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If you are a US citizen or are “lawfully present,” and do not qualify for Medicaid or Medicare, you probably qualify for the federal program known as “Obamacare.”

(Being lawfully present includes having a green card and having a valid non-immigrant visa. You can find a more comprehensive list of immigration statuses that meet the requirements here.)

Qualifying for “Obamacare” does not mean that you are also eligible for a subsidy. (A subsidy is also known as a tax credit.)

Eligibility for “Obamacare” means that you cannot be denied coverage for an insurance policy due to your medical history. However, you won’t find anything in the program that ensures that what you pay will be affordable.

The main requirements to get an Affordable Care Act subsidy include qualifying for “Obamacare” and having a Modified Adjusted Gross Income within certain limits. For most people, their adjusted gross income will equal their MAGI. If you receive non-taxable Social Security income or interest that is exempt from taxes, it may be different.

See table below:

Medicaid and ACA subsidy chart
Family
Size
Medicaid
Limit
“Obama Care” Limit
1 $15,856.20 $45,960.00
2 $21,403.80 $62,040.00
3 $26,951.40 $78,120.00
4 $32,499.00 $94,200.00
5 $38,046.60 $110,280.00

 

About Obama Care Insurance Rates

The net cost of your premiums may be greatly affected by whether or not you qualify for a subsidy. For many Americans, the higher cost of the 2014 policies will be more than balanced by the subsidy they will receive. If you qualify for a subsidy, you should look at the exchange policies first. (Call us. We are authorized to help you on the State of Connecticut’s health exchange, which is also known as the marketplace.)

If you do not qualify for a subsidy, you should consider buying a policy off the exchange. There may be an off exchange policy that is less expensive or is better for your family in some other way. We can help you choose between various on exchange and off exchange options. And help you enroll in coverage. Please call us if you would like to take advantage of our services.

Qualifying for Obama Care Subsidies

If health insurance benefits are available to you from an employer, or a family member’s employer your family will likely be unable to qualify for a subsidy. However, if the group insurance policy from work is deemed unaffordable or if it does not meet the minimum standards, you may still qualify for a subsidy.

If the cost of insuring the employee on the least expensive plan the business offers and that meets the minimum is less 9.5% of the household income, it is deemed affordable. And yes, you read that right they compare the cost of insuring only the individual employee with the income of the entire household. (Hopefully they will fix that for next year, but that is the way the regulations read currently.)

Obamacare Facts and Myths

We have heard many half-truths about how this program will affect Connecticut residents. Some if it is probably politically motivated. Some is simply the result of people misunderstanding a complex law.

One myth we would like to dispel is that you have to do your enrollment by yourself or use a navigator or assistor. Although a navigator or assistor can help you determine whether you qualify for a subsidy, they cannot help you choose a policy. They cannot answer questions about deductibles, copays or provider networks.

Joel and I are authorized to help you enroll on the exchange. We are also appointed with several companies that sell off the exchange. We can answer your questions about the Affordable Care Act, the enrollment process and the policies themselves.

And… your price each month will be the same as if you did it without the help of a broker.

We can save you time and can give you the information you need to shop and to select the best plan for your family. I hope you will give us the opportunity to serve you now and in the coming years.

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Alston

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