Tampa Bay Times readers have been asking lots of questions about the Affordable Care Act, and we invite you to keep them coming as computer problems in the marketplace ease and you get to try it out. We're archiving all of this information in a sortable format at tampabay.com/obamacare. Have a question? Send it to [email protected]
I understand I have until Dec. 15 to sign up for coverage that takes effect Jan. 1. When do I have to send my payment?
Your payment (minus any subsidies) also will be due Dec. 15. The law requires insurers to accept personal checks, electronic fund transfers, prepaid debit cards, cashier's checks and money orders. Insurers may also accept credit cards.
What kind of information do I have to submit to the marketplace website to get a quote for insurance?
You need to supply your name, age, email address, ZIP code and estimated 2014 income and then answer questions about other household members and whether they file taxes jointly or individually and whether they smoke regularly or have recently moved or changed jobs. You'll also need Social Security numbers and health insurance policy numbers for any health plans that cover household members.
That sounds like a pain.
It will take some time if you have a large household. However, if you have in the past bought insurance on the individual market, you'll find this process simpler, since you no longer need to provide your medical history — or any health information at all.
The cheapest marketplace plans appear to be the catastrophic policies. Who can get those?
These plans, which do not include the essential benefits of higher-level plans, are available only to people under 30 and to some low-income people who are exempt from paying the fee because other insurance is considered unaffordable or because they have received "hardship exemptions." Others must purchase plans in one of the four "metal'' groups: bronze (which covers 60 percent of average medical costs), silver (70 percent), gold (80 percent) or platinum (90 percent).
What if I sign up for a plan now but later I hear about one that I like better?
During the annual enrollment period, you can switch as long as your policy hasn't yet become effective. But if you wait until after Dec. 15 to make a change, the new coverage wouldn't begin until Feb. 1, and you'd be without coverage in January. Once the plan becomes effective, generally, you can't change until the next open enrollment period, which next year will be Oct. 15 to Dec. 7. A major life change, such as a job loss or change, a birth or a divorce can win you a special enrollment period.
My daughter, who is 24, lives with me because she can't afford to live anywhere else. Will they look at my income also in determining what she will pay? If the subsidies are tax credits, does that mean she will only be subsidized by the amount she is taxed?
If you don't claim your daughter as a dependent on your tax return and if her own income is between 100 and 400 percent of the federal poverty level ($11,490 to $45,960 in 2013), she could be eligible for premium tax credits on the exchange. However, if her income is below 100 percent of the poverty level, she would not be eligible for subsidies, though she still could shop on the exchange.
If she is claimed as a dependent, then the family income would be the basis for determining credits. The credits are granted as discounts on premiums, not as income tax refunds, so they are not limited by the amount she is taxed.
If you have a group plan through your employer, another option might be to add your daughter to that policy. The law allows her to be covered under your insurance until age 26.
My current monthly premium is $965.74 (this is for myself only — my husband is 65), and we have been using our savings to pay for it. I will be 63 in January, and my husband and I will have approximately $55,000 in income for 2014, which includes IRA withdrawals, Social Security, pension and VA disability. Am I eligible to buy insurance on the marketplace?
Yes, you are eligible. You will need to apply at healthcare.gov to determine whether you qualify for a subsidy, which is calculated based on income and the cost of benchmark coverage. But even without a subsidy, you may find that you pay less for coverage. Though plans can charge more based on age, they cannot charge more based on preexisting conditions. Some people in your age bracket are reporting finding better prices on the exchanges.
What about same-sex married couples? How are they treated in the marketplace in a state like Florida that doesn't recognize same-sex marriage?
According to the IRS, all legally married same-sex couples will be treated as married for federal tax purposes, regardless of where they live. The insurance exchanges will also see you as married. In fact, if you're a married couple buying insurance on the exchanges — gay or straight — you must file a joint federal return. Otherwise, many more people would qualify for subsidies if they used "married filing separately.''
If a husband is, and plans to stay, on Medicare and his wife buys an Obamacare plan, is this a family of two or an individual, for purposes of subsidies? And if the wife has no income of her own, what cost savings would she qualify for?
Sorry, but married couples are considered a household of at least two (see the preceding answer), so the husband's income would be considered in calculating any subsidies for the wife.
Sources: Healthcare.gov, U.S. Department of Health and Human Services, Kaiser Family Foundation, the Internal Revenue Service, the New York Times.