Obamacare

There has been a multitude of confusion over the Affordable Care Act, or Obamacare, as it is generally referred to. Many people are confused on how it will impact them and what protections they have under the law, as well as how the new requirements integrate with insurance they may already have, including Medicaid and employer provided plans. Those seeking answers can always access the official website healthcare.gov; however here are the answers to some of the more commonly asked questions:

         If I already have insurance from an employer do I need to still purchase coverage through the insurance marketplace?

If you are already covered under an employers plan you do not need to purchase coverage through the marketplace. Those with access to employer provided coverage do not qualify for subsidies, so although you can purchase coverage, any bought through the marketplace is likely to be more expensive, and have higher out of pocket costs that coverage offered by an employer.

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         What happens if I chose not to purchase insurance coverage?

For individuals who do not purchase insurance coverage for 2014, a $95 fee per individual is added into the yearly taxes owed to the IRS. This fee will increase for 2015 and paying it does not protect you from any medical bills incurred due to receiving healthcare, so it is generally more affordable to simply purchase insurance coverage. This is known as the individual mandate and requires most citizens to purchase insurance coverage. If you are a member of certain tribal groups or do not make enough income to file a tax return, you may be exempt from purchasing coverage. Also, if the only coverage available to you costs more than 9.5% of your income, you are exempt, but take note this is for an individual plan, not family coverage.

         What services are covered under the insurance plans offered on the marketplace?

Insurance plans are mandated to offer specific services regardless of need, and all insurance plans sold on the marketplace must offer these services. Although the copay, deductibles and out of pocket maximums will vary depending on plan all insurance plans must cover outpatient treatments, emergency care, maternity care, hospitalizations, mental health services, pediatric care, rehabilitation services and treatments, preventative services and chronic disease maintenance, laboratory services and prescription drugs. If the insurance offered by your employer does not cover these services, your employer may face a fine.