Got Questions About Obamacare? Get Them Answered Here

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    Anton J. Gunn, Director of External Affairs in the Office of Intergovernmental and External Affairs (IEA) at the U.S. Department of Health and Human Services, answers your questions about Obamacare and tells you how you should prepare for the changes.

    What is the web site for young folks to receive more info on the Affordable Care Act?
    You should know that thanks to the Affordable Care Act, young people under the age of 26 are eligible to stay on their parent’s health insurance plan. Both young people and parents interested in learning more should visit www.healthcare.gov/young-adults or use the free call center at 1-800-318-2596.

    How does the Affordable Care Act help people like me?
    Whether you’re uninsured, you’ve been denied coverage in the past, or you just want to explore new options, the Health Insurance Marketplace will give you more choices and control over your health coverage. The Marketplace will operate in all states, so no matter where you live you’ll have access to coverage.
    In the Marketplace, you can compare coverage options based on price, benefits, quality, and other features important to you and your family. You can choose the combination of price and benefits that fits your budget and meets your needs. You can find out more information by going to www.healthcare.gov or using the call center at 1-800-318-2596.

    Would I be able to cancel my current high cost insurance and sign up for the government plan?
    If you have job-based health insurance you like, you can keep it. You’re considered covered. You may be able to change to Marketplace coverage if you want to. Any job-based health plan you currently have qualifies as minimum essential coverage. You don’t need to change to a Marketplace plan in order to avoid the fee that uninsured people may have to pay for 2014. You can find out more information by going to www.healthcare.gov or using the call center at 1-800-318-2596.

    Is it true that everyone is required to have a plan? And if not, will we have to pay a penalty?
    If someone who can afford health insurance doesn’t have coverage in 2014, they may have to pay a fee. They also have to pay for all of their health care. If you’re unemployed you may qualify for Medicaid, the Children’s Health Insurance Program, or lower costs on Marketplace insurance based on your income. Your household size and income, not your employment status, will determine what health coverage options you’re eligible for and how much help you get paying for coverage. You can find out more information by going to www.healthcare.gov or using the call center at 1-800-318-2596.

    I’m self employed and have been denied for health insurance due to precancerous cells and  want to make sure there are no income restrictions for government health plans.
    If you’re self-employed with no employees, you’re not considered an employer. You can use the individual Marketplace to find coverage that fits your needs. Starting in 2014, health insurance plans can’t refuse to cover you or charge you more just because you have a pre-existing health condition. If you’re self-employed, you’ll have more health coverage options in 2014.

    Starting October 1, 2013, you can use the Marketplace to find health coverage that fits your budget and meets your needs. You can compare important features of several plans side-by-side, all of them offering a full package of essential health benefits. You can see what your premium, deductibles, and out-of-pocket costs will be before you decide to enroll.

    You can’t be denied coverage or charged more because you have a pre-existing health condition.

    If you currently have individual insurance–a plan you bought yourself, not the kind you get through an employer–you may be able to change to a Marketplace plan. You can find out more information by going to www.healthcare.gov or using the call center at 1-800-318-2596.

    Can you ask If you already have coverage do you still need to register?
    If you have job-based health insurance you like, you can keep it. You’re considered covered. You may be able to change to Marketplace coverage if you want to. Any job-based health plan you currently have qualifies as minimum essential coverage. You don’t need to change to a Marketplace plan in order to avoid the fee that uninsured people may have to pay for 2014.

    Whether you need health coverage or have it already, the health care law offers new rights and protections that make coverage fairer and easier to understand.

    Some rights and protections apply to plans in the Health Insurance Marketplace or other individual insurance, some apply to job-based plans, and some apply to all health coverage.

    These rights and protections provide even more choice and control over your health coverage when key parts of the law take effect in 2014.

    Does the affordable heath care act have policies for individuals with pre-existing conditions?
    Starting in 2014, health insurance plans can’t refuse to cover you or charge you more just because you have a pre-existing health condition. Once you have insurance, the plan can’t refuse to cover treatment for pre-existing conditions. Coverage for your pre-existing conditions begins immediately. This is true even if you have been turned down or refused coverage due to a pre-existing condition in the past. You can find out more information by going to www.healthcare.gov or using the call center at 1-800-318-2596.

