Patients Purchasing Insurance Coverage:
Under the ACA, individuals are required to obtain insurance coverage beginning in 2014 or face tax penalties. This includes both adults and children who are legal US citizens. This provision is often referred to as the “individual mandate.” Those currently uninsured, without employer-based insurance or other coverage and ineligible for public programs, will be required to attain coverage, and will be able to do so through the State Insurance Exchanges.
Learn More: Individual Mandate
Tax Credits are available to individuals of low-to middle-income levels who are purchasing insurance in the Exchanges. These credits take the form of subsidies which are applied to the plan premium (or “premium subsidies”).
Learn More: Tax Credits (Premium Subsidies)
Patients are able to enroll in the Exchanges through a variety of methods, including both electronic and paper applications, as well as in-person, phone, and internet options. Patients also have the benefit of a single enrollment process to determine their eligibility for all ACA options.
Learn More: Patient Enrollment
States offer a variety resources to help consumers with selection and enrollment in plans. In some states, specific personnel can help consumers prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplace as well as providing general outreach, education, and referrals.
These patient assistors are called: Patient Navigators, Certified application counselors, and in-person assistance personnel.
Learn More: Patient Navigators