Skip to content

Health Care Reform:

Health Insurance & Affordable Care Act

Have Insurance? How the Mandate Affects You

Wondering what health care reform means when you already have insurance through an employer or insurance you've bought yourself?

You don't have to make any changes and can keep your current coverage if you have insurance:

  • Through your job
  • As a dependent through a family member’s job (this includes children, but not spouses)
  • Through a type of public health insurance, such as Medicare, Medicaid, CHIP or Veteran's benefits

If you buy insurance on your own without help from a work or group plan, you may be required to switch from an older health plan that does not meet the law's minimum requirements to a new plan that does.Even if your insurer keeps your plan, you have the option to shop for a plan from your state's Marketplace, also called an Exchange. When you enroll through a Marketplace, you might qualify for financial help, called a subsidy.

You might have to make changes and look for a new health plan if you have insurance:

  • Through a spouse's employer
  • In the form of a catastrophic plan

Spouse Covered By an Employer's Plan

By 2014, companies with more than 50 employees must offer you affordable, minimum health coverage. And they must cover your children ages 26 and younger. But they do not have to cover your spouse. Most employers that offer dependent coverage also cover spouses, but that could change.

If you’ve been using insurance from your spouse’s employer, and the company stops covering spouses, first see if your own company offers a health plan. That's likely to be your most comprehensive and affordable option. If not, look for an individual plan in your state's Marketplace. The same is true if your company is the one that’s been providing insurance to your spouse. If your employer drops coverage for spouses, have your spouse see if his or her employer offers health insurance.

If You're Over 30 & Have a Catastrophic Plan

Catastrophic plans cost less and have fewer benefits, and they are typically only for people younger than 30. If you're 30 or older, you can only enroll in a catastrophic plan if buying a more comprehensive plan would cost more than 8% of your income.

If that's not the case, you'll need to enroll in a new health plan. Your state's Marketplace offers plans at different levels, called tiers, of cost sharing between you and the health plan. You may want to consider a bronze-level plan, which has a less expensive monthly premium. A bronze plan, though, will cost you more each time you see a doctor or fill a prescription. What you pay for each time you get health care is called your out-of-pocket costs.

If You're on Your Parents' Plan

If you are between the ages of 19 and 26 and on your parents’ plan, you can stay on it. You likely will have to pay extra for this benefit, but it may be more affordable than buying coverage on your own.

If You Have Public Health Insurance

You don't need to change how you've been getting your insurance if you use one of these types of public insurance.

  • You receive Medicare, the government health insurance program for people ages 65 or older.
  • You receive Medicaid or CHIP, health insurance programs for lower-income adults and children.
  • The Veteran's Administration provides your health care.
  • TRICARE provides your health care. 

WebMD Medical Reference

Your Costs

See insurance premium
costs and financial aid.

Start Here

Health Insurance

Find a plan that's right
for you.

Start Here

Your State's Insurance Marketplace

Get informed about plans, benefits and costs.

From WebMD
Loading …
URAC: Accredited Health Web Site TRUSTe online privacy certification HONcode Seal AdChoices