Health Care Reform FAQfamily2

How does the Federal Subsidy work?

Under the Affordable Care Act (ACA), individuals who purchase insurance after January 1, 2014 may be eligible for health insurance premium subsidies.

How can I find out if I qualify for any subsidies?

Check out the Health Reform Subsidy Calculator at www.kff.org.

What is the Health Insurance Marketplace?

The Health Insurance Marketplace is a way to get affordable medical insurance coverage.  Open enrollment runs from November 15, 2017  to December 15th 2017, for coverage effective as soon as January 1, 2018.

What if I have a pre-existing condition?

Starting January 1, 2014, health insurance plans can no longer refuse to cover you or charge you more just because you have a pre-existing health condition.  Once you have insurance, it cannot refuse to cover treatment for pre-existing conditions. Coverage for your pre-existing conditions begins immediately on the effective date.  This is true even if you have been turned down or refused coverage due to a pre-existing condition in the past.

How long does open enrollment last?

Open enrollment in the public Health Insurance Marketplace ends on December 15, 2017. Outside of open enrollment, you cannot enroll in subsidized coverage unless you have a qualifying life event.

What is a qualifying life event?

Events that permit special enrollment include, but are not limited to:

  • Divorce / Marriage
  • Gaining or becoming a dependent
  • Gaining status as a citizen, national or lawfully present individual
  • Loss of minimum essential coverage (loss of Medicaid eligibility; termination of a qualified health plan); except if termination is based on failure to pay premiums
  • Loss of employer-sponsored coverage
  • Determination that an individual is newly eligible or ineligible for premium tax credits or a change in eligibility for cost-sharing reductions
  • Permanent move to an area where different qualified health plans are available
  • Other exceptions circumstances identified by the public Marketplace

In most cases, you will have 60 days after one of these triggering events to apply & secure coverage