Am I required to have health insurance?
Yes, if you do not you will have to pay an IRS tax penalty. The penalty for not having coverage in 2016 and 2017 is:
The greater of:
2.5% of household income to a maximum of total yearly premium for the national average price of a Bronze plan sold through the Marketplace, or, $695 per adult + $347.50 per child under 18 to a maximum of $2,085
Can I buy a plan anytime during the year?
No, you can only purchase during the Open Enrollment Period which starts on November 1st and ends on January 31st. The only exception to this is if you experience a qualifying event. The following represent the most common qualifying events:
- Involuntary loss of other Individual plan renewing outside of the regular open enrollment.
- Becoming a dependent or gaining a dependent
- Becoming a United States citizen
- A permanent move
- An error or problem with enrollment
- Employer-sponsored coverage reducing benefits such that it no longer provides minimum value, or becomes unaffordable as defined by the ACA.
Can I get a plan if I have ongoing health issues?
Yes, all individual health insurance plans are the same regardless of health or gender. The only factors that affect premium are:
- Zip Code
- Smoking status
What if I cannot afford the premium?
If you have very low income you may be able to qualify for Medicaid.
Depending on your income, you may qualify for a government subsidy to help with the cost of coverage. Subsidy income limits are based on household income. If your household income is less than the limit, you may qualify for subsidy:
1 person $47,080
2 people $63,720
3 people $80,360
4 people $97,000
5 people $113,640
6 people $130,280
Where do I purchase a health insurance plan?
If you qualify for subsidy and want to use it, you must purchase via the Health Insurance Exchange. If you do not qualify for subsidy, you can purchase directly from an insurance company.
Do I need a broker to help me?
Technically, you can purchase directly, however, you will pay the exact same premium whether you use a broker or not. We HIGHLY recommend using a broker to help you through the complexities of individual health insurance. Further, you will have someone to help you on an ongoing basis. Using a broker it TRULY a FREE proposition. Give us a call or send us an email so we can help you.