    Will there be a plan cheap enough for people who have no income?
    If you’re unemployed you may qualify for Medicaid, the Children’s Health Insurance Program, or lower costs on Marketplace insurance based on your income. You can find out more information by going to www.healthcare.gov or using the call center at 1-800-318-2596.

    When can you sign up for Obama care?
    Open enrollment for the health insurance marketplace starts on October 1, 2013 and ends on March 31. 2014. Outside of open enrollment, you can’t enroll in Marketplace coverage unless you have a qualifying life event. You can find out more information by going to www.healthcare.gov or using the call center at 1-800-318-2596.

    As a small business owner with 10 full time employees, how will the Affordable Care Act affect my company?
    Starting in 2014, businesses with 50 or fewer full-time equivalent (FTE) employees can use SHOP to offer coverage to their employees. This applies to non-profit organizations as well. You control the coverage you offer and how much you pay toward premium costs.

    Health coverage through SHOP starts as soon as January 1, 2014. Open enrollment begins October 1, 2013. You can sign up and begin offering coverage any time during the year. For more information on SHOP visit: www.healthcare.gov/marketplace/shop/ or call1-800-706-7893 (TTY users: 1-800-706-7915). Hours: Monday through Friday, 9 a.m. to 5 p.m. EST.

    If I enroll today do I have to pay money?
    No, if you enroll at healthcare.gov today, you have until December 15 to pay for your coverage to start on January 1, 2014.

    Does health care affect college students with part-time jobs?
    Young adults can go to healthcare.gov and find an affordable plan for you as a full-time student. If your parents have coverage, you are able to stay on your parents plan until age 26.

    Will Obamacare Cover Braces?
    You can go to healthcare.gov and find a plan that covers dental services or you can purchase a stand alone dental plan. Contact our call center 1-800-318-2596 for more information.

    What website can I go to and see what plans I qualify for?
    Go to healthcare.gov, create and account fill out an application to see what you qualify for and begin shopping for health coverage.

    Does the Afforable Care Act cover prescription drugs?
    Yes, HealthCare.gov allows you to shop for affordable Health insurance or plans that helps pay for prescription drugs and medications.

    If I already have health insurance do I need to switch to the Affordable Care Act?                 
    If you are in the 85% of Americans that have health coverage through your employer. You can keep you coverage. If you shop for health coverage in the individual market, you can go to healthcare.gov and find an affordable plan that meets your needs and fits you budget.

    If I don’t sign up for Obamacare is there a penalty? If I don’t pay the fine, do go to jail?
    The Affordable Care Act requires all Americans to have health insurance coverage in 2014. If you don’t have coverage during the year of 2014, you could pay a tax penalty of $95 or 1% of your income (whichever is greater). This penalty is assessed on your 2014 Tax Return.

    If we purchase insurance today through the Affordable Care Act, when will I be able to use it?
    If you sign up and purchase coverage through healthcare.gov between October 1, 2013 and December 15, 2013, you coverage is effective January 1, 2014. You can enroll in coverage from Oct 1 – Mar 31, 2014. Your coverage will begin on the following month.

    Can illegal immigrants get Obamacare?
    No, only citizens and legal immigrants are eligible for coverage at healthcare.gov.

    How will Obamacare impact African Americans?

    October 1, 2013:

    • 6.8 million uninsured African Americans, including 3 million African American women, will have new opportunities for coverage through the Health Insurance Marketplace.
    • The Marketplace is a destination where consumers can compare insurance options in simple, easy to understand language. At the Marketplace, consumers will be able to compare insurance options based on price, benefits, quality and other factors with a clear picture of premiums and cost-sharing amounts to help them choose the insurance that best fits their needs.
    • Consumers may be eligible for free or low cost coverage, or advance premium tax credits that lower monthly premiums right away.  Individuals with higher incomes (up to 400 percent of the federal poverty level, or $94,200 for a family of four) will be eligible for premium tax credits to purchase coverage from the Health Insurance Marketplace.
    • States have new opportunities to expand Medicaid coverage to include Americans with family incomes at or below 133 percent of the federal poverty level (generally $31,322 for a family of four in 2013). This expansion includes adults without dependent children living at home. These adults have not previously been eligible in most states.
    • Starting in 2014, over 390,000 African American women who currently buy coverage in the individual market will gain maternity coverage, as part of the Affordable Care Act’s requirement for plans to cover essential health benefits.

