Resources
More information can be found at the below websites regarding additional questions related to the the Health Insurance Marketplace and Medicare/Medicaid and CMS.
Website: www.healthcare.gov
Phone Number: 1-800-318-2596
Website: www.medicare.gov
Phone Number: 1-800-633-4227
Website: www.medicaid.gov
Phone Number: 1-866-762-2237 (Florida)
Website: www.cms.gov
Obamacare Overview
The Health Insurance Marketplace is for people who don’t have health coverage. If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, the Marketplace can help you get covered.
If you have job-based insurance: You can buy a plan through the Marketplace, but you’ll pay full price unless your employer’s insurance doesn’t meet certain standards or if the cost of coverage is not deemed “affordable” (monthly premium is greater than 9.5% of your monthly income). Most job-based plans do meet the standards
What you pay for insurance depends on your income – and you’ll probably save. Your savings depend on your estimate of your expected income for 2016, not your income for 2015. This year, about 8 in 10 of the uninsured who are eligible for Marketplace coverage qualify for financial assistance to lower the cost of their monthly premiums. Get a quick idea if your expected income is in the range to save.
Based on the income estimate you put on your application, we’ll tell you if you qualify for one of these:
A health insurance plan with savings. Most people who apply qualify for a premium tax credit that lowers their monthly insurance bill. Some also save on out-of-pocket costs like deductibles and co payments.
The plans are offered by private insurance companies with a range of prices and features. All plans cover:
- Essential health benefits
- Pr-existing conditions, including pregnancy
- Preventive care
Medicaid and the Children’s Health Insurance Program (CHIP)
Medicaid and CHIP provide free or low-cost coverage to millions of people and families with limited income, disabilities, and some other situations.
- Many states are expanding Medicaid to cover all households below certain incomes. See if your state is expanding and if your income is in range to qualify.
- Your children may qualify for CHIP even if you don’t qualify for Medicaid.
You can apply for coverage 4 ways
- Online
- By phone
- With in-person help
- With a paper application
If you don’t have health insurance, you may have to pay a fee. Most people must have qualifying health coverage or pay a fee with their 2016 federal taxes.
- If you don’t have coverage in 2016, you’ll pay a penalty of either 2.5% of your income, or $695 per adult ($347.50 per child) — whichever is higher.
- In some cases, you might qualify for an exemption from the requirement to have health insurance.
