FAQ

How does the Affordable Care Act work in terms of making healthcare more affordable?

The ACA was set up to make healthcare more accessible and affordable to more Americans. One way this is done is to employ the use of health insurance subsidies to offer assistance in helping someone get a plan that might not have been able to afford one before. Essentially on a sliding scale is used so that households with the lowest income will be offered the most subsidized assistance. These subsidies are administered in the form of a tax credit during your annual income tax filing process. These tax credits can only be used on the health insurance exchange, and can be used when insurance coverage is purchased, no matter if you owes taxes or not.

What is the Marketplace?

The Health Insurance Marketplace, also referred to as Exchanges, are set up to offer a competitive platform to purchase health insurance, compare options, and provide information regarding plans for the consumer. The Marketplace allows you to shop for coverage and compare and contrast plans to find one that will best meet the needs of you and your family. Through the use of premium and cost-sharing subsidies, the Marketplace allows millions of Americans to obtain health insurance at an affordable price, based on income level. Low income individuals and families can also use the Marketplace to find if they are eligible low-cost/free coverage through Medicaid and CHIP programs.

Who is eligible to purchase insurance through the Marketplace?

To be eligible you must purchase through the state’s marketplace in which you live. You must also be a U.S citizen, and cannot be currently incarcerated serving time in jail or prison.

How easy is it to purchase a plan through the Marketplace?

Since the advent and implementation of the ACA legislation, much energy and focus has been put into making applying, enrolling, and purchasing health insurance coverage a dimple and convenient process. Healthcare.gov was the internet portal created to answer questions, provide assistance, and allow you access to purchase a health plan. There are four ways in which you can apply for coverage through the Marketplace and any of these methods can be used, whichever is most comfortable and convenient for you.

1. Online – When you apply for a marketplace plan online, you will be asked to set up an account and specify your state of residence before being directed to the online application where you will be asked to provide information as you’re guided through the entire application process. Once the application is completed, you can view all your plan options based on the information you provided and your eligibility results. If you are eligible for Medicaid, CHIP, savings, and premium tax credits, you will be able to view this information here too. As soon as review and decide on the plan that best suits the need for you and your family, you may now enroll in that plan and you will be provided the contact information of the insurance company to complete the process.

2. Over the Phone – The Marketplace call center is open 24 hours a day, 7 days a week, and is there for anyone that needs assistance for questions, concerns, and complete the application and enrollment process for you over the phone. You can reach a Marketplace call center representative at any time by calling

   (786)683-5373

   .

3. Mail – If you wish, you can send in a hard-copy application through the mail. Once your eligibility results are mailed back, and decide on the plan that best meets your needs, you can complete the process and enroll over the phone or online at your convenience.

4. In Person – Some people may prefer face-to-face assistance. This is not a problem. The Marketplace have assistors to walk you through the application and enrollment procedures and answer any questions you may have along the way. You can find an assistors near you by visiting HealthCare.gov.

Why is it important to have health insurance coverage for me and my family?

We all know that sickness and injury can occur at any moment unexpectedly. Without health insurance coverage, proper medical attention can be very costly. Affordable coverage is very important, as this is your protection from high medical bills through the cost-sharing between you and your insurance company. Oftentimes, you receive savings before you ever meet your deductible, simply by choosing to use in-network healthcare providers that offer a discounts to you insurance company for their services. Savings can also be found in preventative care such as vaccinations, screenings, doctor visits, etc.

Three ways in which we can find protection from high medical costs by purchasing Marketplace health insurance can be found below:

1. An out-of-pocket maximum limits how much you will pay in medical expenses regardless of how much covered care you were given in your coverage year
2. Marketplace plans eliminate yearly and lifetime limits. This means there are no financial limits your insurer will spend on your covered care for your essential health benefits within a given year or your lifetime.
3. When you’ve met your deductible, Marketplace plans will begin to share in expenses after that point. They may cover anywhere between 60% to 90% of post-deductible medical care.