Enroll in Obamacare
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Know Obamacare
Navigating the world of health insurance can be challenging, especially with the range of terms and options available.
This guide will walk you through everything you need to know about Obamacare, from enrollment periods to the types of health plans available.
What is Obamacare?
Also known as the Affordable Care Act (ACA), Obamacare was introduced in 2010 to make health insurance more affordable and accessible to Americans.
Understanding Enrollment Periods
To get health insurance through Obamacare, you need to enroll during specific times of the year, known as the Affordable Care Act enrollment periods.
Obamacare Open Enrollment
The open enrollment period is the main time to sign up for a health plan. This health insurance enrollment runs from November 1 to December 15 each year. You can renew your current coverage, switch plans, or apply for health insurance during this time.
Special Enrollment Period
If you miss the open enrollment period, you might still be able to get coverage if you qualify for a special enrollment period. This can occur if you experience a qualifying life event such as getting married, having a baby, or losing other health coverage.
Key Terms Explained by Obamacare Health Plans
Marketplace (Exchange)
A website where you can compare and buy health insurance plans, and possibly get financial help to make them cheaper.
Subsidies (Premium Tax Credits)
Money from the government to reduce your monthly health insurance payments.
Cost-Sharing
The money you pay yourself for healthcare services, including your deductible, coinsurance, and copay.
Deductible
The amount you must pay for medical services before your insurance starts paying its share.
Coinsurance
The percentage of the cost you pay for medical services after you meet your deductible. For example, with 20% coinsurance, you pay 20% of the cost, and your insurance pays 80%.
Marketplace (Exchange)
A website where you can compare and buy health insurance plans, and possibly get financial help to make them cheaper.
Copay
A fixed amount you pay for certain services, like visiting a doctor or getting a prescription.
Essential Health Benefits
The ten types of health services that all ACA plans must cover, such as doctor visits, preventive care, hospital stays, mental health services, and prescription drugs.
Pre-existing Condition
A health issue you had before getting an ACA plan. ACA rules say insurers can't refuse coverage or charge more because of pre-existing conditions.
Metal Tiers (Bronze, Silver, Gold, Platinum)
Categories of ACA plans showing how costs are shared. Bronze plans have lower monthly payments but higher costs when you get care, while Platinum plans have higher monthly payments but lower costs when you get care.
Network
The doctors, hospitals, and other providers that your insurance plan covers. Using these in-network providers usually costs you less.
Out-of-Network
Providers or doctors, hospitals, not covered by your insurance plan. Visiting these often means higher costs for you.
Types of Health Plans
Here are Obamacare health plans to meet different needs and budgets:
Bronze
Lowest monthly premiums or payments, but you pay more when you use healthcare. Good for young and healthy people who don’t need much medical care.
Silver
Moderate monthly payments and costs when you use healthcare. A good middle ground for those who need occasional medical care and might get extra help to lower costs.
Gold
Higher monthly payments, but lower costs when you use healthcare. Suitable for people who need medical care more often.
Platinum
Highest monthly payments, but you pay the least when you use healthcare. Best for people who expect to need a lot of medical services.
How to Enroll in Obamacare
- Choose Your Method: You can enroll online at HealthCare.gov, by phone with a Marketplace representative, with help from a certified enrollment assistant, or by mail (though this is generally the slowest method).
- Apply & Create Account: Fill out the application form, providing information about your household, income, and desired coverage. Create an account if enrolling online.
- See Your Options: The Marketplace will display plans available in your area based on your information. You’ll see details like premiums, deductibles, and covered services.
- Compare Plans: Use the plan comparison tool to analyze plans based on factors like cost, network coverage, and metal tier (bronze, silver, gold, platinum).
- Estimate Subsidies: The Marketplace will estimate your eligibility for premium tax credits (subsidies) that can lower your monthly costs.
Finalize Enrollment:
- Choose Your Plan: Select the plan that best fits your needs and budget.
- Finalize Application: Review your application, ensure all information is accurate, and submit it.
- Pay Your First Premium: You’ll typically need to pay your first month’s premium to activate your coverage.
Frequently Asked
Questions!
The same period applies, from November 1 to December 15.
- Outside of Open Enrollment, there are several ways to get health coverage. The most common method is through a Qualifying Life Event (QLE), which includes significant life changes like losing health insurance (due to job loss or COBRA expiration), gaining dependents (through birth, adoption, or marriage), moving to a new service area, or changes in household income that make you eligible for subsidies.
- Additionally, you can apply for Medicaid or CHIP at any time, as these government programs provide coverage for low-income adults, children, pregnant women, seniors, and people with disabilities.
- Short-term health insurance is another option, offering temporary coverage for up to 36 months, though it typically lacks the comprehensiveness of ACA plans and may not cover pre-existing conditions, making it a less ideal long-term solution.
- Lastly, if you start a job that offers health insurance, you may be able to enroll during their enrollment period, regardless of the Marketplace’s Open Enrollment period.
Visit Healthcare.gov, create an account, complete the application, choose a plan, and enroll.
The Obamacare marketplace is an online platform where you can compare and purchase health insurance plans offered under the Affordable Care Act.
