Getting covered through President Obama's health care law might feel like a combination of doing your taxes and making a big purchase that requires research.
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 needs.
The process involves federal agencies 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 the process triggers some anxiety, it's not the government poking in your medical records, as Obamacare foes have suggested.
• healthcare.gov. The official federal government website meant to help consumers learn everything they need to know about the Affordable Care Act. Here, you can learn about how to shop for insurance and what benefits the Affordable Care Act provides.
• Special Obamacare Report. This special project by The Star-Ledger offers comprehensive information about all aspects of the Affordable Care Act and its impact on patients, doctors, hospitals, nursing homes and more.
• www.state.nj.us/humanservices/dmahs/clients/medicaid/. The official New Jersey website for those seeking information on Medicaid.
• hhs.gov/opa/affordable-care-act/index.html. The U.S. Department of Health and Human Services website provides access to webinars explaining the new law and where to apply for funding opportunities related to ACA, including health information technology and other areas.
• irs.gov/uac/Affordable-Care-Act-Tax-Provisions-Home. The IRS website explains the new tax provisions in the law, and how they affect individuals, families, employers, and other groups.
• obamacarefacts.com/obamacarebill.pdf The complete text of the Patient Protection and Affordable Care Act.
After state health insurance exchanges or markets open Tuesday, Oct. 1, consumers 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.
THE MAIN STEPS
• Identify yourself and your family members.
• Provide current information on income, jobs and any available health insurance options.
• Learn how much financial assistance you’re entitled to.
• Shop for a health plan and enroll.
Many people, ranging from lower-income workers to the solid middle class, will qualify for tax credits to help buy a private plan through the state markets. 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.
WHAT TO EXPECT
Here’s an overview of what to expect when applying online:
• Go to healthcare.gov and click on “Get Insurance.”
You’ll set up an account and password. (Tip: Treat your password like a bank account or credit card password. It’s not a good idea to set it as “1234567.”)
• 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 immigration documents.
• 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 available.
• 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. How smoothly all this works is one of the big unknowns. It could get tedious if discrepancies take time to resolve.
• Provide the most accurate estimate of your expected income for 2014. If you’re like most people, you’ll be getting a subsidy (tax credit) to help pay your premiums. The credits are based on your income.
• With your subsidy, you can shop for insurance. Beware: You may have to live with your decision until the next annual enrollment period.
• Make sure your doctors and hospitals are in the plan you pick.
• 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.
• 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.
“The biggest challenge for consumers will be understanding health insurance and how to purchase it,” said Richard Onizuka, director of the Washington state market. He says picking a plan could be difficult. Most of his customers were previously uninsured, so insurance jargon could seem like a foreign language.
“The biggest challenge for consumers will be understanding health insurance and how to purchase it,” he saiYou’ll set up an account and password. You’ll provide your contact information and the best way to reach you.
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.
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