Affordable Care Act Questions & Answers
Real People – Real Questions – Real Answers About Health Reform
The following questions are from residents about cost and enrollment in a health insurance plan. Buncombe County Health and Human Services helped provide these answers.
Q: I have no income. Is it mandatory to sign up? How will I pay for coverage if I don’t have income?
Everyone needs to be enrolled in health coverage by March 31st to avoid penalties. You might be eligible for Medicaid or qualify for federal premium subsidies, which will allow you to obtain health insurance under the Affordable Care Act.
For individuals who qualify, federal premium subsidies can reduce the cost of insurance to as low as $0 each month. Meet with an authorized agent to help you learn about your options and figure out what your cost is after subsidy.
Q: My income is less than $11,000 and I have no other subsistence. I can’t afford any other expenses.
We encourage you to talk with representatives at Buncombe County Health and Human Services at 40 Coxe Ave. to determine if you are eligible for Medicaid. NC did not expand Medicaid, and individuals must earn more than 100% of the Federal Poverty Level ($11,490 for a household of 1) to be eligible for federal premium subsidies under the Affordable Care Act.
Q: Without Medicaid expansion in North Carolina, it’s made things very difficult for people to get the health care they need. Will this help me get Medicaid assistance if I’m not able to find a job?
Even if you have never received services before, or if you think you may not meet the eligibility requirements, we encourage you to talk with an authorized agent or a caseworker at the Department of Health and Human Services at 40 Coxe Avenue. They can help you determine if you are eligible for Medicaid or Subsidized Health Insurance under the Affordable Care Act.
In addition, they can also determine if you qualify for a “Cost Share Reduction Subsidy” which provides enhanced benefits like lower co pays & deductibles for individuals who earn less than 250% of Federal Poverty Level. There are no medical questions to enroll, and pre-existing medical conditions are covered immediately. Plus, all preventive health care is covered at no cost.
Q: If I can find a job (down the road), I will sign up — when I can afford to. Will I still be penalized? If so, why sign up? I don’t need the IRS on my back.
Authorized agents can help you learn about your options. Some of the plans will not cost you anything if you qualify for premium subsidies and preventive health care can be offered at no cost.
If you meet income guidelines or are in an exempt category you will not be penalized, and it will help you comply with IRS regulations.
Q: What health insurance company can you trust not to rip you off? That’s the big problem and that’s why I’m skeptical about signing up.
Healthcare Reform protects consumers by requiring all health insurance companies pay out 85% of each dollar they receive from premiums for actual medical claims. In addition to that, health care reform requires health insurance companies to pay 100% of all preventive care so the consumer doesn’t pay anything. It helps to talk with an authorized agent who can help you match a plan with your healthcare needs.
Q: I’m a veteran and go to the VA hospital for healthcare. I get treated at no expense. Do I have to sign up?
No. Veterans who have coverage from the VA Administration (For example – Champus) already have health insurance which qualifies as creditable coverage; therefore, they are not eligible to receive Subsidized Health Insurance under the Affordable Care Act.
