No Health Insurance? What to Know About the Affordable Care Act

By law, nearly everyone in the U.S. has to have Affordable Care Act health insurance with a few exceptions. Each year there is an open enrollment period during which you can use your state Marketplace to shop for and enroll in a health plan. Open enrollment runs from Nov. 1 through Jan. 31. You may qualify for a special enrollment period if you experience certain life evens such as losing your job or having a baby.

Where to Get Insurance

There are several places you can get insurance:

  1. Through your employer. If your employer offers insurance, this is likely where you'll get the most affordable and comprehensive health plan. Many employers share the costs of insurance with their employees.
  2. Through your state's health insurance Marketplace , also called an Exchange. This new web site shows health plansavailable in your state at four levels of cost and coverage. The four levels - bronze, silver, gold, and platinum - correspond to how much the plan costs and how much it covers. The bronze plan will have the most affordable premium, but on average will cover only 60% of your medical costs. Platinum plans, on the other hand, will have the highest premiums, but will cover an average of 90% of your medical costs. On the Marketplace, you'll find simple ways to compare plans. You also will see how much financial aid you can get. The financial aid on the Marketplace is called a subsidy or a tax credit. You can only use it for buying a health plan on the Marketplace. You can also find out if you're eligible for Medicaid in your state.

  3. From an insurance broker. Brokers can help you choose a plan that meets your needs. In many states, brokers can also help you enroll in a Marketplace plan and receive financial aid if you qualify. If you buy a plan through a broker that’s not sold on the Marketplace you will not get financial assistance.
  4. From a public health group like Medicare, Medicaid, or the VA. Public health insurance such as Medicaid offers care for free or low cost.

If You Break the Law

If you don't buy insurance, in most cases, you'll pay a penalty when you file taxes. For the 2016 tax year, the penalty is the greater of $695 for each adult and $347.50 for each child or 2.5% of your family income. The fine won't be any more than $2,085 per family or the national average annual premium for a bronze level plan, whichever is more.

Now you have several options for coverage -- and you must buy insurance, unless you are exempt.

WebMD Medical Reference Reviewed by Sarah Goodell on February 03, 2016
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