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How Does Obamacare Work?

How Does Obamacare Work?

What is Obamacare?

The Patient Protection and Affordable Care Act is most commonly referred to as the ACA or Obamacare, which is a federally facilitated program facilitated by the Marketplace. It was designed to provide health insurance benefits to everyone in the United States and has drastically changed the accessibility of healthcare for millions of Americans over the last eight years. Furthermore, it has created new norms and regulations for individuals, employers and insurance providers.

How does Obamacare work?

The main objective of the ACA is to provide qualifying Americans with a subsidy to obtain affordable health insurance. These subsidies are based off of household size, income, and age. Many lower to middle income Americans benefit from these subsidies as they help to cover cost associated with health insurance. Another perk of the ACA is that health insurance plans offered through the marketplace are significantly less expensive and are available at an affordable rate. What’s more is that Americans can’t be denied by insurance companies participating in the ACA. Furthermore, once Obamacare was implemented it set forth an “individual mandate” requiring that all Americans obtain health insurance. However, those who neglected to obtain health insurance would be faced with a penalty.

When Is Open Enrollment for Obamacare?

Each year Americans are able to apply for a subsidy, modify a current marketplace plan, or renew an existing plan during the open enrollment period or “OEP”. This time period exists between November 1st and December 15th. Any enrollment outside of the “OEP” must qualify for a special enrollment or “SEP”. To qualify for a “SEP” the individual must have reported a life change such as marriage, pregnancy, relocation, or loss of insurance coverage.

Who Qualifies for a Subsidy?

Obamacare provides tax credits and subsidies for lower to middle-income U.S. citizens. The Federal government provides subsidies to individuals with an income of 400% percent of the federal poverty level. Additionally grants also became available to people with 250% of the stated income of the federal poverty level. These grants made the out of pocket expenses associated with medical cost more affordable to a vast majority of Americans. The program has also broadened the scope of Medicaid plans to include individuals earning an income up to 138% of the Federal Poverty level. From this modification many Americans that were previously denied medicaid were now eligible to receive government assistance.

Penalty charges under the Affordable Care Act.

Under the Affordable Care Act, if a qualifying person neglects to obtain health insurance they would be penalized through a tax penalty. The tax penalty was assessed in the upcoming tax year and would either be based upon household size or a predetermined amount set forth by the government. However, in some circumstances those facing financial hardships could request and apply for an exemption when filing their taxes which would prevent them from being penalized. From this mandate many of those in opposition of Obamacare considered this to be an overextension of power. Nonetheless, the reform program has undoubtedly helped to insure millions of underinsured or uninsured Americans.

Do those with pre-existing conditions qualify for Obamacare?

Under the protection of Obamacare no insurance company or individual insurance provider can deny an individual medical insurance. Furthermore, those individuals suffering from chronic illnesses or ailments such as diabetes, blood pressure, and heart disease are able to receive health insurance without facing increased premiums.

How does it work in case of preventive care?

Providing preventive care and disease management to a patient is an essential purpose of Obamacare. Obamacare required that plans cover 10 minimum essential health benefits. These include doctors’ services, inpatient and outpatient hospital care, pregnancy and childbirth, mental health services, and dental coverage for children. Furthermore, insurance providers would be prohibited from charges additional fees for these preventative services.

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Subsidy Eligibility

Reason for New Coverage

I am authorizing a licensed Health Insurance Agent to review, to submit into a free plan or to refer my Health Insurance enrollment to a qualified entity whenever deemed necessary. I as a customer allow access to my or Medicaid accounts to make any updates/uploads as necessary and also to review and advise year to year, using any and all reasonable efforts to ensure that I the customer have a sound decision in my Healthcare plan for the year. I as the customer agree that I qualified for one of the many SEP’s during the year of 2022. (Ex: qualified for unemployment, Covid 19, Etc) I as a customer acknowledge receipt of HIPPA Privacy Information at the time of enrollment. By filling out and providing my personal information and signing, I certify that all of the above information is correct to the best of my knowledge and I give authorization to be enrolled into a free health insurance plan.

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