It has been five years since the Patient Protection and Affordable Care Act (PPACA) or ObamaCare, as it is more commonly called, was enacted as a law yet some Americans are still at a loss on how to go about getting the perfect health insurance plan for them or if they qualify to get subsidies, to say the least. And as the open enrollment period for 2016 is barely months away, more people will be going to shop in and out of the health insurance marketplaces, also known as health exchanges for their healthcare.
Marketplaces are organizations which serve as a megamall of health insurance companies offering different plans for individuals, companies and families. Under Obamacare, Americans can get free or lower health insurance costs, depending on certain factors like age, residence, number of household, income and health status, among others. However, it also mandates individuals to get health insurance coverage and sign up within the yearly open enrollment dates and in cases of missing enrollment for valid reasons, get to take advantage of the special enrollment period.
Failure to be insured can lead to an individual shared responsibility payment or penalty at a cost dependent on a certain percentage of the tax filing threshold or a certain amount, depending on whichever is higher. For 2016, ISRP is 2.5% of the household income or $695 for adults and $347.50 for children below 18 years of age. Expect the amount to change every year and increase in amount.
For the 2016, open enrollment dates run from November 1, 2015 to January 31, 2016. It is also important to note that insurance coverage usually starts a month after enrollment so if you think you will be using your health insurance soon, it is best to sign up earlier. For Medicaid and Medicare, there are no specific enrollment dates since you can do this any day of the year. On the other hand, for private health insurance, there are no unique enrollment dates but they usually adopt the open enrollment period assigned under ObamaCare.
Before knowing the steps on how to sign up for ObamaCare, here is a list of instances you might find relevant to apply under the PPACA during the open enrollment period as well as the special enrollment period.
You are not already happy with your current health insurance plan.
Even if you already have an existing insurance plan but you are looking to make a switch, you can take advantage of the open enrollment dates.
You lost your insurance coverage.
Perhaps you have lost your job or your hours of work have been reduced and you are not entitled anymore for a job-based health insurance policy, you can look for a private insurance company in and outside the marketplace or see if you qualify for subsidies.
You have a major life change.
If you got married, gave birth or have relocated and missed the open enrollment dates, you can catch up on the special enrollment period and sign up for ObamaCare.
How to Apply for ObamaCare
1. Find out if you qualify.
The first step you need to take is to determine if you are eligible to enroll. If you are not an American citizen, not residing in the United States or are currently incarcerated, you are not qualified under ObamaCare. If you are not qualified for Medicare and you want a private health insurance, you can apply using the marketplace. Same thing if you qualify for Medicaid or CHIP, you can do so. However, if you are currently employed, you might be entitled with a job-based health care insurance.
2. Compare health insurance plans.
There are marketplace exchanges where you can see a list of health insurance providers and the plans they offer so you can compare and choose the right plan for you. There are websites to visit like www.healthcare.gov where you can see available plans or visit your state’s health website to find out the different plans and prices. There are four metal plans (Bronze, Silver, Gold, Platinum) and the catastrophic plan for healthy individuals 30 years old and below. Depending on your circumstance, there is a plan fit for you. Some policyholders prefer the Silver plan since it is the premium ObamaCare caps. It is also important to note that anyone can choose to get insurance in and outside the marketplace.
3. Fill up the application form.
By going to the federal government website managed by the U.S. Centers for Medicare and Medicaid Services (CMS), you can input pertinent information like your Social Security number, name, employer, household income, citizenship and current health coverage to properly set up your application. There are four ways to sign up for Obamacare. You can do it online via the website or through mail, by downloading and printing the file and sending it. There is a link where you can see further instructions on how to mail your application. You can also do it in person by driving to a location site near your place or by phone by calling 1-800-318-2596 or TTY at 1-855-889-4325. If you have queries about the application process, this help desk hotline numbers are also the ones to call.
When shopping for health care insurance, you can:
Visit marketplace exchanges and search for plans.
There are states with their own marketplace where you can find different plans and rates. You can also have your questions answered through their help hotline.
Sign up with a health care provider.
This is ideal if you have already made up your mind on the type of plan you want to buy. You can sign up for plans either from the marketplace or otherwise.
Ask the help of an insurance agent.
If you feel comfortable seeking the assistance of an insurance broker, you can also do this. What’s great about this is that an agent can present to you different plans and explain them extensively so you can have a better understanding of the benefits.
Applying for ObamaCare might seem to be a daunting task and there is no doubt it can be. But as years go by, improvements in the system are seen. Case in point, application forms have fewer pages, making it easier to fill in. Moreover, if you do it properly and do your homework, you can make Obamacare work for you.