The new health insurance exchanges will start operating in 2014. The application process will be a first-time experience for everyone, and the deadline to apply is fast approaching. While any unfamiliar process can be daunting, applying for health insurance through the Affordable Care Act, (also known as Obamacare) doesn't need to be. Take advantage of the resources that are designed to help you. Here's a step-by-step guide to walk you through the process.
How to apply for Obamacare
Step 1: Know where to start.
All Americans will be able to start enrolling in health insurance plans through a health insurance exchange beginning Oct. 1, 2013. Sixteen states and the District of Columbia have chosen to run their own exchange. Seven states have partnered with the federal government to run the exchange. The remaining states have elected to have the U.S. Department of Health & Human Services run their state's exchange.
No matter what option your state selects, you'll be able to apply for health insurance coverage under Obamacare via three ways: online, mail or in person. If your state is running its own exchange, you can apply through a state-run website. For example, Maryland consumers will find information and the application process at MarylandHealthConnection.gov, says Betsy Charlow, a spokeswoman for the Maryland exchange. If the federal government is partnering with your state or running your state's exchange, you can apply at HealthCare.gov.
Step 2: Know who can help.
You won't be left to figure out the process on your own; there are designated professionals to help you. Here are the four types of experts who can guide you through the process.
1. Navigators are people trained by either the federal or state government to help consumers go through the application process in person and determine whether they qualify for financial assistance. The official list of organizations that will act as Navigators was released in August 2013 and includes representation in each state. You can visit CMS.gov to learn more.
2. Non-navigator assistance personnel perform many of the same duties as navigators, but they are provided as a service by some states to offer assistance before the navigator services are available.
3. Certified application counselors -- trained professionals from community organizations and local health care providers -- will also be on hand to guide consumers through the application process. However, one of the main differences between certified application counselors and patient navigators is that the counselors will be true advocates for consumers, helping each individual find the best coverage for his or her unique situation. On the other hand, the navigators will be offering impartial guidance on the application process.
4. Insurance agents and brokers who help consumers find insurance through the marketplace will have to meet certain federal and state training and certification requirements so they can offer guidance as well.
There will also be other community resources available. In July, Health and Human Services Secretary Kathleen Sebelius announced that $150 million in grant money would be given to more than 1,150 health centers across the country. These funds will be used to help organizations prepare consumers for the health insurance exchanges. For example, organizations might use the grant money to hire and train workers and outreach personnel to help consumers enroll in health plans through the exchanges.
Step 3: Know what you want.
Once you fill out the application, you'll be able to see and compare all of the health insurance options that are available to you. You can sort through the options based on the criteria that are most important to you. For example, you can see which plans cost the least amount of money if price is your top priority, or you can see which plan offers the most extensive coverage if you want access to a broad range of medical practitioners.
You'll also find out whether you qualify for subsidies, which will lower your premium costs. Under the Affordable Care Act, you may qualify for a tax break if you're an individual making up to $45,960, a couple making up to $62,040 or a family of four making up to $94,200. Though the credit will be for the 2014 tax year, you'll be able to apply it to lower your health insurance premiums immediately rather than wait to get it at the end of the tax year.
Step 4: Know what personal information you’ll need.
To determine whether you qualify for a subsidy or other financial assistance such as Medicaid or the Children's Health Insurance Program, you'll need to provide an estimate of how much income you expect to make in 2014. The U.S. Department of Health & Human Services suggests two ways to come up with your estimate.
- You can use your household's adjusted gross income for 2013, incorporating any changes you expect such as a recent raise.
- You can add up the wages, salaries, tips, self-employment income, unemployment compensation and Social Security payments you expect your household will receive in 2014. Other forms of income you'd need to report include alimony, rental income, annuities and interest.
Other information you'll want to have on hand when applying for health insurance include Social Security numbers of those in your household, policy numbers for current health insurance plans and information about any health insurance plans offered by your employer.
Step 5: Know the consequences.
So what if you make a mistake and miscalculate the amount of money you'll make in 2014? According to the U.S. Department of Health and Human Services, a mistake on an application would be given the benefit of the doubt under the "good faith exception," found in Section 1411(h) of the Affordable Care Act, as long as it was unintentional and later corrected. The Internal Revenue Service will also verify that any credit you receive is in line with your actual income in 2014. If it turns out you made more money and received a larger tax credit than you should have received, you'll owe the difference when you pay your taxes for 2014.
For more information on the application process:
- HealthCare.gov includes answers to frequently asked questions.
- A toll-free call center is available 24 hours a day at (800) 318-2596.
- You can chat online with someone knowledgeable about the process by going to Healthcare.gov/help-center/.