      I currently have health insurance, but I plan to quit my job after the enrollment period. Would I be able to buy insurance after the enrollment period?

      If your individual plan ends outside the open enrollment period, you can still use the Marketplace to get a new plan. Because the plan is ending, you get a special enrollment period. Your Marketplace special enrollment period begins 60 days before your individual plan ends. If you wait until after you lose coverage to notify us, you have 60 days from the loss of the coverage to enroll in a new Marketplace plan. If you want to avoid a gap in coverage, you should sign up for a new plan by the 15th of the last month of your current plan’s coverage. If you miss this window, you’ll have to wait until the next open enrollment period in the fall of 2014 to sign up for a Marketplace plan. The special enrollment period applies only at the end of a plan year or if your insurance company terminates your plan. Otherwise you must wait for the annual open enrollment period before you can buy insurance.

      What happens to Obamacare in the interim you lose your job within the six-month window frame and you’re without benefits and insurance?
      If you lose your job and with it your job-based health insurance coverage, you may buy an individual plan through the Marketplace. You may also have the option of keeping your health insurance for a limited time through a program called COBRA continuation coverage.

      Option 1: Get an individual Marketplace plan If you leave your job for any reason and lose your job-based coverage, you can choose to buy coverage from the Marketplace<https://www.healthcare.gov/what-is-the-health-insurance-marketplace&gt;. This is true even if you leave your job outside the Marketplace open enrollment period of October 1, 2013 to March 31, 2014. By using the Marketplace, you’ll learn if you qualify for lower costs on your monthly premiums on private insurance. You could also qualify for lower out-of-pocket costs. Through the Marketplace you’ll also learn if you qualify for free or low-cost coverage from Medicaid or the Children’s Health Insurance Program (CHIP).

      Option 2: Get COBRA coverage You may also be able to keep your job-based plan through COBRA continuation coverage. COBRA is a federal law that may let you pay to keep you and your family on your employee health insurance for a limited time (usually 18 months) after your employment ends or you otherwise lose coverage.

      If you buy COBRA continuation coverage, you won’t be able to get any of the lower costs on premiums and out-of-pocket costs that people may get using the Marketplace. You’d also have to pay the full monthly premium, including any part of the premium that your employer had contributed.

      How  can a person  with no  income  be  penalized for not having  healthcare?
      Starting 2014, most people must have health coverage or pay a fee (the “individual shared responsibility payment”). You can get an exemption in certain cases. Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”

      You may qualify for an exemption if:

      *   You’re uninsured for less than 3 months of the year
      *   The lowest-priced coverage available to you would cost more than 8% of your household income
      *   You don’t have to file a tax return because your income is too low (Learn about the filing limit.)
      *   You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
      *   You’re a member of a recognized health care sharing ministry
      *   You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
      *   You’re incarcerated, and not awaiting the disposition of charges against you
      *   You’re not lawfully present in the U.S.

      I’m on Medicare can I get Health Care instead of Supplement insurance?
      Medicare isn’t part of the Health Insurance Marketplace, so you don’t need to do anything. If you have Medicare, you are considered covered. The Marketplace won’t affect your Medicare choices, and your benefits won’t be changing. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan, you’ll still have the same benefits and security you have now. You won’t have to make any changes.

      Note: The Marketplace does not offer Medicare supplement (Medigap) insurance or Part D drug plans. For information on these programs, visit Medicare.gov.

      Can someone who works, but company provides a Healthcare plan that is very expensive opt out of this program for the Obama Healthcare plan? Do I qualify for the affordable care act if my job offers insurance but it is extremely expensive?
       If you have job-based health insurance you like, you can keep it. You’re considered covered. You may be able to change to Marketplace coverage if you want to. Any job-based health plan you currently have qualifies as minimum essential coverage. You don’t need to change to a Marketplace plan in order to avoid the fee that uninsured people may have to pay for 2014. If you’d like to explore Marketplace coverage options you can, but there are several important things to consider. With most job-based health insurance plans, your employer pays a portion of your premiums. If you choose a Marketplace plan instead, your employer does not need to make a contribution to your premiums. You should consider this carefully before comparing Marketplace plans. If you decide to check out Marketplace plans, be aware that you may not qualify for lower costs on your monthly premiums and out-of-pocket costs, even if your income would qualify you otherwise. Whether you qualify will depend on what kind of coverage your employer offers. If your job-based coverage is considered affordable and meets minimum value, you won’t be able to get lower costs on premiums or out-of-pocket costs in the Marketplace. This is true no matter what your income and family size are.

