Updated: May 10
The Affordable Care Act has left a lot of Americans questioning how the program works and what the minimum coverage requirements are. Read our Frequently Asked Questions (FAQ) guide for a quick look at some of the answers to the most common questions on this program.
Q1: What programs meet the Minimum Coverage Requirements?
A1: There are several plans that meet these requirements. They include:
Plans purchased through Federal or State Exchanges
Veteran benefits, employer plans, and public programs such as Medicare and Medicaid
Grandfathered plans through employers
Contact your insurance provider or your human resources department to find out if your program meets the Minimum Coverage Requirements.
Q2: What will determine the price of insurance through the exchanges?
A2: There are four factors that will be used to determine the cost of your health coverage:
Premium Rating Area
The number of family members covered
Q3: Are there different insurance plans available?
A3: There are four levels of coverage (Platinum, Gold, Silver, and Bronze). Each level has a different amount of insurance premium and out-of-pocket expense. However, there is a maximum out-of-pocket expense determined by your income with each program. There are also catastrophic plans available that would cover you after you have reached your calculated annual limit.
Q4: What are Essential Health Benefits?
A4: Essential Health Benefits are items that are required to be covered by all health care plans. They include:
Ambulatory patient services
Maternity and newborn care
Mental health and substance use disorder services
Rehabilitative and habilitative services
Q5: What is the penalty for remaining uninsured?
A5: The penalties will increase each year. Please see the chart below:
Q6: Is there any method to avoid paying the penalty?
A6: There are exemptions from the penalty. They include:
Exempt non-citizens (illegal aliens)
Members of recognized religious sects (must have opted out of Medicare and Social Security)
Members of recognized healthcare sharing ministries
Low income taxpayers (be