WASHINGTON (AP) - Getting covered under President Barack Obama’s health care
law might take you more than one sitting. In a media preview, it felt like a
cross between doing your taxes and making an important purchase that
requires research. “Nothing like this has ever existed before,” said Health
and Human Services Secretary Kathleen Sebelius.
You’ll need accurate income information for your household, plus some
understanding of how health insurance works, so you can get the financial
assistance you qualify for and pick a health plan that’s right for your
The process involves federal agencies electronically verifying your
identity, citizenship and income, and you have to sign that you are
providing truthful information, subject to perjury laws.
You heard it was going to be like buying airline tickets online? Not quite.
But even if it triggers some anxiety, it’s not the government poking into
your medical records, as “Obamacare” foes have suggested.
After state health insurance markets open Tuesday, people who don’t have
health care on the job can apply online, via a call center, in person or by
mail. Trained helpers are supposed to be available, but there may not be
enough of them in every state. Foreign language interpreters are available
through the call centers.
The main steps are:
- Identify yourself and your family members.
- Provide current information on income, jobs and any available health
- Learn how much financial assistance you’re entitled to.
- Shop for a health plan and enroll.
Many people will qualify for tax credits to help buy a private insurance
plan. The government will send money directly to your insurer, and you’ll
make arrangements to pay any remaining premium.
The poor and near-poor will be steered to Medicaid in states that agree to
expand that program.
Here’s an overview of what to expect applying online, with tips:
Go to healthcare.gov and click on “Get Insurance.” The site has links to
every state market. You’ll set up an account and password. You’ll provide
your contact information and the best way to reach you.
Tip - Treat your password like a bank account or credit card password.
Now you can tackle the actual application. You’ll need birth dates and
Social Security numbers for yourself and other family members listed on your
federal tax return.
You’ll also be asked if you’re a citizen. Legal immigrants will need their
Tip - You don’t have to plow through the entire application at once. You can
save your work and come back later.
Next, you’ll be asked about income.
You may need your most recent tax return, pay stubs and details on other
kinds of income, such as alimony, pensions and rents. You can still apply if
you haven’t filed a tax return. You’ll also be asked about access to health
insurance through your job. You may be required to take that insurance if
Your personal and income details will be routed through a new government
entity called the data services hub, which will ping agencies like Social
Security, Homeland Security and the Internal Revenue Service for
verification. The feds will also rely on a major private credit reporting
company to verify income and employment.
Tip - Provide the most accurate estimate of your expected income for 2014.
Lowball the number, and you might see a smaller tax refund in 2015.
Overestimate and you won’t get as big a tax credit now.
Most people applying will qualify for a tax credit to help pay premiums. The
credits are based on your income and keyed to the premium for a benchmark
plan known as the “second-lowest cost silver plan” in your area.
With your tax credit, you can finally shop for insurance. Be aware that
you’ll probably have to live with your decision until the next annual
You’ll have up to four levels of coverage to consider: bronze, silver, gold
and platinum. Plans at every “metal level” cover the same benefits and have
a cap of $6,350 a year in out-of-pocket expenses for an individual, $12,700
Bronze plans generally have the lowest premiums, but cover only 60 percent
of medical costs on average. Policyholders will pay the difference, up to
the annual out of pocket cap. Platinum plans have the highest premiums, but
cover 90 percent of costs. Young adults up to age 30 can pick a skinny
“catastrophic” plan - but you can’t use your tax credit on a catastrophic
Tip - Make sure your doctors and hospitals are in the plan you pick. You’ll
have to check the plan’s own website, or better still, call your doctor.
Tip - Your share of the premium could be lower - even zero - if you apply
your tax credit to a bronze plan. It’s because the credit is keyed to the
cost of a silver plan, which is generally more expensive.
Tip - Check if you are eligible for “cost-sharing subsidies,” in addition to
your tax credit. Extra help with out-of-pocket costs is available to people
with modest incomes. But only with a silver plan.