Obamacare Changes and Open Enrollment

open enrollment

The Affordable Care Act was designed to make health insurance available and affordable for millions of Americans who did not already have coverage. The act also said that anyone who did not have health insurance had to pay a penalty when they filed income taxes. The Tax Cuts and Jobs Act changed the Affordable Care Act penalty, but Obamacare is still available, and open enrollment will begin in November. If you are enrolling for the first time, here are the most important things to know for 2019.

Is there a tax penalty for not having health insurance in 2019?

The Tax Cuts and Jobs Act repealed the Obamacare tax penalty. That means that as of Jan 1, 2019, you won’t have to pay a penalty if you do not have health insurance. Note: the penalty is still in effect through the end of 2018. That means that if you did not have coverage for a part of this year, you may owe a fine when you file your income tax return.

Can I stay on my parents’ insurance? 

If you are 26 years of age or younger, you can still qualify for coverage under your parents’ plans under the Tax Cuts and Jobs Act. This is true even if you are married or don’t live with them. The only change that was made to the Affordable Care Act was the repeal of the tax penalty.

What is open enrollment?

The Health Insurance Marketplace is an online platform that makes it easy to compare different plans and enroll for the one that meets your needs. The open enrollment period is designated so that people won’t simply wait for an emergency to sign up for health insurance.

When is open enrollment this year?

Open enrollment for Marketplace insurance coverage begins Nov. 1 and ends Dec. 15, 2018. It is a shortened period this year due to the Tax Cuts and Jobs Act, but you’ll need to select your coverage plan by Dec 15 for it to take effect on Jan 1, 2019.

I need health insurance now. Do I have to wait for open enrollment?  

It depends. There is a special enrollment period for people who need to change or get new coverage after a major life event. For example, if you lose your health insurance, have a baby, get married or move, you have up to 60 days from the date of the event to enroll in insurance through the Marketplace. Otherwise, you must wait for the open enrollment period to get coverage.

Do I have to re-enroll in the Marketplace if I already have health insurance? 

If you are already enrolled through the Marketplace, your plan will renew automatically. Still, certain parts of your plan – like prescription drug coverage, network providers, and copays – can change from year to year.  If your current insurance doesn’t work for you anymore, open enrollment is the time you can change your coverage.

What to Consider When Choosing Your Provider

How much does the plan cost? – When you select your Marketplace insurance plan, think about how much you are willing and able to pay for coverage. Your premium is an amount you will pay every month to your insurance company. You will also pay a certain amount out-of-pocket when you seek medical attention. Insurance plans on the Marketplace are divided into four categories – Bronze, Silver, Gold, and Platinum – based on how you and your provider will share the costs of coverage.

How flexible are my choices? – Insurance plans come in different types: HMO, PPO, POS, or EPO. With an HMO, you are usually limited to visits with doctors who contract with the HMO. PPO and POS plans have a network of doctors for you to choose from, but you may also have the flexibility to see an out-of-network provider for an additional fee. An EPO requires that you be seen by a provider in the network.

Are my benefits covered? – All plans on the Marketplace provide some coverage for 10 essential benefits. The amount of coverage will vary, so you’ll need to consider your needs before selecting the plan that’s right for you. The 10 essential benefits are:

  • Outpatient care including chronic disease management
  • Emergency care
  • Hospitalization
  • Pregnancy and newborn care
  • Mental health and substance abuse services
  • Prescription drugs
  • Rehabilitation services and devices
  • Lab tests
  • Preventive and wellness services
  • Dental and vision care for children

Do I qualify for the premium tax credit?  The premium tax credit is a refundable tax credit that is supposed to make buying health insurance on the Marketplace even more affordable. The amount of credit you’ll receive depends on your household income and eligibility status. When you apply for coverage through the Marketplace, you’ll fill out information about your income and family size that will determine how much credit you’ll receive.

Will the tax law changes and your health insurance coverage affect your tax refund this year? Try out our Refund Estimator today and see how much you could be getting back when you file!

This article is up to date and accounts for tax law changes for tax year 2018 (tax returns filed in 2019). Learn more about tax reform enacted under the Tax Cuts and Jobs Act here.

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