Wisconsin Insurance Services - Serving Green Bay, WI and the Fox Cities
  • Home
    • Home (Spanish)
  • About
    • About (Spanish)
  • Appointment
    • Appointment (Spanish)
  • Articles
  • T
  • Home
    • Home (Spanish)
  • About
    • About (Spanish)
  • Appointment
    • Appointment (Spanish)
  • Articles
  • T

Afordable Care Act (ACA) / Obamacare QA

​"Obamacare" is the popular name for the Patient Protection and Affordable Care Act of 2010.1 Whether you purchase Obamacare insurance or not, the Act has already affected you in ways that no one has told you. Use these facts to get all the benefits you can from this comprehensive piece of legislation. 
Obamacare Affordable Care Act

​1. Sixty Percent of Those Who Are Eligible for Obamacare Subsidies Don't Even Know It ​

​Seventeen million people qualified for subsidies because they did not have insurance from their employer. Those that were eligible had to have a legal immigration status and their income was too high to qualify for Medicaid. However, only 6.6 million did sign up. Don't be one of the 10.4 million people who didn’t sign up and are missing out on this assistance for you to have health insurance. Review your options to find out if you qualify.

2. Do I qualify for Medicaid?

​If your income is below 138% of the federal poverty level (FPL) and your state has expanded Medicaid coverage, you may qualify for Medicaid based on your income.

Many times, children qualify under CHIP (Children’s Health Insurance Program) and the parents qualify for Obamacare.
Picture

​3. Do I qualify for Obamacare?

Obamacare offers subsidies, also known as tax credits, that work on a sliding scale. They limit the amount you pay in monthly premiums to a percentage of your annual income.
To qualify for Obamacare subsidy, you must meet the following criteria:
  • You are currently living in the United States
  • You are a US citizen or legal resident
  • You are not currently incarcerated

4. How much subsidy do I qualify for?
  • Depends on the Adjusted Gross Income (AGI) from your taxes, zip code, age and the number of people in your household.  See your agent to help you determine your subsidy.

5. ACA Already Improved Healthcare and Your Insurance Plans
These improvements include: 
  • All plans must provide 10 essential health benefits.
  • Plans can no longer exclude those with pre-existing conditions.
  • Companies can no longer drop those who get sick.
  • Parents can add their children up to age 26 on their plans.
  • Lifetime limits are eliminated.
  • Annual limits are eliminated.

6. Can I have Obamacare and Medicare?
No.  These are two separate plans and you can only qualify for one or the other. Both are Federal Programs.

7. Do I qualify if I am undocumented?
No, undocumented immigrants that live in the United States cannot receive Obamacare benefits. But the ACA does expand community health clinics to serve them.  These clinics will provide preventive care for chronic illnesses. As a result of this preventative care, the uninsured will use expensive emergency rooms less, lowering healthcare costs for everyone.

8. If I have a pre-existing condition, do I still get coverage?

A preexisting condition, such as cancer, made it difficult for many people to get health insurance before the ACA. Most insurance companies wouldn’t cover treatment for these conditions. They said this was because the illness or injury occurred before you were covered by their plans.Under the ACA, you can’t be denied coverage because of a preexisting health problem
The same was true with chronic health problems there is no underwriting so eligible applicants won’t be decline due to their previous health history.  Before ACA many people would not be covered for these conditions costing the healthcare system more for emergency treatment rather than preventative.  There is also a limit to how much can a member pay annually this is called Maximum Out Of Pocket.  The ACA puts limits to how much a member has to pay for medical care a year.
​
9. Can I still sign up for Obamacare?
In Wisconsin, the Open Enrollment Period (OEP) is November 1st to January 15th. Outside of the open enrollment period, you can still get health insurance 2 ways:
  • If you qualify for a Special Enrollment Period due to a life event like losing other coverage, getting married, or having a baby.
  • If you or your dependents lost coverage through Medicaid or CHIP.
11. Which Obamacare plan should I choose?As an insurance broker, I have been working on assisting member since the first year ACA / Obamacare became law.  I am contracted with all the Insurance Carriers approved with the Marketplace for Affordable Care Act (ACA) plans in Wisconsin.  We can look at your specific needs and based on your current situation, I will make a recommendation for the best option for you and your family.Looking aheadThe ACA is subject to changes every year. The legislation can be amended, and budget decisions can affect how it’s implemented. Changes in the healthcare field, along with changes to the political makeup of future presidential administrations and Congress, make it likely that the ACA will continue to change for years to come.
For more information or to assist you in the process to your eligibility and enrollment call me, text or email me for an appointment.  It will be my pleasure to assist you.
Neither Wisconsin Insurance nor its agents is connected with the Federal Medicare Program.


Wisconsin Insurance Services
200 S Washington - Suite 300, Green Bay, 54301
Green Bay: 920-366-0081

Milwaukee: 
414-748-9660

Follow us on SoCial Media