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How to Get Obamacare

Take These Four Simple Steps


How to Get Obamacare

Getting Obamacare is easier than you think.

Photo: Joe Raedle/ Getty Images

The opportunity to get Obamacare, the informal name for the Patient Protection and Affordable Care Act, is here. What can you do to get Obamacare when enrollment reopens this fall?

STEP 1 - Find Out If You Want To Get Obamacare (When: Now)

Anyone can get Obamacare, and you might be better off, depending on your circumstances.

If you don't have insurance, Obamacare affects you the most. You either need to sign up for health insurance between by March 31, 2014 or pay a tax. Which is the better choice? It depends on your income and the number of people in your household.

For most of you, the tax is 1% of your adjusted gross income (AGI). The AGI is your gross income minus your deductions. For example, if your AGI is $30,000, your Obamacare tax is $300. To find out the exceptions, see Obamacare Taxes.

Would this be cheaper than Obamacare? It depends on the number of people in your household. For example, if you live alone, then a $300 annual tax might be cheaper than the $200 monthly premium. However, if your income is below $45,000, the government will subsidize some or all of your premium. In that case, Obamacare could be cheaper. (Find out how much at Will I Qualify to Save on Monthly Premiums?)

If your income is less than $30,000, and there's four people in your family, you qualify for free insurance through Medicaid. Find out if you qualify for Medicaid.

In some states, you can't get Medicaid but at least you won't have to pay the tax. That's because some governors refused expanded Medicaid coverage as a protest to the Federal government. Find out if your state has expanded Medicaid coverage.

If you decide to pay the tax instead of getting Obamacare, here's where to find low-cost community health centers in your area. Be aware that the tax rises to 2% of AGI in 2015, and 2.5% in 2016. Furthermore, you're taking a financial risk by not getting insurance. If you go to the emergency room, you pay about $1,265 on average. If you get cancer, you'll face a $30,000 bill. If you an easily afford this, then it's worth the risk. If not, you might face bankruptcy. In fact, the number one cause of bankruptcy in this country is healthcare related costs. See Why Should I Have Health Coverage?

If you are under 30, you have two additional options. First, you can go on your parents' plans until you are 26. Second, you can buy less-expensive "catastrophic" insurance. This covers emergency room visits and hospital stays, but only three regular doctor visits. Find out more in Can I Buy a Catastrophic Plan?.

If you have insurance, you can keep your plan, whether it's a company plan or one you bought yourself. That's true even if it's catastrophic insurance, a retiree plan, COBRA or any other qualifying health plan. Keep in mind that a Discount Plan, Vision Care or Dental Discount Plan, or Worker's Comp does not qualify as insurance.

Even if you have insurance, go ahead and compare it to Obamacare plans in case you can get better coverage at a lower cost. There's three ways this could happen:

  1. Your plan was "grandfathered in." That means it was in existence before March 23, 2010, and therefore doesn't have to offer the Obamacare benefits. These include the 10 essential benefits, protection from being dropped if you get sick, and the ability to put your adult children on your plan. Find out what benefits you should have in How Does the ACA Protect Me?
  2. You qualify for a subsidy or free health care. If you make less than $45,960 for an individual/$94,200 for a family of four, the government will pay for part or all of your insurance. Find out more.
  3. Your company drops your insurance plan. This could happen to 3-5 million employees. (Source: CBO, The Effects of the Affordable Care Act on Employment-Based Health Insurance, March 15, 2012)

You Have Medicare or Medicaid - You already have Obamacare.

You're a Small Business Owner - You must provide health insurance in 2015 or pay a fine. For more, see How Does Obamacare Work?

You can also use the exchanges to compare local physicians, hospitals, nursing homes, home health agencies and dialysis services. Compare providers now.

STEP 2 - Compare Plans (When: October 1, 2013 - March 31, 2014)

If you've decided to take advantage of Obamacare, then go to the Health Insurance Marketplace. You'll be prompted to enter your state, since some of them have their own marketplaces. You'll then create an account using your name and email address. You'll then create a user name, password and answer three security questions. You will receive an email to authenticate your account. In addition to shopping for plans, you can find out how much in subsidies you qualify for. To do that, you'll need your Social Security number, and your most recent W2, 1099 or other income information. (Note: The Federal site had many problems and delays when it started. I was on it last week and experienced no delays.)

Compare the premiums, deductibles and copays of the plans. All plans will offer services in each of the 10 essential benefit categories, as well as the other Obamacare benefits. Plans are grouped into four different categories, arranged by the amount of coverage. Those with the least coverage have the lowest premiums. Here's how much you'll pay in total health care costs for the plans in each category:

  1. Bronze - 60%
  2. Silver - 30%
  3. Gold - 20%
  4. Platinum - 10%.

STEP 3 - Purchase the Plan You Want (When: October 1, 2013 - March 31, 2014)

On October 1, you can purchase the plan you want. Submit your first premium payment by December 15, 2013 for coverage to begin by January 1, 2014. Find out How Much Will Obamacare Cost Me?

STEP 4 - Coverage Begins (When: January 1, 2014 - March 31, 2014)

You must submit payment 15 days before coverage will begin. However, as long as you're signed up for insurance by the March 31, 2014 deadline, you won't have to pay the tax. Article updated November 7, 2013

Obamacare In Depth

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