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Frequently Asked Questions

When does the federal law require that I buy insurance and what happens if I don’t?
Effective January 1, 2014, the law requires all U.S. citizens and legal residents to have qualifying health insurance coverage. Those who do not obtain coverage will pay a tax penalty. 

Will my current coverage qualify as minimum essential coverage?
Visit Healthcare.gov to find details on your particular coverage.

I want health insurance but I can’t afford it. What can I do?
The law may assist individuals who were not able to afford coverage in the past. Depending on annual income, an individual may qualify for premium subsidies to help pay for health insurance premiums. These subsidies will be available for individuals with incomes from 100 to 400 percent of the federal poverty level (FPL). Subsidies are on a sliding scale of income. The FPL is based on the number of family members. For example, in 2014, 400 percent of the FPL is $58,320 for an individual and $119,280 for a family of four.

Cost sharing reductions, or discounts that lower the amount you have to pay out-of-pocket for deductibles, coinsurance, and copayments, may be available for incomes from 100-250% FPL.  Alaska Natives are eligible for zero cost-sharing if incomes are 100-300% FPL. 

I own a small business with fewer than 50 full-time employees. Do I have to provide health insurance for them?
No. The law requires that, starting in 2014, employers with 51 or more full-time employees provide coverage or pay a penalty. The law offers a tax credit to qualifying small employers with fewer than 25 full-time employees. You must pay at least 50% of your full-time employees' premium costs to qualify.

I’m a veteran. What will happen to my health care coverage?
The law does not make any changes to VA benefits.  

Will the healthcare reform help cover my Medicare prescription drug costs that are not covered in the Medicare Part D “donut hole”?
Medicare beneficiaries who reach the gap in prescription drug coverage known as the “donut hole” will receive a $250 rebate in 2010. Beginning in 2011, those in the “donut hole” will receive a 50% discount on prescription drugs; thereafter, phasing out the gap until elimination in 2020.

I have a Medicare Supplement (Medigap) plan. Must I make any changes to my plan under the new law?
No. The law does not require Medicare beneficiaries to change their Medigap coverage.