Health Care Reform FAQ’s

You have questions, we’ve got answers.

The Affordable Care Act, or Obamacare, requires most people to have health insurance with a deadline for open enrollment of January 31, 2017. We have answers to the most common questions about how this will affect you and your family, below. For questions that are not answered here, please call 760-736-6734, and an NCHS enrollment specialist will be happy to help you.

Q: What is Open Enrollment?
A: The yearly period when people can enroll in a health insurance plan through the Health Insurance Marketplace. For 2016 coverage, the Open Enrollment Period is November 1, 2016 – January 31, 2017. People may qualify for Special Enrollment Periods allowing them to enroll outside of Open Enrollment if they have certain life events, like getting married, having a baby, or losing other coverage.

Q: What is Covered California?
A: Covered California is an online marketplace where you can shop for and compare health plans. You can choose a plan that best fits the needs of you or your family at a price you can afford. Depending on your income and family size, you may be eligible for tax credits to help pay for your new health plan. For help choosing a plan and seeing what tax credits you may qualify for, please call an NCHS enrollment specialist today at 760-736-6734.

Q: Is a private health plan purchased through Covered California considered minimum essential coverage?
A: Yes! All Covered California health plans, whether they are the catastrophic/minimum coverage, bronze, silver, gold or platinum, are considered qualifying health plans.

Q: What is Medi-­‐Cal?
A: Medi-­‐Cal offers free or low-­‐cost health coverage for California residents who meet eligibility requirements. Most individuals who apply through Covered California and enroll in Medi-­‐Cal will receive services through managed care health plans, similar to the majority of the health coverage options available through Covered California. On January 1, 2014, California expanded Medi-­‐Cal eligibility for some low-­‐income adults. When you complete a Covered California application, your application will be automatically reviewed for Medi-­‐Cal eligibility.

Q: Is there a deadline to enroll in Medi-­‐Cal?
A: You can enroll in Medi-­‐Cal during any month of the year. If you are eligible for Medi-­‐Cal, you are eligible for the entire month in which you were found eligible. In some cases, you may be able to get Medi-­‐Cal coverage right away. Contact one of our enrollment specialists for FREE assistance today. We can help you apply for Medi-Cal, fill out the paperwork and schedule you for your first appointment, 760-736-6734.

Q: What is the ‘Individual Mandate’?
A: If someone who can afford health insurance doesn’t have coverage for 9 out of 12 months of the year, they may have to pay a tax penalty. The tax penalty is sometimes called the “individual responsibility payment,” or “penalty.”

Q: What is the penalty if I do not have coverage?
A: The penalty for not having coverage is either a flat dollar amount, or a percentage of your household income, whichever is greater. The penalty will be increased over the next two years.

  • In 2015, the annual penalty is the greater of:
    • $325 for each adult and $162.50 for each child, up to $975 per family
      OR
    • 2% of the tax filer’s annual household income minus the federal tax filing threshold. (See Table 1 for 2012 filing information.)
  • In 2016 and beyond, the annual penalty is the greater of:
    • $695 for each adult and $347.50 for each child
      OR
    • 2.5% of the tax filer’s annual household income minus the federal tax filing threshold.

Q: Are immigrants required to purchase health coverage?
A: Most immigrants who are lawfully present in the U.S must have health insurance coverage in
2014 or they will have to pay a tax penalty. Immigrants who are not lawfully present in the U.S. are exempt from the individual mandate and will not pay a tax penalty if they do not have health insurance.

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