The most well-known provision in the Patient Protection and Affordable Care Act, also known as "Obamacare," states that as of January 1, 2014, Americans are required to have "minimum essential health insurance" for themselves, spouses and dependents. The legislation also included tax credits and penalties related to the health care reform that continue to be applicable.
If you already have health insurance through an employer or government-sponsored program like Medicare or Medicaid, or you purchase insurance on your own, you likely have minimum essential coverage and don't need to take any action.
If you don't have insurance, the ACA requires that you obtain coverage or pay a tax penalty (unless you're exempt).
If your employer does not offer insurance, you can obtain coverage through your state's marketplace (also called an exchange) during open enrollment. Alternatively, you can purchase coverage on your own through a private exchange or directly from an insurance company.
You may qualify to enroll in marketplace coverage outside of open enrollment periods if you experience a life event like having a baby, getting married or losing other coverage.
Marketplaces offer five levels of coverage defined by the percentage of the total costs of an average person's care paid for by the insurance company:
- Bronze — Your health plan pays 60 percent on average of covered healthcare expenses
- Silver — Your health plan pays 70 percent on average of covered healthcare expenses
- Gold — Your health plan pays 80 percent on average of covered healthcare expenses
- Platinum — Your health plan pays 90 percent on average of covered healthcare expenses
- Catastrophic — Your health plan pays less than 60 percent of the total average cost of covered healthcare expenses. Catastrophic plans are only available for people who are under 30 years old or have a hardship exemption.
If you purchase coverage through a marketplace, you may be eligible for the advanced premium tax credit to help reduce the cost of your monthly premiums. Find out how much you can save on health insurance now.