Health Information Exchange Frequently Asked Questions

When can I enroll?

Starting October 1, 2013, you can apply for health insurance coverage. And you can find out about government subsidies that can make your premiums more affordable than ever.

Important Dates to remember:

Oct. 1, 2013 – Open enrollment begins
Jan. 1, 2014 – Coverage begins
Mar. 31, 2014 – Open enrollment closes

Who is Eligible?

Many 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
  • Are not eligible for affordable health coverage through your employer

How can I be sure I am eligible?

You can view and compare health insurance options online at www.healthcare.gov. With one simple application, you can have those options tailored to your personal situation and find out if you might be eligible, based on your income, for financial assistance to lower your costs.

The same application will let you find out if you and your family members might qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program (CHIP).

How do I enroll?

Enrollment information is all available online (www.healthcare.gov). You can apply four ways:

Please remember enrollment begins Oct. 1, 2013.

What if I can’t afford health insurance?

Based on your income and family size, you may qualify for financial assistance. Individuals making up to $45,960 or a family of four making up to $94,200 may qualify for help paying their monthly premiums when they purchase health insurance through the Marketplace. Additionally, individuals making up to $28,725 or a family of four making up to $58,875 may qualify for additional assistance to help lower the amount they pay for out-of-pocket costs like deductibles, coinsurance and copayments.

How much will insurance cost me?

Monthly premium costs for the Health Insurance Marketplace are still being determined. Premium costs will be available through the online enrollment process.

What can I do to prepare?

  1. Make a list of questions. (How do I stay with my current doctor? What will my co-payments be? What services will be covered?)
  2. Gather info about your household income.
  3. Set your budget.

I have insurance through my employer. Does this affect me?

If you are eligible for employer-sponsored health coverage, you are generally not eligible for the insurance product.

Whether or not you qualify for the Marketplace depends on what kind of coverage your employer offers. If your job-based coverage is considered “affordable” and meets minimum value, you won't be able to get lower costs on premiums or out-of-pocket costs in the Marketplace. This is true regardless of your income and family size. Employer coverage is considered affordable if the employee’s share of the annual premium for self-only coverage is no greater than 9.5% of annual household income.

I have Medicare. How will the Health Insurance Marketplace impact me?

Persons on Medicare stay in their current coverage and do not have a need for the Health Insurance Exchange products

What if I am self-employed? Do I qualify for health insurance through the Marketplace?

You could be eligible based on your annual income.

Where can I go for additional information?

For more information, visit HealthCare.gov. Or, call the Health Insurance Marketplace Call Center at 1-800-318-2596, 24 hours a day, 7 days a week. TTY users should call 1-855-889-4325.

© Copyright AtlantiCare 2016. All Rights Reserved.