Susanna, you can buy a plan on the Marketplace, but evaluate this decision very carefully. Employer health insurance is tax advantaged, meaning you receive the benefit without having to pay taxes on its value. If you buy your own coverage, you'll lose that as well as whatever portion of your coverage your employer helps pay for (most employers cover 70%-80% of employees health benefit costs). That's all to say, yes, you can leave your employer's plan and buy your own coverage, but in most cases, it's not in your best financial interest to do so. Just tread carefully.
And you won't be able to make any changes outside of open enrollment unless there's some big event like a job loss.
Psychteacher, no one is required to buy insurance on the exchanges, but if you do not have some type of coverage, you may have to pay a penalty. If you have an insurance plan that offers the “essential health benefits”, you will not face a penalty for being uninsured. If your income is sufficiently low (about $9,000 for an individual) will not have to pay a penalty. If you are currently uninsured, I recommend looking at the options on the exchanges.
Mike from PA asks: "How should I choose between 3 insurers if the rates for both are basically the same on the exchange site?"
There are four metallic benefit tiers (from least to most generous): bronze, silver, gold, and platinum. Check to see that the plans you are considering are all in the same tier (they probably are). The main factor that differentiates plans within a benefit tier is the provider network. If you have a preferred physician or hospital, check to see if they are in each insurer’s provider network. You may need to call the plans to find this information.
Your wife will qualify for assistance at an income level of $25,000. The premium's cost will be limited to 4% of your income. In addition, she'll get some help with her out-of-pocket medical costs, meaning her deductibles and co-pays will be lowered when she visits the doctor or fills a prescription.
Luna, no, you will not be penalized as long as your kids' coverage meets ACA requirements. If you do not want to pay the penalty, you should buy coverage for yourself.
La'Fay, if you live in a state expanding its Medicaid program it sounds like you might qualify. Otherwise you'll certainly qualify for financial assistance to buy a plan through the Marketplace. The good news is you can no longer be turned down because of your health problems.
I suggest you contact your state's Marketplace (go to Healthcare.gov to find the contact information) and see what's available to you. You can also go to LocalHelp.HealthCare.gov to find personalized assistance in your state either by phone or in person.
Here's a question from Darlene in NM: "My whole family is Native American. We always got health care from Indian health service which is under the government. Do we have to sign up for this health care?"
No, if you're covered through Indian Health Services you're covered. No need to sign up for any other health plans.
Kirk, if you live in a state that opted to expand Medicaid, then you can enroll in Medicaid at no cost. If you live in a state that did not expand Medicaid, then you can buy insurance on your own on the Exchanges, but you will not receive subsidies for the premium. You will have to pay the full cost. (Only people with incomes above 100% of the poverty level receive subsidies). If you are uninsured, you will not have to pay a penalty because of your income (or lack of), assuming that you will have no income next year.
Steve, as long as your wife’s plan covers “Essential Health Benefits” (which it almost certainly does), then you are fine. If she were to quit, you would be uninsured. You would have to pay a penalty or buy insurance on your own. You may qualify for subsidies to buy insurance on the Exchanges.
Karen, if either you or your spouse is uninsured and your income is sufficiently high (which it probably is), then you or your spouse will face a penalty. However, if you are covered under your spouse’s plan or vice versa, then you are fine…no penalty.
Roger, you need to check directly with your insurer as to whether your existing plan will be available after January 1. Not all plans are going away. As I said earlier in this chat, for people who don't qualify for a subsidy, it's possible rates will increase. I would suggest you shop all your options both inside and outside the Marketplace. And, work with a licensed agent if you can to get help selecting the best possible plan for you.
Betty, subsidies are calculated based on “modified adjusted gross income”. It does not matter if income is in the form of wages or other payments like annuities. If your income is sufficiently low (400% of the poverty level, about $45,000 for an individual), you will qualify for subsidies.