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Pros and Cons of Obamacare Insurance

Two doctors discussing patient notes in an office pointing to a clipboard with paperwork as they make a diagnosis or decide on treatment. you need health insurance, but aren’t sure about Obamacare?

Are you looking for affordable options for yourself or your family, but don’t know if you qualify for premium tax credits?

Have you been considering the pros and cons of Obamacare insurance, but aren’t sure where to start?

Obamacare insurance doesn’t have to feel overwhelming.

This blog looks at the advantages and disadvantages of Obamacare insurance.

Continue reading to get in-depth information that can guide you to the right healthcare plan.

A Fiorella Insurance Agent can help you choose insurance that’s right for you.

What is Obamacare Insurance?

Also known as the Affordable Care Act (ACA), Obamacare insurance is health insurance provided through the healthcare marketplace. Even small businesses can use the marketplace to sign up for insurance to offer their employees – Obamacare is available to many people in the U.S. through various marketplace avenues.

Obamacare is designed to be affordable for most Americans, with some states expanding their Medicaid coverage for low-income residents. This expansion gives more people access to better healthcare.

One of the requirements of Obamacare insurance is that certain employers offer “minimum essential coverage” for employees or pay a penalty. Not all employers will be required to pay this fee. Most businesses, like small businesses, will be exempt.

You can get insurance through Obamacare by applying online during the open enrollment period. Alternatively, you can get coverage if you qualify for a Special Enrollment Period. Special Enrollment Periods can be something like getting married or adding a dependent.

Fiorella Insurance Agency can help you with your Obamacare insurance needs.

Be sure to submit any documents that are requested so you can get coverage as soon as possible, and report any income changes to ensure you are getting the most savings. Family changes should be reported, too.

The Pros of Obamacare Insurance

While having health insurance, in general, is a “pro”, there are some specific benefits to having health insurance through the ACA. The major advantages of Obamacare insurance are:

1. No Pre-existing Conditions to Deny Coverage

One of the most practical benefits of Obamacare insurance is that marketplace coverage cannot be denied because of pre-existing conditions.

This means that if, for example, you have a heart condition that requires frequent medical care, you cannot be denied coverage. They also cannot charge you more for coverage because of a pre-existing condition.

2. May Qualify for Premium Tax Credits

Depending on your income and family situation, you may qualify for premium tax credits. When you apply online for health insurance coverage, you’ll find out if you qualify for those savings. You can apply them to any of the plans you are interested in purchasing through the marketplace.

 If you don’t qualify for tax credits, you’ll still be able to purchase insurance through the marketplace or a broker.

3. Variety of Options Depending on Health Needs

There are four different plan levels available to purchase: bronze, silver, gold, and platinum. In some cases, you may be eligible for catastrophic insurance as well. These options do not indicate the level of care you receive – they indicate the differences in premiums, deductibles, and copayments.

Compare your options carefully. The components of health insurance coverage will vary and can add up if you have specific health needs.

The Cons of Obamacare Insurance

Though there are several reasons you want to have coverage with Obamacare, there are are few disadvantages to the options available to everyone. Some of those risks include:

1. Not All States have Expanded Medicaid

Unfortunately, not every state expanded Medicaid coverage. While some states offer coverage for individuals that made \$16,753 a year in 2019 and families of three that made \$28,676 in 2019, several states opted out of the expanded coverage. Due to Covid-19, we recommend contacting your insurance provider for this year’s Medicaid or CHIP enrollment details because they have changed frequently with each state.

There are 34 states, plus Washington D.C., with expanded Medicaid coverage, and three other states recently voted on whether to expand or not.

2. Best Plans May Still be Cost-Prohibitive

Everyone’s financial situation is different. Plans that are at the higher end of the spectrum – the platinum plans, for example – will cost more per month than the plans on the lower end – the bronze plans.

If you have limited monthly income, it may be hard to afford the platinum plans even with premium tax credits. This can be difficult for families to manage.

3. Not All People Will Qualify for Premium Tax Credits

For the 2021 plan year, the individual amounts to qualify for premium tax credits ranged from $12,760 to $51,040. The limits for a family for three were $21,720 to $86,880. If you make more money than the premium tax credit limits, you won’t qualify for the savings.

A Fiorella Insurance broker or agent can help you through the process. They will let you know if you qualify for savings, and connect you with the best plan for your needs.  

Small Business Tax Credits with Obamacare Insurance

Small businesses may also benefit from Obamacare insurance. Small business tax credits may be available to your business if you offer health insurance to your employees. Your enrollment period may be different than with an individual plan, so talk with an agent about your options.

This also means your employees may have different enrollment periods, as well. You want to be clear on that when you offer a healthcare plan to your employees.

Obamacare Insurance Open Enrollment 2021

Open enrollment for 2021 plans begins November 1, 2020, and ends December 15, 2020. You’ll be able to apply online during this period. You’ll also find out if you qualify for tax credits during that time.

There have been some recent updates to Obamacare insurance. Previously, if you did not have health insurance, you were required to pay a “Shared Responsibility Payment.” This penalty no longer applies as of the 2019 plan year.

Obamacare insurance can be a great option for individuals who qualify for tax credits. If you don’t qualify for the tax credits, however, you may have more options with an insurance agent. An insurance agent can walk you through plans and all of your options, rather than you having to guess which plans to compare against.

Fiorella Insurance Agency can help you with your Obamacare insurance needs. Don’t let the healthcare jargon overwhelm you – contact us today.

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