Affordable Care Act: Exchanges open

Tuesday, October 01, 2013

Access to health insurance through the Affordable Care Act exchanges is now available during the 2013-2014 open enrollment period, ending March 31, 2014. With the start of Obamacare’s open enrollment period, residents of the United States—regardless of age, gender or previous sickness—will have new options for individual health insurance. At HealthCare.gov, you can start reviewing your options from the Health Insurance Marketplace.

Fill out the Marketplace application to learn if you qualify for:

• Private insurance plans. Learn if you qualify for lower costs based on your household size and income. Plans cover essential health benefits, pre-existing conditions and preventive care. If you don’t qualify for lower costs, you can still use the Marketplace to buy insurance at the standard price.
• Medicaid and the Children’s Health Insurance Program (CHIP). These programs provide coverage to millions of families with limited income. If you qualify, HealthCare.gov will share information with your state agency and it will contact you. Many (but not all states) are expanding Medicaid in 2014 to cover more people.

Whatever state you live in, you can use the marketplace. Some states will operate their own marketplaces. In other states, the marketplace is run by the Federal government. You can access your state's plan through HealthCare.gov. If you enroll by Dec. 15, coverage can begin as soon as Jan. 1, 2014.

Penalties

Most people must have health coverage in place by 2014 or pay a penalty (individual mandate) when they file their taxes. For the 2014 tax year, the penalty will be $95 per adult, $47.50 per child, or 1% of your income (whichever is higher). This penalty will increase every year. Some people may qualify for an exemption from this fee. (Read more about exemptions.)

Open enrollment

Marketplace open enrollment ends March 31, 2014. For late 2014 and subsequent years, the open enrollment period is Oct. 15 to Dec. 7. After open enrollment ends, you won't be able to get health coverage through the marketplace until the next annual enrollment period, unless you have a qualifying life event. Qualifying life events are changes in your life that require changes in your health care insurance outside open enrollment. Examples include moving to a new state, certain changes in your income, and changes in your family size (for example, if you marry, divorce or have a baby).

Are you already covered?

You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage.

Even if you’re eligible for job-based insurance, you can consider switching to a marketplace plan. But you won’t qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn’t meet minimum requirements. Be careful: If your employer covers all or part of your premiums, you could lose these benefits if you leave your employer's plan. (Unaffordable means that the minimum amount you pay out of pocket is more than 8% of your household income. Employer-sponsored coverage generally constitutes minimum essential coverage under the law.)

If you have Medicare, you’re considered covered and don’t have to make any changes. Medicare beneficiaries can’t use the marketplace to buy a supplemental or dental plan.

For more information

If you have questions, the federal government hotline is open 24 hours a day, 7 days a week: 800-318-2596 (TTY: 855-889-4325). Online, visit HealthCare.gov.

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