      Your employer can tell you whether the insurance plan it offers meets minimum value and can provide you with information to determine if the plan is considered affordable to you. If you do not qualify for lower costs in the Marketplace, and your employer does not pay part of your premiums on the Marketplace, be sure you take these things into account before you consider choosing a plan other than your employer’s.

      My only child has not worked for sometime now. She was given the flu shot and came down with Guillian Barre Syndrome. Her meds are very expensive. He is 36 years old. Will she be able to get health insurance?
      Starting in 2014, being sick won’t keep you from getting health coverage. An insurance company can’t turn you down or charge you more because of your condition. Once you have insurance, the plan can’t refuse to cover treatment for pre-existing conditions. Coverage for your pre-existing conditions begins immediately. This is true even if you have been turned down or refused coverage due to a pre-existing condition in the past.

       I’m currently covered by an insurance plan grandfathered. I was notified by employer that with this change. They can no longer provide coverage for my family. They will only cover me.  Can they do that?
       Grandfathered plans are exempted from many changes required under the Affordable Care Act. Plans or policies may lose their “grandfathered” status if they make certain significant changes that reduce benefits or increase costs to consumers. A health plan must disclose in its plan materials whether it considers itself to be a grandfathered plan and must also advise consumers how to contact the U.S. Department of Labor or the U.S. Department of Health & Human Services.

      My company is discontinuing our insurance on December 31st. Will I be penalized on January 1st? Or can I sign up now?
       Yes, If your plan is not being offered any longer, you can use the Health Insurance Marketplace to find health plans available to you, compare them based on price, coverage, and other important features, and enroll in a plan that fits your budget and meets your needs. If you enroll in a Marketplace plan you may qualify for lower costs on premiums and out-of-pocket costs based in your household size and income. All Marketplace plans will offer the protections and benefits required in 2014. Coverage can begin as soon as January 1, 2014. Open enrollment ends March 31, 2014. You can sign up now. Visit www.healthcare.gov or call 1-800-318-2596 to apply for coverage. For your coverage to be effective January 1, 2014, you need to enroll in a new plan by December 15, 2013.

      If your individual plan ends outside the open enrollment period, you can still use the Marketplace to get a new plan. Because the plan is ending, you get a special enrollment period.

      Is dental included in the Affordable Health Act?
      In the Health Insurance Marketplace, you generally can get dental coverage as part of a health plan or by itself through a separate, stand-alone dental plan. Under the health care law, dental insurance is treated differently for adults and children 18 and under. Dental coverage for children is an essential health benefit. This means it must be available to you as part of a health plan or as a free-standing plan. This is not the case for adults. Insurers don’t have to offer adult dental coverage. Starting in 2014, you must have health coverage or pay a fee. But this is not true for dental coverage. You do not need to have dental coverage to avoid the penalty.

      Dental coverage is available two ways

      ·         Health plans that include dental coverage. In the Marketplace, dental coverage will be included in some health plans. You’ll be able to see which plans include dental coverage when you compare them. You’ll also see what the dental benefits are. If a health plan includes dental coverage, you will pay one premium for everything. The premium shown for the plan includes both health and dental coverage.

      ·         Separate, stand-alone dental plans. In some cases separate, stand-alone plans will be offered. You may want to choose this option if the health coverage you plan to enroll in doesn’t include dental coverage, or if you want different dental coverage.

      If you choose a separate dental plan, you’ll pay a separate, additional premium for the dental plan.

      How do I get started with the affordable care today? Do you have to pay as soon as you sign up?
      Visit www.healthcare.govor call 1-800-318-2596 to apply for coverage. For your coverage to be effective January 1, 2014, you need to enroll and pay (if required) by December 15, 2013.

