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- The Affordable Care Act requires that every citizen, national, and other authorized residents of the US get and maintain health insurance coverage
- The coverage must meet the requirement of the Affordable Care Act and provide Essential Health Benefits
- Plans that meet the essential health benefits requirements are qualified health plans
- All plans sold through Healthcare.gov or state exchanges meet the requirements of the Affordable Care Act
Individuals must have insurance that meets the minimum requirements of the Affordable Care Act. The insurance must have the essential health benefits prescribed in the landmark reform law. Comparison shopping is the best way to find the health plan that meets the Individual Mandate and offers maximum benefits. Start comparing health insurance plans now by using our FREE tool above!
Employer Sponsored Insurance
The Employer mandate requires companies that employ 50 or more full-time employees to provide health insurance coverage. The insurance must meet the requirements of the Affordable Care Act and offer the essential health benefits required by law. Qualified health plans relieve the employer of any further liability for tax penalties and shared responsibility fees.
Small Business Plans
The SHOP program provides tax credits for businesses with 25 or fewer employees that offer coverage. Aimed at a maximum credit for businesses with ten or fewer employees, tax credits add to the bottom line. Small group coverage purchased through the Obamacare Marketplace will meet the requirements of the Affordable Care Act’s individual mandate.
Medicaid coverage meets the requirements of the Individual Mandate and avoids any tax penalties. Medicaid expansion was part of Obamacare and it makes more persons eligible by raising the income limit for eligibility to 138 percent of the federal poverty guidelines.
The Essential Health Benefits
The Affordable Care Act established ten essential health benefits which must be included in any health plan that meets the standards of the law. These plans are also called qualified health plans. The essential health benefits must be included at no extra costs. While not a perfect fit for every need, the essential benefits provide advantageous elements. They include prescription drugs, screenings and procedures for early detection of preventable diseases, annual physical examinations, hospital care, maternity care, and mental health services.
Getting Insurance for Obamacare
Open Enrollment provides a time for sign up open to everyone that needs or wants health insurance. It is the time when everyone has a right to sign for new coverage, renew old coverage, or change plans. The Obamacare insurance marketplace offers five ways to sign up for health insurance coverage that meets the Individual Mandate, and this includes convenient online sign-up.
Ways to sign up
Individuals seeking health insurance during Open Enrollment can use any of the below-listed methods to sign up. For most people, online applications are quick and easy. In enrollment locations, people can use hard copy printed applications or electronic sign-up. Individuals can use telephone sign ups to get insured and meet the requirements of the individual mandate.
- Hardcopy paper application by mail
- Hardcopy paper or electronic application at Obamacare locations
- Online with Healthcare.gov or state exchange
- Telephone sign up with state exchange or Healthcare.gov
- Private sign ups direct with insurers or insurer’s agents
Open Enrollment for the calendar year 2016 runs from November 1, 2015, through January 31, 2016.
Applicants can use any of five methods for enrollment and avoid the shared responsibility fee. One can select, buy, renew, and change qualified health plans during this open season.
After Open Enrollment
After Open Enrollment, one must qualify for a special enrollment period. The ACA recognizes some status changes and provides a new enrollment period if they occur. The following Life Events are among the exceptions recognized by the federal and state governments.
- Giving Birth to a child or adoption
- Losing insurance from job or as dependent
- Moving to a different state
Shopping Outside of the Marketplace
Most people with incomes near or above the maximum level to receive Obamacare financial benefits will get few financial advantages from the Obamacare marketplace. For this group, it is important to shop outside of the Obamacare Marketplace.
Private insurers base plans to cover particular geographic areas, and this includes price and terms of coverage.
To see the complete range of plans available in a particular area, one must shop directly with insurance providers and use alternative approaches such as insurance sales agents and brokers.
Meeting the Individual Mandate
US nationals, citizens and other eligible residents can get the insurance needed for Obamacare from the Obamacare marketplace, employer plans, small group plans, and qualified individual plans. They can also satisfy the mandate by getting covered through Medicare, Medicaid, and CHIPs. Comparison shopping is the recommended method for exploring options and selecting the best plan for the individual or family situation. Comparison shopping applies to all types of plans including those offered by small businesses and larger employers. Start comparing health insurance plans now by entering your zip code in our FREE tool below!