Within the new Marketplace (Insurance Exchange)
The Marketplace is the way to find quality health coverage, you can learn if you can get lower costs based on your income, compare your coverage options side-by-side, and enroll please use HealthSherpa
DO THIS FIRST!
Determine Eligibility: Please use the quick and easy Health Care Reform Calculator below (provided by: Kaiser Foundation)
Then, look below at OPTION’S 1 & 2
2019 Open Enrollment OpensIf you don’t enroll in the 2019 Open Enrollment ( it runs from November 15, 2018 to December 15, 2018) you can’t enroll in a health insurance plan for 2019 unless you qualify for a Special Enrollment Period.If you looking for a ON Exchange Plans ( Healthcare.gov ) click the link below an review your options via our link to through Healthcare.gov.
OPTION 1: ON MARKETPLACE / EXCHANGE
If your income is below 400% of the federal poverty limit (See the Federal Poverty Guidelines Table below:) — which is about $48,560 for an individual and $100,400 for a family of four — you’ll be able to shop for a policy in the PUBLIC MARKETPLACE / INSURANCE EXCHANGE.
OPTION 2: OFF MARKETPLACE / EXCHANGE
If your income is above 400% of the federal poverty limit (See the Federal Poverty Guidelines Table below:) — which is about $48,560 for an individual and $100,400 for a family of four — you’ll be able to shop for a policy in the PRIVATE MARKETPLACE / INSURANCE EXCHANGE.
2019 OFF Exchange Carriers
Individual Health Insurance Companies
Please click link to see the Carriers Coverage in your Area
Following Carrier Link Provided
O’Brien Benefits & Financial Services Inc. has partnered with HealthSherpa to help you find quality, affordable health insurance.
FREQUENTLY ASKED QUESTIONS and MORE INFORMATION:
People who don’t have health insurance from work can buy health coverage under the Affordable Care Act, also known as Obamacare. The premiums are made affordable by a premium subsidy in the form of a tax credit calculated off your income relative to the federal poverty levels (FPL), also known as HHS poverty guidelines.
You qualify for the premium subsidy only if your modified adjusted gross income (MAGI) is at 400% FPL or below. If your MAGI goes above 400% FPL even by $1, you lose all the subsidy.
Modified Adjusted Gross Income for Obamacare is basically your gross income minus above-the-line deductions, plus tax-exempt muni bond interest, plus untaxed Social Security benefits. In order to see if you qualify for the premium subsidy, you have to know where the FPL is.
Please see Link for Levels – HHS Link for Carts
Affordable Care Act (ACA) included a provision for every state to have a public health insurance exchange. Each state has an exchange (although only 17 states are running their own exchanges – most of the exchanges will be run by Health & Human Services (HHS) or a partnership between the state and HHS).
These exchanges will be a marketplace for both individual and small-group health insurance. Although they are called public exchanges, their health plans are offered by private health insurance carriers, including many of the big-name carriers that you’ve known about for years.
For individual health insurance coverage, people will be able to shop within their state’s exchange and choose from a variety of qualified health plans. The exchanges will be the place where applicants can compare plans, enroll in coverage, and receive premium and cost-sharing subsidies if they are eligible.
When you use the Health Insurance Marketplace, you’ll fill out an application and see all the health plans available in your area. You’ll provide some information about your household size and income to find out if you can get lower costs on your monthly premiums for private insurance plans. You’ll learn if you qualify for lower out-of-pocket costs.
The Marketplace will also tell you if you qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP).
Most Americans will be eligible to use the Marketplace. Learn more about Marketplace eligibility.
The Health Insurance Marketplace is sometimes known as the health insurance “exchange.”
Individual health insurance will be available both in and out of the exchanges. You’ll be able to purchase health insurance through a trusted broker, directly through a carrier, or via your state’s exchange. The first thing to do is figure out if you qualify for a premium subsidy or cost-sharing subsidy based on your household income. If you do, you’ll definitely want to get your health insurance through the exchange, because that’s the only way the subsidies are available.
Individual ACA-compliant plans are rated with “metal” designations, which helps consumers compare apples to apples. There is plenty of variation from one carrier to another, both in terms of plan design and price, but policies are labeled based on their actuarial value, or the percentage of costs that the plan covers before the out-of-pocket maximum is reached.
Bronze plans will cover roughly 60 percent of costs, Silver plans 70 percent, Gold plans 80 percent, and Platinum plans 90 percent. For people under age 30 or those with income-based hardship qualifications, catastrophic plans are also available. All plans are subject to out-of-pocket maximums which cannot exceed $6,350 for an individual or $12,700 for a family in 2014. Cost-sharing subsidies are only be available on Silver plans. Premium subsidies for eligible applicants can be applied to any of the “metal” plans.
The exchanges will be open for business on November 1, 2014, with coverage available as of January 1, 2015 (exchange opening may be delayed in some states, but it likely won’t matter in the long run, and policy effective dates of January 1, 2015 should be available in all states). If you’re currently enrolled in a high risk pool, you’ll be transitioning to a new ACA-compliant plan as of 2015.
Exchange navigators and licensed brokers will be available to help applicants determine their best course of action during the transition to ACA-compliant plans. Although it might take a while to iron out all the wrinkles, the ACA changes to the individual market will result in far fewer people being uninsured, better access to healthcare, and more affordable coverage for people who are most in need of financial assistance.
You can apply for Marketplace coverage two ways: online or by mail, with the help of a Navigator or other qualified helper. Downloadable and paper applications will are available below.
Link – Single Application
Link – Family +2 Application
Insurance plans in the Marketplace are offered by private companies. They cover the same core set of benefits called essential health benefits. No plan can turn you away or charge you more because you have an illness or medical condition. They must cover treatments for these conditions. Plans can’t charge women more than men for the same plan. Many preventive services are covered at no cost to you.
While all insurance plans are offered by private companies, the Marketplace is run by either your state or the federal government. If your state runs its Marketplace, you’ll use your state’s website, not this one.
The Marketplace simplifies your search for health coverage by gathering the options available in your area in one place. You can compare plans based on price, benefits, and other features important to you before you make a choice. Plans will be presented in four categories – bronze, silver, gold, and platinum – to make comparing them easier.
In the Marketplace, information about prices and benefits will be written in simple language. You get a clear picture of what premiums you’d pay and what benefits and protections you’d get before you enroll. Compare plans based on what’s important to you, and choose the combination of price and coverage that fits your needs and budget.
Learn more about the Marketplace, and visit the page where the application will start on November 1, 2014.
Most people will be eligible for health coverage through the Health Insurance Marketplace. To be eligible for health coverage through the Marketplace, you:
- must live in the United States
- must be a U.S. citizen or national (or be lawfully present)
- can’t be currently incarcerated
U.S. citizens living outside the U.S.
U.S. citizens living in a foreign country are not required to get health insurance coverage under the Affordable Care Act. If you’re uninsured and living abroad, you don’t have to pay the fee that other uninsured U.S. citizens may have to pay.
Generally, health insurance coverage in the Marketplace covers health care provided by doctors, hospitals, and medical services within the United States. If you’re living abroad, it’s important to know this before you consider buying Marketplace insurance.
Residents of a U.S. territory
U.S. territories can decide whether to create their own Health Insurance Marketplace or expand Medicaid coverage. Residents of a U.S. territory aren’t eligible to apply for health insurance using the federal or state Marketplace.
Check with your territory’s government offices to learn about these options.