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FAQs

Q?

How do I report changes to my income, family, or address?

A.

You can report changes to the Marketplace 3 ways: Online, by phone, or in person — not by mail. Learn how.
It’s important to report any changes as soon as possible. These changes may affect your coverage and savings.

Q?

How do I find out if I qualify for an exemption from the penalty for being uninsured?

A.

Select the year you want an exemption for, and answer a few questions to find out if any exemptions may work for you. We’ll tell you how to apply. If you qualify for an exemption, you don’t have to pay the penalty for being uninsured.
Exemptions are available based on certain hardships or life events, health coverage or financial status, membership in some groups, and more.

Q?

What’s the difference between a deductible, a copayment and coinsurance?

A.

All three are medical charges you must pay out of your own pocket, even if you have insurance. Your deductible is the initial amount you must pay each year for covered health services before your insurer will start to chip in. Plans may have separate individual and family deductibles and/or deductibles for separate services such as hospitalization. A copayment is a fixed amount you pay toward each medical service, such as $25 for a checkup. Coinsurance is a fixed percentage, rather than a flat amount, that you pay toward each service.

Q?

I’ve had the same policy for years. Does health care reform affect my plan?

A.

Some provisions of the Affordable Care Act do not apply to so-called grandfathered plans written before the law took effect. These include the freedom to choose your own doctor, preventive services at no additional cost, and the right to appeal if your insurer denies a claim. However, as with new policies, grandfathered plans are required to cover children up to age 26, provide a simple summary of coverage and costs, and cease any lifetime limits on benefits.

Q?

I can’t afford to buy health insurance. What should I do?

A.

Depending on your income, you may be eligible for lower-cost, subsidized coverage purchased through Obamacare's state health insurance exchanges. Or, you may qualify for free or low-cost coverage through Medicaid or the Children's Health Insurance Program, aka CHIP.

Q?

Who is exempt from paying the penalty for not having health insurance?

A.

The law excuses certain individuals from the penalty, including members of religious sects that have religious objections to health insurance, participants in health care sharing ministries, and those who are uninsured for less than three months of the year. You also could be exempt if your income is too low to require a federal tax return, you can't reasonably afford coverage, or you would have qualified for Medicaid had your state elected to expand the program as provided for under the Affordable Care Act.