FAQ

Here are a few questions to help you get a better understanding of  Health Insurance Exchange and the Affordable Care Act in Florida.

What is a health insurance exchange?

It’s an online marketplace where individuals and small employers can shop for insurance coverage. Enrollment began Oct. 1 for policies that will go into effect on Jan. 1. The exchanges will also help people find out if they are eligible for federal subsidies to help cover the cost of coverage or if they are eligible for Medicaid, the federal-state health insurance program for the poor.

Do all states have exchanges?

Yes. Sixteen states and the District of Columbia are running their own exchanges and the federal government is setting them up in 27 states. In seven states, federal and state officials are partnering to run the exchanges. You can get information about the exchange at healthcare.gov, which has details on the federal exchanges and links to state-run exchanges.

Do I have to buy insurance on an exchange?

Some people do, but definitely not everyone. These exchanges are for two major groups of people: Those who don’t have insurance now, and those who currently purchase their own insurance, meaning they don’t get it through an employer.

If you have insurance at your job or through a public program like Medicare, Medicaid or the VA, you don’t need to pay attention to the exchanges unless you lose that coverage for some reason. If you have insurance through your employer, you can shop for and buy insurance on an exchange if you like, but you probably won’t qualify for a subsidy or tax credit. And you would lose the contribution your employer makes toward health insurance.

How does it work to shop for insurance from an exchange?

In theory, you can do it all or most of it online. You go to healthcare.gov or to your state-run exchange, if there is one, and create an account. You provide some basic information, like where you live and how old you are and you’ll get a list of plans available in your area. If you provide income information, you’ll be able to get an estimate of whether you’ll eligible for federal help paying for insurance or whether you might qualify for Medicaid.

The exchange will offer a list of health plans and their premiums and out-of-pocket costs, including deductibles and co-payments. If you decide to buy one of those plans, in most cases, you will be directed to the insurer’s Web site to make the payment. Some plans or insurance companies may require a phone call to set up payment. In some jurisdictions, consumers will make their first premium payment to the exchange and then further monthly payments to the insurer.

If your income makes you eligible for a tax credit subsidy, it will be applied upfront to the monthly premium payment. You won’t have to wait until you file your taxes in 2015 to get the credit.

You can also fill out paper applications or apply over the phone.

What determines my amount of Tax Credit?

Your tax credit is determined by how much total household income you report on your 1040 tax return and the number of members of your household you claim on your tax return including yourself.

What if I need help with signing up?

The federal government has set up call centers to answer questions from people in states with federal exchanges. However, Brevard Health Advantage has trained professionals that can help you with the exchange. We will gladly meet with you and discuss the exchange at no cost to you!