Frequently-asked questions by tag
If I don’t enroll in a plan by the open enrollment deadline, what are my options?
January 12, 2023 – Your options for coverage are very limited if you don't enroll in a plan by the end of open enrollment in your state. The open enrollment…
What type of health insurance exchange does my state have?
December 13, 2022 – As of the 2023 plan year, there are 18 fully state-run health insurance marketplaces (SBMs), three state-based marketplaces that use the…
Are visits to the chiropractor or physical therapist covered under the Affordable Care Act?
December 1, 2022 – Q. Are visits to the chiropractor or physical therapist covered under the Affordable Care Act? A. All ACA-compliant individual and small…
Should I buy the health plan my college offers? or buy through an ACA exchange?
December 1, 2022 – Most student health plans offered by colleges and universities are fully compliant with the ACA, with just a few exceptions that don't…
How does my access to employer-sponsored coverage impact my eligibility for subsidized coverage through the exchanges?
November 21, 2022 – A. Fortunately, the IRS has issued new rules, effective in 2023, to allow some families to take advantage of premium subsidies in the…
What happens if I don’t make my premium payment by the end of the grace period?
November 8, 2022 – If you fail to pay your premiums and exhaust the grace period for plans offered in a health insurance marketplace, you will lose your…
Is pediatric dental coverage included in exchange plans?
October 5, 2022 – There is no penalty for not having pediatric dental on your policy – and in most exchanges, you can purchase a plan without pediatric…
If my income is less than expected this year, I might be eligible for Medicaid. What can I do to cover my bases?
September 1, 2022 – Q: I'm self-employed, so my income varies from one year to the next. I enrolled through the exchange and projected an income that makes me…
If all Silver plans cover the same benefits and percentage of costs, why do premiums vary by carrier?
July 5, 2022 – Q. If all of the Silver plans in an exchange must offer the same benefits, and cover 70 percent of the cost of those benefits, why do…
Who can help if I have a problem with my ACA-compliant coverage or exchange enrollment?
June 15, 2022 – Here's where you should look for help if have trouble enrolling through a health insurance marketplace – or if you have issues with your…
I earn too much to qualify for a subsidy. Why should I buy through an exchange?
May 23, 2022 – The American Rescue Plan (ARP), enacted in March 2021, makes health insurance coverage more affordable for millions of people who buy their…
If I enroll in the exchange, will that coverage take effect immediately?
May 16, 2022 – If you enroll through your marketplace your coverage effective date mostly depends on whether you're enrolling during open enrollment or a…
Would my 21-year-old’s subsidy be based on his income – or mine?
April 26, 2022 – Q. My 21-year-old son is in college. I know he could stay on my employer's plan until he is 26. But he might be able to get better coverage…
Can health insurance policies still have lifetime or annual benefit maximums?
April 18, 2022 – All new individual and small-group plans have covered essential health benefits (EHBs) since 2014, and there cannot be dollar limits on…
How is vision care covered under the Affordable Care Act?
March 10, 2022 – The Affordable Care Act requires coverage for pediatric vision care as one of the essential health benefits. But there is no requirement…
If I have insurance through my employer, can my spouse get coverage through the exchange?
December 16, 2021 – Q. I have insurance, with a small fee, through my employer. However, my husband is unemployed and to cover him on my insurance is almost…
I’m 21, single with no kids, living with my parents and going to school full time. Do I apply for health insurance as a household of one and list only my income?
September 14, 2021 – Q. I am a 21-year-old dependent living with my parents and going to school full time. I'm not married and have no kids, so do I apply for…
Do Gold exchange plans offer more generous coverage than Bronze or Silver plans?
September 13, 2021 – Q. I have read that the Gold plans sold in the exchanges offer more generous coverage. What exactly does a Gold plan cover that isn't…
I am on Medicare and Social Security. My wife is self employed and needs insurance from the state exchange. How do we figure our household income?
August 18, 2021 – Q. I am on Medicare and Social Security, my wife recently became self-employed and needs insurance from the state exchange. How do we…
I’m 60 and retired. I can get insurance from my former employer but it’s very expensive. Do I qualify for insurance under the exchanges?
August 18, 2021 – But for retirees, the guidelines are more relaxed. Retirees who have access to a plan that provides minimum essential coverage can still…
Did health insurance premiums go up or down for 2021?
August 18, 2021 – Q. I've seen a lot of differing headlines about health insurance rates for 2021 – some say rates increased, some say they decreased, and…
My doctor posted a sign saying she ‘doesn’t take Obamacare.’ What should I do?
August 3, 2021 – Q. My doctor posted a sign saying she doesn't take Obamacare. What should I do? A. It depends on your relationship with your doctor. If…
Can small businesses use the ACA’s health insurance marketplaces (exchanges)?
June 1, 2021 – The Affordable Care Act included an enrollment platform called SHOP (Small Business Health Options Program), an exchange where businesses…
Are dental benefits included in ACA’s marketplace health plans?
May 5, 2021 – A: Pediatric dental is one of the ACA's essential health benefits. But there's no requirement that dental care for adults be…
My parents are 68, but recently moved to the U.S., so they don’t qualify for Medicare. Can they buy insurance in the exchange?
January 18, 2021 – If your parents are 65 or older, but don't qualify for Medicare because they have not lived in the U.s. long enough, they can purchase a…