Affordable Care Act aka Obamacare, signed into federal law during the Obama Administration March 23, 2010. Affordable Care Act (ACA) required all citizens to have insurance, and the penalty for non-compliance increases yearly. However, the law has also made it easier and more affordable to purchase individual insurance and family plans than ever before. It used to be more difficult because a medical insurance underwriter could decide not to insure you due to a pre-existing condition, but with ACA this is not a problem.
The act largely retained the existing structure of Medicare, Medicaid and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of "essential health benefits". Trump Administration removed the fine/tax but some states opt to keep the fine.
Individual and family health insurance plans are perfect for consumers who don’t qualify for insurance through their employer. Due to the continually rising cost of medical care, it has become more important to provide health insurance for you and your family. Also benefits the unemployed, student, part-time worker or self-employed. Click on the links below to learn more about ACA.
Open enrollment begins November 1st through December 31st.
(Please check with your state to see if there's an extension through January 31)
1. ambulatory services
2. emergency services
3. hospitalization
4. maternity and newborn care
5. mental health, behavioral health treatment and substance abuse
6. prescription drugs
7. rehabilitative services and devices
8. lab services
9. preventive and wellness services
10. pediatric services
1. Loss of Health Coverage
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losing existing health coverage, including job-based, individual and student plans
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turning 26 and losing coverage through a parent's plan. Exception if child is disabled.
2. Changes in Household
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getting married or divorced
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having a baby or adoption
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death in a family
3. Change in Residence
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moving to a different zip code or county
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seasonal worker moving to or from the place they both live and work
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moving to or from a shelter or other transitional housing
4. Other Qualifying Events
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changes in your income that affect the coverage you qualify for
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becoming a U.S. citizen
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leaving incarceration
ON EXCHANGE vs OFF EXCHANGE
ON EXCHANGE
Health insurance plans that are offered through the Marketplace – a massive online store for health insurance plans that is run by the federal government or state. These plans are required to provide essential health benefits and follow more guidelines as set by the Affordable Care Act (ACA)
OFF EXCHANGE
Plan describes a health insurance policy that you buy directly from an insurance carrier or through a licensed broker outside of an official state or federal ACA Marketplace. Some off exchange plans offer the same sorts of coverage that are available with ACA plans
INDIVIDUAL AND FAMILY INSURANCE
Bronze Coverage - 60% coverage
Didn’t go to the doctor much last year? Looking for a plan that offers free services and protection in case something goes wrong? A Bronze plan could work for you, but expect big deductibles.
Silver Coverage - 70 to 94% coverage
Silver Comes in Four Varieties: 70, 73, 87 and 94
Which one you qualify for depends on your household income.
Use the Shop and Compare Tool to see if you can get extra savings
with Silver 73, 87 and 94.
Gold Coverage - 80% coverage
No surprises or deductibles. Count on set prices from day one.
Platinum Coverage - 90% coverage
No deductibles and the lowest prices on services — two great reasons to go Platinum.
PENALTIES
The penalty for not having coverage the entire year will be at least $750 per adult and $375 per dependent child under 18 in the household when you file your 2020 state income tax return in 2021. A family of four that goes uninsured for the whole year would face a penalty of at least $2,250.
EXEMPTIONS
Below are a few exemptions.
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A short coverage gap of three consecutive months or less.
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Citizens living abroad or residents of another state.
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Members of a health care sharing ministry.
Care2Partner offers health insurance programs to individuals which offer extensive coverage as well as high-deductible programs which are designed to protect against catastrophic financial losses. As an independent agency, C2P can provide insurance plans from numerous health insurance companies. We have several partners and with the health insurance market changing frequently, we're always on the lookout for quality, service-oriented insurance companies for our clients and the many changes in their lives.
families independent contractors
becoming US citizen moving
turning 26 getting married
Many Care2Partner partners...
