Health insurance choices

The Affordable Care Act (also called the ACA or Obamacare) gives Americans new choices for health insurance. Health insurance (also called health coverage or health plan) helps you pay for medical care.

Your health insurance choices depend on things like where you live and how much money you make.  You may get your health insurance from your employer (where you work) or your partner’s employer. Or you may get it from the government or buy it on your own. No matter where you get it, health insurance is important to help you pay for medical care for you and your family.

For more information about health insurance choices, go to:

What are your health insurance choices?

Depending on your annual income (the amount of money you make each year), you may be able to get your insurance from:

  • Your employer or your partner’s employer
  • A private insurance company
  • Medicaid or the Children’s Health Insurance Program (also called CHIP). Medicaid is a government program that provides free or low-cost health insurance to people with low income. CHIP is a government program that provides health insurance to children and some pregnant women in certain families with low income.

You can find out about different kinds of insurance from the Health Insurance Marketplace (also called the Health Insurance Exchange). This is an online resource that helps you find, compare and buy health plans in your state. You answer some basic questions, and the Marketplace shows you your insurance choices and the cost for each. Then you can pick the plan that works for you and fill out an application to enroll. Find your state’s Marketplace at: www.healthcare.gov/what-is-the-marketplace-in-my-state.

For more help choosing a plan, you can talk to a Navigator. This is a person who’s trained to help you understand your insurance choices. She can tell you about the plans you’re looking at and what each one offers. She also can help you fill out forms and find out if you can get help to pay for your coverage. Navigators are available 24/7 (every day, all day and all night) at:

If you or your partner work, do you have to get insurance through your employer?

It depends. Many people get health insurance through their employer or their partner’s employer. In fact, this may be your best option for insurance if it’s affordable. Under the law, affordable means that it costs less than 9.5 percent of your household income. Household income is the total income from everyone who lives with you, including anyone who files a tax return.

If your employer offers an affordable health plan, you can still choose to buy insurance from the Marketplace, but you can’t get a tax credit (a discount) to help you pay for it. For example:

  • If your household income is $40,000 a year and the health plan offered by your employer costs less than $3,800 a year, this may be the best insurance plan for you. If you choose not to take this plan through your employer, you can still buy a plan offered in the Marketplace but you can’t get a tax credit to help pay for it.
  • If your household income is $40,000 a year and your employer’s health plan costs more than $3,800 a year, you may be able to get a tax credit for plans offered in the Marketplace. You can decide which plan is best for you - your employer’s or one from the Marketplace.

To help you figure out how much your employer health plan costs, you can:

  • Look at the plan information you get from your employer.
  • Talk to someone from the human resources department at your work.

If you get your health insurance through your employer, it may be limited if you work part time. And not all employers offer coverage for employees’ families. If your employer doesn’t have coverage for family members, you can look for coverage for them in the Marketplace. 

For more information on getting health insurance through your employer or your partner’s employer, visit:

If an employer’s health insurance is too expensive, or if you’re unemployed or self-employed, what choices do you have for health insurance?

Starting October 1, 2013, you can use the Health Insurance Marketplace to find a plan that meets your needs. If you pick a plan from the Marketplace before December 31, your coverage begins January 1, 2014. If you choose a plan after December 31, your coverage may not be in place for a few months .

When you use the online Marketplace to get your insurance, it tells you the amount of financial help you can get. Many Americans will qualify for (can get) help to pay for health insurance. The amount of help depends on a few important questions, like:

  • How much money do you earn each year (your annual income)?
  • How many people are in your household (live with you)?
  • Does your employer offer an affordable health plan?

The Marketplace uses your answers to these questions to figure out how much help you can get to pay for health insurance. For example:

  • If you’re younger than 65 and earn less than about $15,000 a year, you may qualify for (be able to get) Medicaid. Medicaid is health coverage offered by your state government. The income amount for Medicaid is different for each state. To learn more about your state’s Medicaid program, go to: https://www.healthcare.gov/do-i-qualify-for-medicaid
  • If you earn more than about $15,000 a year, you may be able to get help paying for health care costs, including premiums, deductibles and co-pays. But if your income reaches a certain level, you don’t qualify for this kind of help. For example, if you’re a family of 3 and your annual income is at least $73,000, you can’t get a tax credit to help pay for insurance. To see how much of a tax credit you may be able to get for health insurance, go to: http://kff.org/interactive/subsidy-calculator/

You can use the information you get in the Marketplace to help you choose a health plan that you can afford and that meets the needs of you and your family.

 

Most common questions

What is happening with health care reform?

While some provisions take effect this September (see our In-depth article), the new law will not fully go into effect until 2014. In the interim, the March of Dimes is reviewing and commenting on the rules for implementation that are being issued by the Administration.

The March of Dimes will update this site on items that directly affect women of childbearing age, infants and children, but to get even more information about all of the advances, visit http://www.healthcare.gov/.

Where can I find out about getting insurance coverage for my child?

The first place to inquire is with your state insurance commissioner's office. The U.S. Department of Health and Human Services also has a Web site to help parents determine if their children are eligible for free or low-cost health coverage under the reauthorized Children's Health Insurance Program. Visit http://www.insurekidsnow.gov/ for more information.

Why did the March of Dimes support health care reform?

Since our founding, the March of Dimes has worked to shape public policy that affects maternal and child health. Health reform offered an unparalleled opportunity to improve the health of and address the needs of women, infants and children. Specifically:

  • Expanding and improving coverage for maternity and pediatric care
  • Strengthening Medicaid (which covers more than 40% of all births)
  • Increasing the number of currently uninsured women of childbearing age and children who will be covered in 2014

By law and longstanding tradition, the March of Dimes is strictly nonpartisan and remained nonpartisan throughout the debate. Initially, we worked with members with many different views and party affiliations, but as the debate went on, we focused our energies on ensuring that legislation likely to be approved contained the strongest provisions possible to address the unique health needs of children and pregnant women.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).