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How to Get Obamacare Insurance: Everything You Need to Know

Learn to enroll in Obamacare with this guide. Find out about eligibility, plans, and how to apply for affordable health insurance.

DOPPCALL

DOPPCALL Editor

Super
June 15, 2024
How to Get Obamacare Insurance: Everything You Need to Know
How to Get Obamacare Insurance: Everything You Need to Know
DOPPCALL

DOPPCALL Editor

Super
June 15, 2024

How to Get Obamacare Insurance: Everything You Need to Know

Learn to enroll in Obamacare with this guide. Find out about eligibility, plans, and how to apply for affordable health insurance.

The Affordable Care Act (ACA), commonly known as Obamacare, was designed to provide affordable health insurance coverage for all Americans, regardless of their income level or personal circumstances. Today, many individuals and families rely on Obamacare plans to access quality healthcare services at a reasonable cost.

So, how do you get Obamacare insurance? The process typically involves determining your eligibility, understanding the enrollment periods, preparing the necessary information and a few documents, and choosing a suitable plan from the four available tiers.

While all of this might sound a bit overwhelming, this comprehensive guide should help you navigate the enrollment process with ease. 

Who is Obamacare for?

The Affordable Care Act or Obamacare is meant to help make health insurance affordable for anyone, no matter your income or situation. Whether you earn a little or a lot, you can get covered under Obamacare.

If your household earns between 100% and 400% a year based on the Federal Poverty Level (FPL), the government may help pay for your insurance. This is called getting premium tax credits or subsidies, which lower the monthly cost of a health plan.

For example, say you make $30,000 a year. Your subsidies could cut your monthly payment from $400 to just $100.

Who is Eligible for Obamacare Insurance?

Most people living in the U.S. can qualify for health coverage through Obamacare. But there are a few requirements:

  • You need to live in America.

  • You must be a citizen or national of the U.S.

  • You can't be in jail or prison.

  • You can't be on Medicare already.

There are also some non-citizens who can sign up. For example:

  • Green card holders

  • Refugees

  • People granted asylum

  • Cuban or Haitian entrants

  • Those with work or student visas

  • Family of victims of human trafficking

  • People protected under immigration laws

  • Those with temporary protected status due to problems in their home country

  • Members of American Indian tribes

  • Residents of American Samoa

As long as your immigration status is on this list, you, too, may qualify for health insurance through Obamacare. The rules aim to make care available to as many lawfully present individuals as possible.

Enrollment Periods: When Can I Sign Up for Obamacare?

There's usually only a certain time each year when you can enroll in an Obamacare health insurance plan. This period is called "Open Enrollment."

For 2025, Open Enrollment runs from November 1st, 2024, to January 15th, 2025. During these few months, you can pick a plan for the following year.

Outside of Open Enrollment, you can still enroll if something big changes in your life. This could be losing your job and health benefits or moving to a new state. Getting married or divorced also counts. Having a baby is another qualifying event.

If one of those things happens, you'll have a "Special Enrollment Period," during which you can get an additional period of time to sign up. There's more info about other qualifying life events on this link if needed.


Preparing for the ACA/Obamacare Enrollment Process

Here are some helpful tools you can use while getting ready to enroll:

  • An Explainer: This gives quick tips on how the marketplace works.

  • A Savings Estimator: You can use this to see if you qualify for financial help with premium costs through subsidies. The tool also helps you find out if CHIP (Children’s Health Insurance Program) or Medicaid is an option for you.

  • Income Information: This can help you figure out what counts as income on your application.

If you qualify for ACA coverage, you'll need to fill out an application. So, when you apply, you'll need some personal details handy. The application will ask for the following:

  • Your name, birth date, and basic information

  • Anyone else applying, like your spouse/partner or kids living at home

  • Your home/mailing addresses

  • Social Security numbers for everyone applying

  • How you file taxes - jointly or separately, and who you claim as dependents

  • Your current income from work, tips, etc.

  • Your estimated income for next year

  • Any other health insurance you have now, like through work

  • Help from an employer to pay medical costs

Applying and Choosing a Plan: How to Get Obamacare Coverage

The process of enrolling in the ACA or Obamacare involves filling out an application, choosing a plan, and paying your first premium if necessary.

The best place to start your enrollment is the HealthCare.gov website. You can get started simply by visiting the site and clicking "Get Coverage" at the top. 

From there, you'll need to select your state and create an account by filling out a form with basic information like your name and address. The site will then guide you through the entire process, which may take up to 30 minutes.

