The Health Insurance Marketplace is sometimes known as the health insurance “exchange.” It is a state’s price comparison website for subsidized health insurance.
Each state has its own Marketplace. In Pennsylvania, you can access yours at HealthCare.gov
The Exchange gives consumers the opportunity to compare prices and plans before applying. You can get quotes immediately and compare plans side by side.
Health Insurance plans are divided in metallic tiers:
The official ObamaCare enrollment period ended on March 31, 2014. Important Notice: Its urgent, to avoid future fines and penalties, to sign up for health insurance under the Affordable Health Care Act.
Pennsylvania Individuals & Families: Find out the most cost efficient healthcare insurance for you.
The lowest cost plan available. It has the lowest premiums and the lowest actuarial value. The actuarial value of a bronze plan is 60%. This means that 60% of medical costs are paid for by the insurance company, leaving the other 40% to be paid by you.
The second lowest cost plan. It has an actuarial value of 70%. This means that 70% of medical costs are paid for by the insurance company, leaving the other 30% to be paid by you.
The second most expensive plan. It has an actuarial value of 80%. This means that 80% of medical costs are paid for by the insurance company, leaving the other 20% to be paid by you.
The plan with the highest premiums.The Platinum plan as an actuarial value of 90%. This means that 90% of medical costs are paid for by the insurance company, leaving the other 10% to be paid by you.
These are plans for people under 30. They usually have high deductibles, essential benefits and low premiums.
What if I can’t afford it?
The Marketplace will let you know if you can get lower costs based on your income and household-size.
This way you can choose the combination of price and benefits that fits your budget and meets your needs.
You may be eligible for an Advanced Tax Credit, Cost Sharing, Medicaid or CHIP.
ObamaCare subsidizes those with incomes ranging from 139% to 400% of the FPL.
It also helps to make Medicaid and CHIP available for those below the 139% mark.
In 2013 400% FPL was:
- $45,960 for single person.
- $62,040 for a family of two.
- $78,120 for a family of three.
Subsidies are given as refundable tax credits.
The Tax Penalty
If someone can afford health insurance and decides not to have coverage in 2014, they may have to pay a fee also known as Tax Penalty. The penalty can be any of the options explained below (whichever is higher):
- 1% of your yearly household income.
- $95 per person for the year ($47.50 per child under 18).
*This fee increases every year.
*If you’re uninsured for less than 3 months, you don’t have a make a payment.
To avoid the fee you need insurance that qualifies as Minimum Essential Coverage.
You’re considered covered and don’t have to pay a penalty if you have any of the following:
- A Marketplace plan.
- An individual insurance plan.
- Any employer plan with or without “grandfathered” status.
- The Children’s Health Insurance Program (CHIP).
- Veteran health care programs.
- Peace Corps Volunteer plans.
Some people are exempted from the fee.
• Individuals whose health coverage may cost more than 8% of their household income.
• Individuals with incomes too low for filing taxes.
• Individuals with religious exemptions.
• Undocumented immigrants.
• Individuals who are incarcerated.
• Members of Native American tribes.
Where can I find help?
You can find help online at HealthCare.gov, by phone at 1-800-318-2596/TTY 1-855-889-4325 and in your community at localhelp.healthcare.gov