How to Get Obamacare in 2016

Throughout my blog I have explained many different aspects of health insurance reform under the Affordable Care Act (ACA), or Obamacare. Understanding how Obamacare affects your health insurance is very important but all the knowledge in the industry does nothing if you do not know how to sign up for Obamacare. Many of my clients start our conversations with varying understandings of health care reform and one of the most common misunderstandings that I encounter is assuming that the only way to get actual Obamacare is to go through healthcare.gov. If Obamacare to you is insurance SUBSIDIZED (paid for – in part or in whole) by the government then yes, you must sign up through the government’s website at healthcare.gov. However, many people also refer to Obamacare as any plan regulated under the ACA and if you are not receiving a subsidy for your health insurance (paying full price) then you may go directly to the insurance carriers’ websites to sign up for Obamacare.

IF YOU BELIEVE YOU WILL RECEIVE A TAX SUBSIDY:

1. ESTIMATE YOUR TAX SUBSIDY
   Signing up for Obamacare through healthcare.gov is rather time consuming but usually worth the effort if you are receiving a subsidy. Before going through the process required to sign up on the government’s website, I advise you to first use the Estimator Tool that will allow you to predict your tax subsidy and review the various plans in your area. These plans will have the adjusted rates that you would pay if approved for the predicted subsidy as well as full details of their coverage benefits.
2. CREATE AN ACCOUNT
   Once you find a plan and a price that will work for you the next step is to create an account on healthcare.gov, if you have not already done so. This is easily done by clicking the “Log In” button at the top right corner of the page, then clicking the “Don’t have an account?” button, choosing your state, clicking “Apply Now”, filling in the various fields of the sign-up form and finally verifying your email address. Once your email address is verified you will be prompted to log in to the website.
3. VERIFY YOUR IDENTITY AND SUBMIT THE SUBSIDY APPLICATION
   When you have logged in to the site you will see a large green button “Visit the marketplace for individuals and families” and this will take you to the next step. On this page you will be asked to select the year for which you need insurance and to select your state. Then click the green “Apply or Renew” button. From here the page will direct you through the various steps of determining your tax subsidy. You will first verify your identity and then fill out the actual subsidy application.
4. SELECT YOUR INSURANCE PLANAfter you are done with the subsidy application you will finally be brought to the health insurance plans. This selection should mirror what you saw on the Estimator Tool in step one and the prices on this page are the exact amount you will be charged by whichever carrier you choose. To finalize your plan click “Enroll” and fulfill the final input fields – agreeing to some terms and conditions and doing an electronic signature. The insurance carrier will send you a bill within about 2-3 weeks.

IF YOU DO NOT BELIEVE YOU WILL RECEIVE A SUBSIDY, OR DO NOT WANT TO RECEIVE A SUBSIDY

1. RECOMMENDED: USE THE ESTIMATOR TOOL
   If you do not want to use a tax subsidy from the government to lower your rates then you can skip to the next step. However, even if you believe you will not receive a subsidy I advise you to still use the Estimator Tool and double check. Many clients I talk to believe they will have to pay full price and once I enter in their information they find out that they do indeed qualify for reduced rates.
2. SHOP THE VARIOUS CARRIERS IN YOUR AREA
   If you are predicted to receive a very small subsidy, or no subsidy, then I recommend avoiding healthcare.gov by going directly to the various insurance carries websites to sign up for your health insurance plan. Not only will this save you time but, more importantly, you will not have to worry about going through the government every time you need to make alterations to your insurance policy.
3. SELECT A “METALLIC” PLAN
   The main concern when shopping for health insurance off of the marketplace (not on healthcare.gov) is making sure you choose QUALIFIED COVERAGE. Qualified coverage refers to health insurance plans that are regulated under the ACA and therefore will not cause you to receive a penalty from the government for not having insurance. Qualified plans will always have a “metallic” modifier; one of the following words will be included in the plan’s name: Bronze, Silver, Gold or Platinum — if you are under 31 any plan labeled Catastrophic will be considered qualified coverage as well. Many insurance carriers offer plans NOT regulated under the ACA in conjunction with their Obamacare plans. These are usually short term coverage and, while still great coverage for healthy people, could cause you to still receive a penalty at the end of the year as if you did not have any coverage at all.

Whichever route you choose – going on exchange to healthcare.gov and receiving a tax subsidy or going directly to the insurance carriers’ websites – the process of signing up for coverage can be time consuming and confusing. If you would like assistance or if you have any questions about the process please feel free to submit them below and I will respond as soon as possible.