Obamacare
Obamacare is a colloquial term used to describe the Affordable Care Act (ACA). This law was introduced to make it easier for people to buy the health insurance they need.
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The Affordable Care Act requires health insurance companies to offer certain levels of coverage with each plan. When it was first implemented, it required Americans to have health insurance just like they have auto insurance. However, as of 2019, health insurance is no longer required at the federal level. Some states may still require it, so it's important to check what the current mandate is based on where you live.
The Affordable Care Act also created marketplaces where people can review and compare health plans to find the right one for them.
Different types of Obamacare insurance?
Yes, there are different types of health insurance under the Affordable Care Act. Obamacare coverage may vary depending on the coverage you purchase. Typically, the floor plan is divided into four separate floors.
- Bronze strata generally have lower deductibles, but they also have lower coverage levels than other strata.
- Silver tiers are generally considered moderate costs, including lower deductibles.
- Gold-level plans typically have higher monthly premiums, but lower deductibles and out-of-pocket costs.
- Platinum plans typically have the highest monthly premiums but have very low deductibles and maintenance costs.
When looking at your Obamacare coverage options, be sure to compare each plan's premiums, deductibles, and coverage levels. This way you can decide for yourself which health insurance is best for you.
What does Obamacare cover?
The specific coverage you get under your Obamacare plan depends on the plan you choose. However, the required ACA plan coverage includes:
- Prevention
- Urgent Care
- Outpatient treatment when you are not hospitalized
- Hospitalization
- Pregnancy and newborn care
- Services for Mental Health and Addiction Disorders
- Rehabilitation services
- Pediatric care
- Laboratory services
Under the Affordable Care Act, insurance companies cannot deny you coverage or charge you extra for your plan if you have a pre-existing medical condition. A pre-existing medical condition is one that was diagnosed before your new coverage started.
Obamacare Open Enrollment Period
The Open Enrollment Period (OEP) is when you buy a new health plan for the next year. The 2023 federal OEPs run from November 1, 2022, to December 15, 2022, for coverage beginning January 1, 2023, and remain open until January 15, 2023. Some states have a public health exchange and therefore the enrollment period is open. which may differ slightly from the federal open enrollment period. If you don't enroll in a plan during OEP, you may not be able to purchase ACA-compliant coverage unless you experience a qualifying event such as:
- Job loss
- Enter a new coverage area
- Childbirth
- Loss of existing coverage
- Family events such as marriage, divorce, or death
If you determine that you do not have insurance and do not qualify for a qualifying event, you may be able to enroll in a short-term plan depending on the state in which you live. Contact eHealth to learn more about short-term plan options that will get you the coverage you need until your next OEP.
Explore all ACA-compliant health insurance options with eHealth! Our team of licensed insurance agents can help you review all possible plans and find a plan that offers the coverage you need at an affordable price.
Do you have to pay a penalty if you don't have Obamacare insurance?
It depends. As mentioned, health insurance is no longer federally required, but some states still do.
In these cases, if you do not have health insurance for a long time, you will have to pay a penalty. Children may also be required to have health insurance.
The amount of the penalty can vary depending on how long you were without health insurance and how many other people in your family do not have health insurance. To avoid this penalty, you must ensure that you have health insurance if necessary.
If you live in a state that requires health insurance for everyone, you can use our free eHealth tool to find a plan that fits your needs and budget.
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Advantages and disadvantages of Obamacare
The Obamacare program has many important benefits. Some of the main benefits include:
- The Affordable Care Act made health insurance more affordable for many people. It requires health insurance companies to spend at least 80% of their premiums on people's health care, which has led to many premiums being cut.
- People with existing medical conditions can also find health insurance. Insurance companies can no longer deny coverage just because they have pre-existing medical conditions.
- More verification processes are covered. Preventive care is now much more covered than before.
- Prescription drugs also cost less. It is no longer so expensive to get prescription drug coverage.
- On the other hand, there are some disadvantages that people are also aware of.
- Health insurance premiums for some people have increased as a result of Obamacare. People who paid very low premiums in the past may now pay higher premiums because health insurance companies have to cover more people.
- You can pay a big fine if you don't have health insurance. In some states, people are now required by law to have health insurance or pay a tax penalty.
- When you buy insurance from the marketplace, you have to sign up at certain times of the year. You should pay attention to special Obamacare enrollment periods.