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Health Care Reform:

Health Insurance & Affordable Care Act

Mandated to Get Insurance but Can't Afford It?

If you haven't been able to afford insurance , what does health care reform mean for you? According to laws created from the Affordable Care Act, almost everyone has to have health insurance starting in 2014 or pay a penalty. Depending on your income and other factors, you may be able to get financial help.

You can go online (or call) your state's online Marketplace , also called an Exchange. Enter your income, age, and family size, and see if you can get financial aid for health insurance. 

You may be able to get Medicaid , the public health plan for people and families who don't make much money. Many states are expanding their Medicaid coverage. So even if you made too much money in the past to use Medicaid, you may be able to now. It depends on the state you live in.

In states that expand their Medicaid coverage, single people who earn less than about $15,400 a year and families of four who earn less than about $31,800 a year will qualify for Medicaid. If you get Medicaid, you don't need to buy private insurance.

You may be able to get help paying for your insurance from the U.S. government. When you go to your state's Marketplace, you can see exactly how much money in the form of a subsidy, also called a tax credit , you can get. How much you get depends on how much money you make in a year and how many people you are getting insurance for. You can only use this money if you enroll in a health plan through the Marketplace.

In general, if you enroll in a health plan through your state's Marketplace, you'll be able to get some financial help. If you are getting insurance for:

  • Just yourself. You'll get a subsidy if you make less than about $46,000 a year.
  • A family of four. You'll get help if your total family income is less than about $94,000 a year.

You may be eligible for a catastrophic plan. This type of health plan has lower monthly premiums, but it isn't available for everyone. You can enroll in a catastrophic plan if either of these is true for you:

  • You are under age 30.
  • You're exempt from the requirement to buy insurance.

Catastrophic plans have high deductibles. That means you have to pay a lot of money before your health plan helps share the cost. Each year, the deductible is $6,350 for one person. For a family it's $12,700.

One good thing is that a catastrophic plan will help pay for the following care before you've paid all of the deductible:

  • At least three primary care visits
  • Preventive services

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