by Lauren Mandel
Now that Open Enrollment is over, you’d think the confusion surrounding Obamacare would dissipate, right? Not quite.
You guys still have questions. A lot of them. And if one person has a question about their health plan activation or how to use their coverage, we bet a few more of you also need the answer to that exact same question.
As your go-to health insurance resource, we’ve provided answers to 13 of your top Obamacare questions.
- What is Obamacare?
It’s important to first understand the context in which you’re talking about the term “Obamacare.” You may also hear the terms “Affordable Care Act” or “health reform” when talking about Obamacare, which means the United States law that gives more people better access to the health care they need. This law also mandates that all Americans get health insurance or face a fine. Alternatively, if you’re talking about Obamacare as a type of health insurance, this means private health insurance that you can buy through the government or a private exchange, like GoHealth.
- How much is the tax penalty for going uninsured?
The tax penalty – sometimes referred to as the “Obamacare fine” – usually varies from year to year. For 2016, the tax penalty will be 2.5 percent of your income or $695 for each adult and $347.50 for each child in your household, whichever is greater. In many cases, paying the tax penalty and facing your own medical bills is much more expensive than getting health insurance.
- How can I avoid the tax penalty now that Open Enrollment is over?
In order to avoid the tax penalty, you must have an ACA-compliant health insurance plan with minimum essential coverage, also known as a major medical health insurance plan or Obamacare plan. If you did not enroll in coverage during Open Enrollment, you may still be able to get major medical insurance if you experience a Qualifying Life Event, such as having a baby or moving.
- How can I get an exemption from the tax penalty?
Depending on various details, you may qualify from an exemption under the Affordable Care Act, meaning you won’t have to get health insurance and you won’t have to pay the tax penalty. Those who may qualify for an exemption include members of a recognized Native American tribe and individuals who are currently incarcerated. For the full list and more information, take a look at our recent blog post.
- Can I enroll in Obamacare whenever I want?
Most Americans must get health insurance during the annual Open Enrollment Period, which most recently ran from November 15, 2015 through January 31, 2016. An exception to this rule is anyone who experiences a Qualifying Life Event, including moving, having a baby, or adopting, which means those people have 60 days from the time of the event to find new coverage.
- Do I need to purchase dental and vision plans?
While dental and vision insurance aren’t required by law, they are encouraged. The same way major medical insurance can help you afford your medical bills, dental and vision insurance can help you afford those corresponding bills, as well. To save even more money on dental and vision services, check out GoHealth Access.
- Can I keep my doctor with the Obamacare plan I chose?
Maybe. Some health insurance plans require patients to visit only in-network doctors, meaning doctors who are pre-approved. Other plans give patients flexibility, which means you may be able to go out-of-network and see any doctor you choose. It’s important to note that going out-of-network is much more expensive than staying in-network. If your current doctor does not take the plan you chose, you may want to consider finding a new in-network doctor.
- Why don’t I qualify for an Obamacare tax credit?
While most people (last year, 85%) qualify for financial assistance, it is true that not everyone will qualify for a tax credit. Tax credit eligibility is based on a few factors, including the number of people in your household and your household income, so it’s important to regularly update your personal information.
- How and when do I make my first premium payment?
Once you have a health plan, you should make your first payment as soon as possible directly to your health insurance provider. Even if you bought your plan through a private exchange like GoHealth, you will still need to contact your health insurance provider directly to make each payment.
- Why is short-term health insurance not compliant with the Affordable Care Act?
Short-term health insurance is not ACA-compliant because it does not include minimum essential coverage as outlined by the health law. If you have minimum essential coverage, then you can avoid the tax penalty.
- Will I avoid the tax penalty if I have short-term coverage?
Unfortunately, no, you will not avoid the tax penalty with just short-term coverage. As outlined above, short-term health insurance does not include minimum essential coverage under the Affordable Care Act. You will still face the tax penalty, even if you feel short-term coverage is substantial enough for your lifestyle.
- What’s the point of purchasing short-term if I won’t avoid the tax penalty?
No matter what, you should have health insurance. Short-term is a great option for those who missed the Open Enrollment deadline, but who still want some sort of coverage. Having short-term coverage and paying the tax penalty could still be less expensive than going uninsured and facing medical bills on your own.
- Does a short-term plan cover essential health benefits and pre-existing conditions?
Unlike a major medical plan, short-term health insurance does not cover essential health benefits or pre-existing conditions. But short-term coverage is usually an inexpensive option that helps bridge the gap in times of transition.
Still have questions? Leave us a comment, and we’ll get you an answer!