      Does everyone have to get Obama care?  If I cannot afford it right now and can get it around June or July, how will I be penalized?
       If you have job-based health insurance you like, you can keep it. You’re considered covered. You may be able to change to Marketplace coverage if you want to. If someone who can afford health insurance doesn’t have coverage in 2014, they may have to pay a fee. They also have to pay for all of their health care. When someone without health coverage gets urgent—often expensive—medical care but doesn’t pay the bill, everyone else ends up paying the price. That’s why the health care law requires all people who can afford it to take responsibility for their own health insurance by getting coverage or paying a penalty. People without health coverage will also have to pay the entire cost of all their medical care. They won’t be protected from the kind of very high medical bills that can sometimes lead to bankruptcy.

      I am a General Manager for Wendy’s.  I would like information on how my employees can get affordable health care.
      Visit www.healthcare.gov or call 1-800-318-2596 to apply for coverage.

      What if your child is in college and doesn’t have a job? I am disabled and I receive SSI and Medicaid and I don’t have any money leftover.
      If you’re unemployed you may qualify for Medicaid, the Children’s Health Insurance Program, or lower costs on Marketplace insurance based on your income. Your household size and income, not your employment status, will determine what health coverage options you’re eligible for and how much help you get paying for coverage. When you apply for Marketplace coverage you will report your current income and estimate your income for 2014.

      If you’re under 30, you may be able to buy a special kind of health insurance plan that protects you from very high medical costs. These “catastrophic” plans usually have lower premiums and protect you from worst-case scenarios. In the Marketplace, catastrophic plans cover 3 doctor visits per year at no cost and free preventive benefits. Visit www.healthcare.gov or call 1-800-318-2596 to apply for coverage.

      How long do I have to apply for the Obamacare?
      Open Enrollment to apply for coverage is October 1, 2013 – March 31, 2014.

      I work for Dekalb police and the health care is expensive for a family of 4. My youngest is 3 oldest is 9. Can I refuse the job policy and buy into the affordable care act?
      Anyone can apply at the Health Insurance Marketplace. With most job-based health insurance plans, your employer pays a portion of your premiums. If you choose a Marketplace plan instead, your employer does not need to make a contribution to your premiums. You should consider this carefully before comparing Marketplace plans. If you decide to check out Marketplace plans, be aware that you may not qualify for lower costs on your monthly premiums and out-of-pocket costs, even if your income would qualify you otherwise.

      Whether you qualify will depend on what kind of coverage your employer offers. If your job-based coverage is considered affordable and meets minimum value, you won’t be able to get lower costs on premiums or out-of-pocket costs in the Marketplace. This is true no matter what your income and family size are.

      Your employer can tell you whether the insurance plan it offers meets minimum value and can provide you with information to determine if the plan is considered affordable to you.

      If you do not qualify for lower costs in the Marketplace, and your employer does not pay part of your premiums on the Marketplace, be sure you take these things into account before you consider choosing a plan other than your employer’s.

      I work 26 hours a week. I have Crohn’s. Would I be able to get vision & dental?
      If you’re a part-time worker and your employer doesn’t offer you health insurance, you can use the Health Insurance Marketplace to find a plan. You may be able to get lower costs on your monthly premiums and out-of-pocket costs based on your household size and income. You may also qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP). You’ll learn if you qualify for these options when you fill out your Marketplace application. You can apply now. Coverage begins as early as January 1, 2014.

      All private health insurance plans offered in the Marketplace will offer the same set of essential health benefits. These are services all plans must cover. The essential health benefits include at least the following items and services:

      *   Ambulatory patient services (outpatient care you get without being admitted to a hospital)
      *   Emergency services
      *   Hospitalization (such as surgery)
      *   Maternity and newborn care (care before and after your baby is born)
      *   Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
      *   Prescription drugs
      *   Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
      *   Laboratory services
      *   Preventive and wellness services and chronic disease management
      *   Pediatric services

      Essential health benefits are minimum requirements for all plans in the Marketplace. Plans may offer additional coverage. You will see exactly what each plan offers when you compare them side-by-side in the Marketplace. Questions? Call 1-800-318-2596, 24 hours a day, 7 days a week. (TTY: 1-855-889-4325)

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