Obamacare Revisted

In the midst of the pandemic, the subject of health insurance has been pushed to the background, even as millions have lost their jobs and their health insurance at the same time. But one of the first acts of the Biden administration was to reopen HealthCare.gov — the health insurance marketplace established by the Affordable Care Act, or “Obamacare” — to new applicants.

This special open enrollment period runs through May 15. It’s a second chance for those without health insurance to see if they qualify for either state Medicaid programs or subsidized health insurance policies.

According to the Kaiser Family Foundation, there are currently approximately 15 million uninsured Americans. Of those, about 8.9 million, or 60%, are eligible for free or reduced-price bronze plans through the ACA.

Are you one of them? This is not a guessing game. These plans are so personalized that you really need to go online to do the comparisons.

The place to start your search for information is at www.Healthcare.gov. That’s where you can do some basic research, price policies and sign up. Or you can visit websites like www.eHealth.com, where trained agents (at no extra cost) can help you sort out which policy makes most sense for you.

And if you just want to get a ballpark idea of what kind of subsidy you might be eligible for and what the monthly cost of insurance might be, you can start by using the Health Insurance Marketplace Calculator provided by the well-known Kaiser Family Foundation www.kff.org/interactive/subsidy-calculator.

If this entire process intimidates you, or if you don’t have computer access, you can call eHealth at 866-335-1781 and talk to a licensed agent to get expert help choosing your Obamacare policy. There is no extra charge for this service.

The Basics

Here’s a simple overview. All plans must offer 10 basic coverages. Expenses fall into four levels: bronze, silver, gold and platinum. The difference is the amount you must pay in deductibles (up to stipulated maximum out-of-pocket expenses). The bronze plan is least expensive, but you must pay 40% of your healthcare costs. The silver plan requires you to pay 30%, gold 20% and platinum 10% (but it costs the most).

You qualify for federal aid if your 2021 projected income is one to four times the 2020 federal poverty level for your household size. So for 2021 health plans, a family of four could earn between $26,200 to $104,800 and receive a subsidy. But a couple could not earn more than $68,960 and receive a subsidy.

Don‘t be intimidated. You might be surprised at how little a bronze plan will cost you. Of course, with a bronze plan you will have higher copay costs, but it could keep you from losing the family home in a medical emergency.

Getting Started at Healthcare.gov

The first step is to fill in your state of residence, because some states have negotiated plans on their own state marketplaces. Next, you create a secure account. That requires your name and email address. You will create a user-name, password and three security questions. They’ll send an email to authenticate your account.

At that point, you can start comparing and shopping for plans. You can even search the plans to find out which include your favorite physician or hospital. You’ll need your Social Security number, and your most recent W-2 or 1099 income information. That will help you find out how much in subsidies you are eligible to receive.

One warning: Those subsidies are based on estimates of what you will earn in 2021. Some people who received large unemployment benefits in 2020, beyond their projected income, are now finding they must repay some of their subsidies.

Don’t ignore the need for health insurance for you and your family. Take the first steps to investigate. It may be more affordable than you think.