Common Patron Inquiries
Affordable Care Act 101: Anticipating Common Patron Inquiries
There are a series of questions and information requests that will likely be common to many of your patrons seeking Affordable Care Act (ACA) marketplace guidance. The following includes examples of those questions, and suggestions for related resources to help clarify the answers. A very detailed collection of frequently asked questions and answers is also available through the Henry J. Kaiser Family Foundation. The resources shared here are intended to be broadly applicable across all states. However, please be sure to identify the marketplace operating in your state to understand if additional state-specific guidance is available.
What is the health insurance marketplace, and how do I access it?
HealthCare.gov is the official federal site for individuals with questions about the health insurance marketplace. It includes a one-page guide to understand the basics of the health insurance marketplace, including information on the important topic of Medicaid expansion and eligibility. It also provides information on how to apply for health insurance. A feature to verify the marketplace serving each state helps individuals connect with the most locally relevant resources.
How much will I have to pay if I purchase health insurance through the marketplace?
Like other types of insurance (home, auto, etc.), costs for health insurance depend on a number of complex factors that vary by individual. The Henry J. Kaiser Family Foundation provides a number of resources related to health reform. This includes a subsidy calculator, which provides estimates for potential healthcare costs or related savings, also known as subsidies. HealthCare.gov also provides information on frequently asked questions related to getting lower costs on health coverage.
Will people without some form of health insurance have to pay a fee? Where can I learn more about that?
Information on requirements for coverage, penalties for not having coverage, and exemptions from the penalty can be accessed at HealthCare.gov in response to the frequently asked question what if someone doesn’t have health coverage?
Are there certain timelines in which I must enroll? What if I miss these timelines?
There are a number of key dates associated with enrollment in the health insurance marketplace. You can review these dates at HealthCare.gov. You can also learn more about obtaining health insurance outside of these dates by exploring qualifications for a Special Enrollment Period. If your state is operating an independent marketplace, be sure to verify the timelines directly at your state’s marketplace site.
I'm a small business owner. Where can I learn more about health insurance options for my business?
The SHOP marketplace has been established to support small businesses with 50 or fewer full-time equivalent (FTE) employees. More details on the SHOP marketplace for business owners are available at the SHOP marketplace site. (Requirements and resources for businesses are otherwise outside of the scope of this guide.)