Health Insurance FAQs

The Health Insurance Literacy ASK group provides answers to your questions about the Affordable Care Act to help you make smart health insurance choices and to plan your personal finances.

Here is a collection of the most common questions. If you can’t find the answer to your question among the list, you can search for additional information using the search box at the top of the page or submit your own personal question to our Ask an Expert Feature. …

What happens if even the bronze plan under the Affordable Care Act (ACA) costs too much?

The Affordable Care Act mandates that most people are insured either through their place of employment or purchasing a policy on their own. Remember, beginning in October 2013 there will be options in every state for purchasing insurance through a state-wide Marketplace.

There are exemptions from that mandate for several reasons including financial hardship, which is an official definition based on income and family size. The good news is that, depending upon your income level, you may qualify for

Do children fall off my insurance policy on the day of their 26th birthday? How do they avoid a lapse in coverage?

Under the Affordable Care Act, children and step children can stay on their parent’s insurance policies until their 26th birthday, provided the parent’s plan allows dependent coverage. Retiree insurance plans, for example, are not required to extend coverage to dependents. Children can be covered by the parent’s insurance plans even if they are married, do not live with the parent or are not financially dependent on the parent. They can also be covered even if they are eligible to …

The Affordable Care Act and Income Taxes

Barbara O’Neill, Ph.D., CFP®

Extension Specialist in Financial Resource Management and Distinguished Professor

Rutgers Cooperative Extension

oneill@aesop.rutgers.edu

 

For the first time ever, during the 2014 federal income tax year, health insurance became intertwined with income taxes. More than 75% percent of Americans with year-long health insurance provided by an employer, private insurance policy, or other non-Marketplace health insurance source simply have to check the “Full-year Coverage” box on Line 61 of the 1040 tax form. For others, the process of …

Are all hospitals supposed to accept any or all insurance?

In the past, each hospital has been able to select which insurance plans it will accept. This could mean that if you got sick or injured while traveling, for example, and you had to visit an emergency room that you may have had to pay entirely out of pocket for care provided at that distant hospital if they “didn’t take your insurance.”

This will no longer happen to a large degree. All Marketplace plans will offer the same set of …

How do I take on a new cost for health insurance when I can barely pay my bills now?

A spending plan is just exactly that, a plan for how you will spend all the dollars your earn and those given to you (including, hopefully, directing some to savings). To make a change in your spending plan such as adding in health insurance costs or taking on a new car payment, it helps to be as inclusive as possible when calculating all of your monthly expenses. In other words, don’t write in only the premium cost, but include some …

How are health insurance and car insurance similar and different?

Car (automobile) insurance is similar to health insurance in a very important way: both types of policies provide protection against financial losses. 

Automobile and health insurance both help policyholders cover large costs that could financially devastate the individual or the family, like those experienced in unexpected car accidents or major medical procedures such as surgery, chemotherapy, expensive tests, or hospital stays. 

Health insurance generally provides a wider range of benefits than car insurance. Car insurance, for example, will not pay …

Is there anyone who can help me determine my best health insurance option?

Each state will have consumer helpers available to assist individuals with health insurance decision-making. Find these helpers at Healthcare.gov the official site which provides accurate information to guide you through health insurance decision-making, and which also connects you to the Health Insurance Marketplace in your state.

Beware of commercial insurance industry professionals offering “free advice” or “assistance;” their efforts may be just a ploy to get you to buy their company’s policy regardless of other options that may meet …

Why is there a Health Insurance Marketplace?

The Patient Protection and Affordable Care Act mandates that each state must have an online health insurance “marketplace” or “exchange” to make comparing health insurance and purchasing a policy easier for you. This is not the only way to enroll. More information about getting help by phone or in person is available in the FAQ “Is there ayone who can help me determine my best health insurance option?”

The Health Insurance Marketplace will be open October 1, …

Are all pre-existing conditions allowed?

Yes, all pre-existing conditions are allowed and can no longer be used to bar an individual from obtaining health insurance coverage. This provision of health care reform and guarantee of coverage went into effect for children in 2010 and will apply to adults in 2014.  Premiums will not be allowed to use pre-existing conditions as a factor for establishing rates.

The cost of coverage can be adjusted using only these four factors:

1) whether the policy covers an individual or …