eligible for subsidies to help cover premium and out-of-pocket costs however, only these channels provide access.
Obamacare should be applied for and purchased during its annual Open Enrollment Period; however, you may also apply outside this window if an event qualifies – for example losing other coverage, moving house, getting married, having children etc. You can even use the marketplace to apply for Medicaid or Children’s Health Insurance Program at any time.
