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The Q&A section below covers ObamaCare, TrumpCare, Medicare, Medicaid, Employer Coverage, HealthCare Taxes, HealthCare Changes, and other general HealthCare topics. Just click on a question to get our answer, provide your own answer, or ask additional questions.
You should complete Part III of 1095-C ONLY if the employer offers employer-sponsored self-insured health coverage in which the employee or other individual enrolled.
If you sort plans by price you’ll be able to easily find HSA compatible High Deductible Health Plans.
If you work, but aren’t offered coverage through your employer, you can still get an ObamaCare Marketplace plan with cost assistance.
Federal foster care or adoption assistance income is exempted from MAGI and won’t affect Medicaid or tax credit eligibility.
All US citizens, who qualify based on income, must obtain coverage or an exemption. For someone traveling back and forth between the U.S. they can be exempt for spending 330 consecutive days in the year outside the US.
Gender based pricing rules apply to new plans in the individual and small employer markets. They do not apply to grandfathered plans, large employers, or self insured businesses.
Typically a person would only need one policy that counts as minimum essential coverage under ObamaCare, but can have more than one if they choose.
The cheapest plan is typically $200 – $400, cost assistance caps the cost between 2% – 9.5% of MAGI. It’s rare that someone would pay over $600 for individual coverage, let alone $800.
Some of the less reputable third party companies on the internet resell leads or spam phone calls when customers fill out a quote form. This is not a practice that is endorsed by any reputable entity including ObamaCareFacts.com, HealthCare.Gov, or any major insurer, broker, or advertiser.
Preventive screening, including mammograms, is covered at not cost under ObamaCare but additional exams may have cost sharing or may not be covered.
A coverage family can include any tax dependent so a grandchild can be covered, but only if the natural parent isn’t living in the same household.
A legal immigrant can buy a private plan or get cost assistance through ObamaCare (if they file taxes), but can’t get Medicaid before 5 years in most cases.
If you have Medicare you cannot use ObamaCare’s Marketplace or buy non-Medicare insurance, even if you only have Part A or Part B.
If you move to a new state you have 60 days to enroll in a plan via special enrollment in that states Marketplace. There will never be an instance where you move out of state and aren’t allowed to enroll in an individual health plan
Under ObamaCare full-time is defined as working an average of 30 hours a week or more or 130 hours a month in a measurement period between 3 and 12 months.
A firm with ten or less employees doesn’t have to offer health coverage, but can get tax breaks of up to 50% of an employees premium. The ACA aims to help small businesses, not hurt them.
You can decline employer health insurance (it’s called a waiver of coverage), but you won’t be able to get cost assistance through ObamaCare or dependent coverage through the employer plan if coverage was offered.
The best way to provide coverage for another person who you don’t file taxes with is to look into their cost assistance options through ObamaCare first and then look at private or employer options.
ObamaCare expanded Medicaid, but each state has a unique Medicaid program, when moving contact the state you plan to live in and arrange coverage before you move.
Worker’s comp doesn’t counts toward ObamaCare subsidy eligibility, as it’s not taxable. You can switch to an ObamaCare plan when worker’s comp ends.
If you are a small business with ten or less employees you can either not offer health coverage, or get tax credits for up to 50% of employee premium costs.
Only people who file taxes together can be covered under a family plan together, even if two people share a child or live together.
The ACA does not require coverage of prophylactic mastectomy or reconstruction procedures, but some state laws do. Thus it will be plan specific and state specific.
Wellness visits and key preventive care are covered with no out-of-pocket costs, but some related services aren’t covered without cost sharing.
An incarcerated person can’t use the Marketplace, doesn’t owe the fee for not having coverage, and can be dropped from a family plan without penalty.