Resources Health

Affordable Care Act

What is Affordable Care Coverage?

The ACA plans are for people who don’t have health coverage

If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, this would qualify you for coverage through the Affordable Care Act.

What you pay for insurance depends on your income – and you’ll probably save

Your savings depend on your estimate of your expected income for 2016, not your income for 2015. This year, about 8 in 10 of the uninsured who are eligible for Marketplace coverage qualify for financial assistance to lower the cost of their monthly premiums. Based on the income estimate you put on your application, we’ll tell you if you qualify for one of these:

A health insurance plan with savings

Most people who apply qualify for a premium tax credit that lowers their monthly insurance bill. Some also save on out-of-pocket costs like deductibles and copayments

The plans are offered by private insurance companies with a range of prices and features. All plans cover:

Medicaid and the Children’s Health Insurance Program (CHIP)

Medicaid and CHIP provide free or low-cost coverage to millions of people and families with limited income, disabilities, and some other situations.

You can apply for coverage 4 ways

You can apply for health insurance any way that works for you:


By phone

With in-person help

With a paper application

If you don’t have health insurance, you may have to pay a fee

Most people must have qualifying health coverage or pay a fee with their 2016 federal taxes.

  • If you don’t have coverage in 2016, you’ll pay a penalty of either 2.5% of your income or $695 per adult ($347.50 per child) — whichever is higher. Learn about the fee.
  • In some cases, you might qualify for an exemption from the requirement to have health insurance.

ObamaCare Special Enrollment Period

A special enrollment period is a time outside of open enrollment when you and your family can sign up for health insurance in the health insurance marketplace.

  • You may qualify for a special enrollment period of (typically) 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage.
  • Job-based plans must allow special enrollment periods of 30 days (giving you no less than 30 days of coverage while you switch to a Marketplace plan).
  • Many special enrollment periods start before you lose coverage, thus giving you time to enroll in a plan and avoid a coverage gap.
  • IMPORTANT: Even though an enrollment period starts 60 days following the day of the event, in most cases you can enroll up to 60 days before the event. This allows your coverage to start on the day of the event and allows people to avoid any gaps in coverage.
  • If you don’t have a special enrollment period, you can’t buy insurance inside or outside the Marketplace until the next open enrollment period.

You can call Healthcare National Marketing at 1-800-396-7683 at any time for more assistance on this information or 1-800-308-9015 to enroll in a health or dental coverage.