Frequently Asked Questions about the Affordable Care Act (ACA)

Click on any of the frequently asked questions about the Affordable Care Act below to see an answer from HealthKY.com.

Individual Responsibility To Have Health Coverage

I got a cancellation letter, what does it mean?

There are three options:

Your plan is still available but there’s a fine.
Your provider is informing you that your health plan is still available through them but it doesn’t meet the “minimum essential benefits” required by law. You will be charged a fine of $90 per adult and $45 per child each year if you keep your current plan.

Your plan has been cancelled.
Your provider has decided to terminate your plan because it doesn’t meet the “minimum essential benefits” required by law. They are informing you that if no action is taken on your part, they will automatically enroll you in a new plan that closely resembles your canceled health plan.

Your plan was “grandfathered in”.
If you purchased your health plan before March 23, 2010, you’ve been “grandfathered in” and no action is required at this time.

I lost coverage March 15 and didn’t get new coverage until April 1. Am I considered uninsured for the month of March because I lacked coverage for part of the month?

No, if you are covered even one day during a month, you are considered to be insured for that month. Similarly, a person who is considered exempt from the individual responsibility requirement for even one day during a month is considered exempt for that month.

How do I apply for an exemption?

For some types of exemptions, you must apply through the health insurance Marketplace; for other types, you must apply when you file your taxes; some types of exemptions can be claimed either way.

The religious conscience exemption and most hardship exemptions are available only by going to a health insurance marketplace and applying for an exemption certificate.

The exemptions for members of Indian tribes, members of health care sharing ministries, and individuals who are incarcerated are available either by going to a Marketplace and applying for an exemption certificate or by claiming the exemption as part of filing a federal income tax return.

The exemptions for unaffordable coverage, short coverage gaps, certain hardships and individuals who are not lawfully present in the United States can be claimed only as part of filing a federal income tax return. The exemption for those under the federal income tax return filing threshold is available automatically. No special action is needed.

I’m uninsured. Am I required to get coverage in 2014?

Everyone is required to have health insurance coverage – or more precisely, “minimum essential coverage” – or else pay a tax penalty, unless they qualify for an exemption. This requirement is called the individual responsibility requirement, or sometimes called the individual mandate.

How do I prove that I had coverage and satisfied the mandate?

When you file your 2014 tax return (most people will do this by April 15, 2015) you will have to enter information about your coverage (or your exemption) on the return. You should get a notice from your insurance provider by January 31, 2015, describing your coverage status during the previous year.

If I owe a penalty, when and how do I have to pay it?

If you do not maintain minimum essential coverage in 2014 and you don’t qualify for an exemption you will need to pay a “shared responsibility payment” to the IRS on your 2014 tax return. If you are like most people, you will need to submit your return by April 15, 2015.

What if someone doesn’t have health coverage in 2014?

If someone who can afford health insurance doesn’t have coverage in 2014, they may have to pay a fee. They also have to pay for all of their health care.

The fee is sometimes called the “individual responsibility payment,” “individual mandate,” or penalty.

How does the health care law affect me?

  • If you already have health insurance, you now have access to expanded preventative services like checkups, cancer screenings, mammograms and contraception at NO additional cost.
  • Young adults can now remain on their parents’ health insurance plan until the age of 26.
  • Many seniors will save hundreds of dollars each year on their prescription drugs.
  • Health insurance companies will no longer be able to deny you coverage or charge you more because of a pre-existing health conditions, including pregnancy or disability.
  • Beginning 2014, most people are required to have health coverage. If they don’t, they may have to pay a fee.
  • If you need help finding a plan, that’s what HealthTN is here for.