Questions - Page 7 of 34 - Obamacare Facts

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Temp Agency, Who Has to Insure Employee?

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For some purposes of the ACA a temp agency and the client may be a joint-employer. A joint or primary employer must comply with the employer mandate.

Unemployed, How Do I Answer “Do I Plan To File Federal Taxes”?

When you project your income for ObamaCare’s cost assistance you need to attest to the amount of income you expect to claim and whether or not you plan to file taxes.

Small Business in Formation Stages, Should We Offer Coverage?

If your business has over 50 full-time equivalent employees full-time employees must be offered coverage. Since it seems you will end up having to offer coverage it would be smart to include benefits

Charged for Office Visit Before Wellness Visit?

Everyone gets one free preventive visit a year, other visits are subject to cost sharing, you may owe the full amount for a visit not coded correctly.

Can Health Premium Be Increased if a Claim is Made?

A health insurance premium can’t be based on health status or claims, so an insurer can’t increase premiums based on claims made. The ACA protects against discrimination based on health status. You can’t be denied or charged more based on health status or claims.

Can Group Health Insurance Discriminate Based On Health of Group?

Insurers can charge a group health plan as a whole more based on health status, but not individuals or families. The law doesn’t actually protect groups of people for being charged more

Does ObamaCare Cover Alcohol Rehab?

ObamaCare covers rehab for alcohol and drugs as part of it’s ten essential benefits. Treatment can still include cost sharing amounts and other limits.

52 Week Waiting Period For ObamaCare?

It is not true that a restaurant can make you wait 52 weeks for insurance, large employers must offer coverage to all employees with over 30 hours. The max waiting period is 90 days.

Can’t Pay Cash if Doctor Doesn’t Accept ObamaCare?

If a doctor doesn’t accept ObamaCare (doesn’t accept Medicaid or a private plan you bought on the Marketplace), then they are considered out-of-network for purposes of cost sharing.

Do I Have to Switch to Employer Health Insurance From ObamaCare?

If you have access to an employer health plan you can’t get ObamaCare’s subsidies, you can keep the plan without subsidies or switch to an employer plan.

Health Insurance Options For College Students?

If you attend college you can get a Marketplace health plan with assistance or get a student health plan through your school, Medicaid may also be an option.

Can I Get ObamaCare With a Disability?

If you have a disability you can get ObamaCare. Cost assistance eligibility is based on household MAGI income, disability income can count toward MAGI.

What Will Happen If ObamaCare is Repealed?

If ObamaCare is repealed those who get cost assistance and those with preexisting conditions could lose coverage options.

ObamaCare Compliance for Foreign Residents?

If you are a US citizen you can get covered using ObamaCare’s health insurance exchange when you move to the US and cancel your plan when you leave. You’ll simply use special enrollment to enroll.

How Do Student Loans Affect Health Insurance Under the ACA?

Student loan debt isn’t tax deductible, health insurance cost assistance is based on total household income and isn’t affected by loan debt.

How Does My HSA Contribution Affect the MAGI?

Your HSA contribution lowers your AGI and MAGI qualifying you for more cost assistance (assuming you stay within 100% – 400% of the Federal Poverty Level.)

Waiting Period For Travelers Health Insurance?

Travelers health insurance and short term health insurance can start as soon as the insurer allows after the payment is processed. This can mean getting coverage within 24 hours in some instances.

Are Roth Distributions Counted Towards MAGI?

Qualified withdrawals from a Roth IRA don’t count toward modified adjusted gross income (MAGI) for ObamaCare, but taxable IRA withdrawals do. Withdrawals of your original contributions are never taxable income (as you already paid taxes on them), therefore taking them back out doesn’t affect your MAGI.

Do I Lose Deductible When I Switch Health Plans?

If you switch plans mid-year what you paid toward your deductible or out-of-pocket maximum will reset. This can be avoided with a multi-state plan.

Switch Plans or Get Supplemental Outside of Open Enrollment?

If you have a plan you don’t like, for instance due to cost, you can switch plans via special enrollment or look into supplemental options. That being said for private insurance there isn’t really a supplemental option that makes financial sense.

Subsidy Repayment for Total Income, Not Just Months I Got Assistance?

When you get tax credits you get them based on projected total income after deductions for the year (technically Modified Adjusted Gross Income or MAGI).

Health Insurance for Extensive Travel Inside and Outside US?

If someone travels often inside and outside the US, but lives in the US they still need health insurance. We suggest a multi-state plan, that will cover the person no matter which state they travel in. BCBS offers multi-state plans for example. The person should also get some sort of travelers insurance for when they travel outside of the US (although that part isn’t required by law).