Finding the Best Obamacare Plan for You and Your Family
The Patient Protection and Affordable Care Act (also known as ObamaCare) is a national plan designed to give everyone access to the heath care system. It works through a collection of health insurance marketplaces in each state. The marketplaces offer plans tailored to each state, and are regulated by the federal government.
The plans are structured by cost and income level, and offer a variety of different coverages. They offer mandatory coverage for pre-existing conditions, and no lifetime benefit caps. Preventive are and essential health services like childbirth are covered in every plan. Many services are covered with no out-of-pocket expense.
In general, the plans come in four categories--bronze, silver, gold and platinum--which vary based on how much out-of-pocket responsibility you have. Starting in 2014, all Americans must have health insurance coverage--either through an employer or through one of the state exchanges--or pay a penalty enforced through the IRS and income tax filing.
If you decide not to purchase health insurance, you will have to pay a fee called the Individual Shared Responsibility payment through your federal income tax return. It is the greater of Two percent of your household income, or a flat dollar amount per family, $325 for an adult and $162.50 per child. The payment is capped at the amount a bronze level plan would cost in your state.
The cost of coverage--and the amount you’re responsible to pay in deductibles and co-pays--can be affected by your income level and family size. Most families will get tax credits based on income level that offset at least part of the cost of coverage.
To find out the best Obamacare plans for your particular situation, go to the official U.S. Centers for Medicare and Medicaid site.
You can also visit the website for the exchange in your particular state. To find the plans available in your state, you can visit the official marketplace.
-What happens if I don’t sign up for insurance?
Participation in the program is monitored through IRS and your tax return. If you don’t signify you’ve obtained insurance either through the Affordable Care Act marketplace or your employer, you’ll have to pay a fee through your tax return. That fee can range from $95 up to more than $1,000, depending on your household income and the number of people in your family.
If you don’t pay the fee through your taxes—either by failing to file or not paying in the event you have a tax bill due, you will not receive a criminal penalty, but the IRS will withhold the amount due from any future tax refund.
-What is the deadline for getting coverage?
You need to be signed up for the current year’s coverage by March 31. Open enrollment generally runs from November to the end of January.
-If I’m already covered by Medicare, do I need to go through the exchange and get a new plan?
No. If you have medical insurance through Medicare, you’re already covered.
-Do I have to use the health care insurance exchange in the state where I live?
Yes. The plans are managed on a state-by-state basis, and have different coverage, benefit, premium and deductible levels based on state.
-Do I have to be a citizen to qualify for Obamacare?
No. If you’re a legal resident of the United States, you can sign up through the exchanges just like any American citizen. Illegal aliens are not eligible to obtain coverage in the program. If you’re a U.S. citizen living abroad, you’re exempt from obtaining coverage, as long as you’re away for more than 330 days per year.
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