Simple Steps Towards Getting Obamacare

How to Get Obamacare
••• Photo: Joe Raedle/ Getty Images

You are still able to get Obamacare, the informal name for the Patient Protection and Affordable Care Act. That's despite President Donald Trump's efforts to dismantle or repeal it. Here are four steps you can take get Obamacare now.

STEP 1 - Find Out If You Want To Get Obamacare (When: Now)

Anyone can get Obamacare, and you might be better off, depending on your circumstances. The next enrollment period is between November 1, 2019, and December 15, 2019. But you can always use the exchanges now to compare plans and find out how much of a subsidy you would get. Anyone can also use the exchanges to compare local physicians, hospitals, nursing homes, home health agencies, and dialysis services. Compare providers now.

If you don't have insurance, Obamacare affects you the most. If you've been without insurance this year, you'll longer be hit with a tax. President Trump's tax act repeals this tax effective 2019. But you could get hit with high medical costs. For example,  diabetes treatment costs $26,971 per family. Neurological disorders like multiple sclerosis cost $34,167 on average. If you get cancer, you'll face a $30,000 bill.

Even if you're young and healthy, you're taking a financial risk by not getting insurance. If you go to the emergency room, you pay about $1,265 on average. If you can easily afford this, then it's worth the risk. If not, you might face bankruptcy. In fact, the number one cause of bankruptcy in this country is healthcare-related costs. That's just one of the many reasons why you should have health coverage.

If your income is below $45,000, the government will subsidize some or all of your premium. In that case, Obamacare will most definitely be cheaper. Healthcare.gov helps you figure this out.

If your income is low enough (for example, less than $18,000 for an individual or $35,000 for a family of four), you may qualify for free insurance through Medicaid if your state expanded coverage. Healthcare.gov helps you determine if you are eligible for Medicaid.

In some states, you can't get expanded Medicaid but at least you won't have to pay the tax. Healthcare.gov lists whether your state has expanded Medicaid coverage.

If you are under 30, you have two additional options. First, you can go on your parents' plans until you are 26. Second, you can buy a less-expensive catastrophic plan. It covers emergency room visits and hospital stays, but only three regular doctor visits. 

If you have insurance, you can keep it whether it's a company plan or one you bought yourself. That's true even if it's catastrophic insurance, a retiree plan, COBRA or any other qualifying health plan. Keep in mind that a Discount Plan, Vision Care or Dental Discount Plan, or Worker's Comp does not qualify as insurance.

Even if you have insurance, go ahead and compare it to Obamacare plans. You may be able to get better coverage at a lower cost.

There are three ways this could happen:

  1. Your plan was "grandfathered in." That means it was in existence before March 23, 2010, and, therefore, doesn't have to offer the Obamacare benefits. These include the 10 essential benefits, protection from being dropped if you get sick, and the ability to put your adult children on your plan. 
  2. You qualify for a subsidy or free health care. If, for example, you make less than $50,000 for an individual or$100,000 for a family of four, the government may pay for all or part of your insurance.
  3. Your company drops your insurance plan. The Congressional Budget Office found that happened to 3 million to 5 million employees.

    You Have Medicare or Medicaid - You already have Obamacare.

    You're a Small Business Owner - You must provide health insurance or pay a fine. 

    STEP 2 - Compare Plans (When: Now)

    If you've decided to take advantage of Obamacare, then go to the health insurance marketplace. You'll be prompted to enter your state since some of them have their own marketplaces. You'll then create an account using your name and email address. You'll then create a user name, password and answer three security questions. You will receive an email to authenticate your account. In addition to shopping for plans, you can find out how much in subsidies you qualify for. To do that, you'll need your Social Security number, and your most recent W2, 1099, or other income information.

     

    Compare the premiums, deductibles, and copays between the plans. All plans will offer services in each of the 10 essential benefit categories, as well as the other Obamacare benefits. Plans are grouped into four different categories, arranged by the amount of coverage. Those with the least coverage have the lowest premiums. Here's how much you'll pay in total health care costs for the plans in each category:

    1. Bronze - 60%
    2. Silver - 30%
    3. Gold - 20%
    4. Platinum - 10%

    STEP 3 - Purchase the Plan You Want (When: November 1, 2019 - December 15, 2019)

     Starting November 1, you can buy the plan you want. There are five factors that predict how much Obamacare will cost you. One is the type of plan. The other four are your age, income, family size, and location.

    STEP 4 - Coverage Begins (When: January 1, 2020)

    You must submit payment 15 days before coverage begins.

    To save money on Obamacare, see my book "The Ultimate Obamacare Handbook."