Since you already have both Medicare and Medicaid, you do not need to do anything. You will not be subject to any tax penalty because you have qualifying health coverage.
Here's a question from Rob in GA: "I heard that current law prevents the IRS from having the authority to collect unpaid penalties for not signing up except by deducting them from tax refunds. If you structure your withholding to never get a refund can you permanently avoid Obamacare until it fails?"
You are correct in saying that the law bars the IRS from applying its usual means of collecting outstanding taxes, such as liens, foreclosures and criminal prosecution. The primary means at the agency’s disposal to collect the ACA penalty is to garnish tax refunds from those who have overpaid.
You can go to www.healthcare.gov. In more than half the states the federal Department of Health and Human Services is running the marketplace, but even in the states that they are not, the HHS website will lead you to the correct state website.
Judith, supplemental insurance products sold by AFLAC, such as accident or critical illness insurance, will not count as qualified health insurance under the Affordable Care Act. As their name suggests, these products are designed to supplement, not take the place of major medical insurance. I believe an HNO is a product that is a hybrid between an HMO and PPO -- sometimes called a POS (point of service plan), but you would need to confirm the details of that plan with the insurer offering that product.
Our reader, Mo, asks: "If you get a job in 2014 that provides health insurance benefits of their own, then are laid off during 2014, can you apply for ACA insurance at that time, or do you have to wait for an end-of-year open enrollment period?"
Mo, if you lose a job and your employer sponsored during the year, you can shop for coverage on your state marketplace even if you are outside the open enrollment period. Losing employer sponsored insurance is considered a “qualifying event” which gives you an opportunity to shop for a health plan and apply for a premium subsidy at that time.
It sounds like you are a family of two, unless I am misreading your question. For a family of two, the income limit to qualify for a premium subsidy is $62,000 so you are over that limit.
2222, I hope you'll take my previous suggestion to work with someone in your state to get personalized help -- it can be invaluable in helping you make the best possible choice for yourself. Regarding exchange or off exchange plans, all are required to cover the 10 essential health benefits outlined under the law. If you don't qualify for a subsidy, it's probably a good idea to also shop plans that are off-exchange because you'll have more options from which to choose and you'll likely find that the provider networks are much broader than plans sold through the exchange.
It is true that not all providers will be participating in all the plans offered through the marketplace. One of the ways insurance companies operate is by only contracting with providers who are willing to accept their terms. You may want to change providers to one who is in one of the plans offered in the marketplace. If you do not want to change plans, you should compare what kind of out-of-network coverage each of the plans offers.
Terri, assuming your employer doesn't offer retiree health benefits, you'll want to head to your state's health insurance exchange once you retire to search for your health insurance options. You can do that at Healthcare.gov.
December 23rd is the last date to sign up for coverage through a marketplace and have it begin on January 1. January 1 is not only the start date of coverage purchased before the 23rd, but also when a number of protections in the ACA begin – such a ban on pre-existing condition exclusions. March 31st, is the end of the open enrollment period for 2014. If you do not sign up for coverage prior to March 31st, you will not be eligible to purchase a policy through a marketplace until the next open enrollment period unless you have a “qualifying event” such as a job lose.
First, you should know that your last opportunity to enroll in a plan for 2014 is March 31st. If between now and then you sign up for coverage between the 1st and 15th of the month, your insurance will kick in on the first day of the following month. For example, say you enroll on January 10th, your insurance will go into effect February 1st. If you enroll between the 16th and end of the month, your insurance will take effect the first day of the second following month. So, if you sign up on January 25th, your insurance won't take effect until March 1st.
You cannot be denied care simply because you have a policy offered under the ACA. Not all physicians and hospitals participate in every plan offered through a state marketplace, however. If you go to a physician or hospital that is not in your plan’s network, you will have to pay out-of-network rates. Depending on what type of out-of-network benefits your plan offers, you may have to pay the full cost.
Lianne, you can keep your COBRA coverage until it expires. Losing insurance is considered a qualifying event so you'll be able to sign up for a plan in that case even if it's outside of the open enrollment period. Because of the Affordable Care Act no longer is anyone considered uninsureable. Everyone is guaranteed coverage regardless of their health condition. You also can't be charged more for coverage if you have a pre-existing condition.
Regarding your fluctuating pay, report your very best estimate when you apply. If there are any significant changes in your income during the year you can report that to your state's Marketplace. That will enable you to either take advantage of higher subsidies to lower your costs or avoid a tax bill should your income turn out to be much higher than what you anticipated.
Since you have employer coverage, it is up to your employer what plans are being offered. It is true, however, that in most states there are one or two dominant insurers in both the individual and small employer market. One of the goals of the ACA is to try to increase the number of options available for people who shop through the marketplace. Unfortunately, that goal was not reached in all areas, at least for 2014.
Steve, you must use the exchange in the state in which you live. And, you must be a resident in the state in which you purchase an insurance policy.