Skip to content

    Health Care Reform:

    Health Insurance & Affordable Care Act

    Reviewed by Lisa Zamosky

    WebMD Health News

    Affordable Care Act: Your Top 8 Questions Answered

    Oct. 2, 2013 -- To help readers on Day 1 of open enrollment for the health insuranceMarketplaces, WebMD hosted a live chat to answer their questions about the Affordable Care Act. While our expert panel fielded a range of subjects, the eight topics below came up most often. Our weekly series of live chats will continue Oct. 8 at noon. You also can go here to ask a question or search for more answers.

    1. Who can sign up for insurance in the new Marketplaces?

    The new health insuranceMarketplaces, also known as Exchanges, are mostly for people who buy insurance on their own and for people who don’t have any insurance.

    People with COBRA can also shop in their state's Marketplace.

    If you have insurance through your employer, you probably don’t have to do anything. But if your insurance costs more than 9.5% of your income or it doesn’t cover an average of 60% of your medical expenses, you can shop for insurance through your state’s Marketplace, and you may qualify for federal tax credits.

    If you have insurance through Medicaid, Medicare, or another government program, you won’t be eligible to buy insurance in the Marketplace.

    2. How do tax credits work?

    Tax credits are only available on health plans purchased through the Marketplaces. If you are single and you make less than about $46,000, or if you are a family of four and you make less than about $94,000, you may get a tax credit from the government to help pay your premium.

    When you enter your personal information and income, you’ll find out if you're eligible for credits.

    Tax credits can be taken in three ways. You can apply it entirely to your premium to pay the lowest possible cost for coverage. You can apply part of it during the year and take the rest at tax time. Or you can pay your full premium throughout the year and use the credit as a deduction at tax time.

    3. How is income calculated when you apply for insurance?

    The income used to figure out if you are eligible for a subsidy is modified adjusted gross income (MAGI). That means your household income after deductions and other credits. For most people, MAGI will be the same as adjusted gross income, or AGI.

    Here’s where you can find your AGI, depending upon the tax form you use:
    Form 1040 EZ - Line 4
    Form 1040A - Line 22
    Form 1040 - Line 38

    Today on WebMD

    stethoscope on person's chest
    Your Marketplace choices,
    How not to waste money on health care.
    man in cafe looking at computer
    Finding low-cost health insurance.
    doctor showing girl a stethoscope
    Get the facts on health insurance.
    Loading …
    URAC: Accredited Health Web Site TRUSTe online privacy certification HONcode Seal AdChoices