Now, although most states use the national HealthCare.gov site for applications, some run their own state marketplaces. But don’t worry – the site will direct you to the right place while completing the application process based on your location.

Other Application Methods

While using the HealthCare.gov website provides the easiest way to apply, it isn't the only option when signing up for Obamacare. Here are some other routes you can try:

  • Apply by Phone: First, you can call 1-800-318-2596 to speak with a helpful representative. They can walk you through the application over the phone.

  • Apply by Mail: If you prefer paper, you can also request an application be sent to you, which you can mail back once complete. It usually takes about two weeks to process.

  • Find Local Help from Brokers or Agents: On this page on HealthCare.gov, you can type your zip code to get contact information for navigators or insurance agents nearby. Typically, they're also happy to assist in person.

  • Work with an Enrollment Partner: Companies certified by Obamacare can apply for you and enroll you in a plan. Just let them know you need health insurance, and they'll take care of the details. Follow this link to learn more about finding a partner. 

The Types of Obamacare Plans You Can Choose

There are four main "metal levels" to choose from for health insurance under the Obamacare Act:

  • Bronze

  • Silver

  • Gold

  • Platinum

Each tier has different costs associated with it. However, premiums can also vary depending on factors like age, location, and the insurance company.

Bronze and Silver tend to have the lowest monthly payments. However, these plans usually come with higher out-of-pocket costs if you need care.

Gold and Platinum have higher monthly premiums. In exchange, though, you pay less money overall when actually using your coverage for things like doctor visits or prescriptions.

Most people choose Bronze or Silver plans because those options offer the most flexibility in pricing. But you’ll be wise to take the time to examine the costs, your budget, coverage details for doctors/services, and everything relevant to decide which tier best suits your situation.

The average copay for Obamacare health insurance plans is shown below.

Plan Tiers

Paid by Insurance

Paid by Patient

Bronze

60%

40%

Silver

70%

30%

Gold

80%

20%

Platinum

90%

10%

Paying Your First Premium to Start Your Obamacare Insurance Coverage

After choosing a health insurance plan, your coverage won't become active until you pay your first monthly payment. This helps the insurance company start covering your medical costs.

You must pay directly to the insurance company, not the marketplace. Look for information from your insurance provider with payment details, like the due date and accepted methods.

It's important to pay on time each month so your coverage stays in effect. If a payment is missed, the insurance company can terminate your policy. To avoid accidentally letting coverage lapse, it’s a good idea to set up automatic payments or calendar reminders.

How to Purchase Obamacare Insurance: Paying Premium on HealthCare.gov

If your insurance provider offers online payment, you can conveniently do it directly through the HealthCare.gov website.

  • Sign into your account

  • Under "Your Applications" click on the one you want to pay for

  • Select "Pay Your First Monthly Premium"

  • Then click "Pay Now" - this will take you to your insurance provider's site to enter your payment info.

If online payment isn't offered, your insurance company will contact you about other options, like mailing a check. Be sure to get clear instructions from them if you don't see payment details or aren't 100% sure they got your money. Their phone number may be on plan documents or the website if you need to check in.

Frequently Asked Questions

Can I be Turned Down for Obamacare Coverage?

As long as you meet the basic requirements, you cannot be denied an Obamacare health insurance plan. So, if you live in the U.S. legally, aren’t in prison, and aren’t on Medicare already, you can enroll. It's possible that your income is too high to get financial help with costs, but you won't be rejected from joining a plan.

What Happens If I Switch Jobs While I Have Obamacare?

If you're getting health insurance through Obamacare and then land a new job that offers insurance coverage, you won't be eligible for financial help paying for an Obamacare plan anymore. In that case, it's usually better to drop your Obamacare plan and take the insurance offered through your employer instead.

Is Obamacare Different from Medicaid?

Yes. Medicaid provides health insurance for lower-income families and individuals. Both the federal and state governments run it. On the other hand, Obamacare aims to make quality coverage more accessible and affordable for everyone regardless of income through HealthCare.gov plans and subsidies. It also allows states to expand Medicaid eligibility to include more middle-income people.

Conclusion

As you can see, Obamacare presents several easy ways to get signed up for quality health insurance. You can apply on your own online, over the phone, through the mail, or with help from a local guide.

No matter the method, compare the different plan levels carefully. Choose the one that best suits your medical needs and is within your means. Think about what you can expect to pay based on your situation. Then, make sure to pay monthly on time so coverage sticks around.

Also, remember help is out there—whether from this article, someone at 1-800-318-2596, or navigators near you.

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