Free Medical for Seizures / Epilepsy?


The Affordable Care Act (ObamaCare) bans insurers from denying coverage or charging more for coverage for preexisting conditions like epilepsy.

Tobacco Surcharge On Employer Coverage?


Under the ACA you can be charged a tobacco surcharge for smoking of up to 50% of your premium after subsidies, regardless of where you get coverage. Typically won’t be charged the full amount and some insurers may not charge anything at all.

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 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.

How Do I Switch From Family Plan to Individual Plan?


To switch to an individual plan from a family plan outside of open enrollment you need to have a qualifying life event that triggers a special enrollment period.

I Owe the Penalty, Can I Get Coverage?


You have until April 30, 2015 to enroll in a Marketplace plan if you don’t have coverage and would owe the fee from 2014.

When Does Special Enrollment Coverage Start?


You qualify for special enrollment on the day you lose coverage. The new coverage can start as early as the day you lose coverage, but you can apply early.

Does ObamaCare Provide Travel Insurance?


Short term and travel insurance are sold by private companies, they don’t count as coverage under the ACA, but if you’ll have a less than three month gap you won’t owe a fee.

Why Do I Have to Pay Back ObamaCare Subsidies?


If you projected a higher annual household income then you claimed, you may owe tax credits you received in advance up to the repayment limit for your income when you file 8962 at tax time.

What is the Maxmium Gap In Coverage Allowed Under ACA?


If you go less than three months in a row without coverage or if you get covered during open enrollment, you can claim an exemption on form 8965 and avoid the fee

Can I Qualify For ObamaCare with SSD?


Social Security Disability (SSD) counts as income for getting cost assistance on the Marketplace. If your household income is between 100% – 400% of the Federal Poverty Level then you can get cost assistance.

Insurance Agent Fraud – Story

My families health Insurance thru HEALTHCARE MARKETPLACE: BC/BS of NC has been Fraudulently CANCELLED by the Licensed Independent Agent that originally set it up in May of 2014. Background information: I contacted a recommended Authorized Licensed Agent in May of 2014 to see if my family would qualify for insurance thru the Healthcare Marketplace. We… Read More

How Do Child Dental Provider Reimbursements Work Under ACA?


The ACA doesn’t create new dental, it just extends existing dental plans (either as stand-alone or as part of a medical plan). So nothing changes in regard to how a dentist would handle billing and claims under the ACA.

What are ACA Rules for Employer Payment Plans?


Employer payment plans are valid under the ACA, count as group health plans, and are subject to market reforms (no pre-exiting conditions, no dollar limits, etc).

Travel Exemption Over Multiple Years?


You can use any 330 day period outside the US for ObamaCare’s travel exemption. This means you can have two exempt periods in the same year of 12 months each.

Returning to US From Abroad and ObamaCare


US citizens can enroll in ObamaCare’s Health Insurance Marketplace via Special Enrollment when retuning to the US after living abroad.

How to Comply With ObamaCare After Incarceration?


Those who are incarcerated are exempt from the requirement to have health coverage, once a person leaves incarceration it triggers a special enrollment period to use the Marketplace.

How Does ObamaCare Define Full-Time Hours?


Under the ACA full-time status is 30 hours a week. Employers can use a look-back period of up to 12 months. Employers typically use 27 hours as a safe harbor to ensure employees qualify as part-time status.

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