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FAQs

Q?What is the difference between Navigators and Web Brokers?
A.

Agents and Web Brokers are licensed thru the state and require continuing education yearly. Our Partners at Policy Online Network Agents are fully market place certified and it is our business to make sure we take care of our clients. Our platform is an approved W.B.E. or web based entity by CMS to offer these plans exclusively on the exchangeor off the exchange. Navigators are NOT licensed to sell insurance. They are just there to help with questions and point someone in the right direction. The training for a navigator is 20 hr course. Either method you use to enroll will not cost any money for the consumer.

Q?Are you the same the government sites?
A.

We have no Affiliation to the Government or any of the government sites. We are all Marketplace certified and our technology platform has been approved as a Web Based Entity to offer you the coverage and subsidies if  you qualify. We do not off any MINI- MEDS or any plans that do not have the minimum essential benefits. The Applyforobamacare.org site is strictly used for information. You will not be asked for any Personal Information. In order to proceed you will need to call in or request a call. That will eliminate any confusion about selecting a plan.

Q?What Is PPACA?
A.

Patient Protection and Affordable Care Act
From Wikipedia, the free encyclopedia
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Patient Protection and Affordable Care Act Great Seal of the United States.
Long title The Patient Protection and Affordable Care Act
Colloquial acronym(s) PPACA
Nickname(s) Affordable Care Act, Health Insurance Reform, Healthcare Reform, Obamacare
Enacted by the 111th United States Congress
Effective March 23, 2010
Most major provisions phased in by January 2014; remaining provisions phased in by 2020
Citations
Public Law 111–148
Stat. 124 Stat. 119 through 124 Stat. 1025 (906 pages)
Legislative history

Introduced in the House as the “Service Members Home Ownership Tax Act of 2009” (H.R. 3590) by Charles Rangel (D–NY) on September 17, 2009
Committee consideration by: Ways and Means
Passed the House on October 8, 2009 (416–0)
Passed the Senate as the “Patient Protection and Affordable Care Act” on December 24, 2009 (60–39) with amendment
House agreed to Senate amendment on March 21, 2010 (219–212)
Signed into law by President Barack Obama on March 23, 2010

Major amendments
Health Care and Education Reconciliation Act of 2010
Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011
United States Supreme Court cases
National Federation of Independent Business v. Sebelius

v
t
e

The Patient Protection and Affordable Care Act (PPACA),[1] commonly called Obamacare[2][3] or the Affordable Care Act (ACA), is a United States federal statute signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act, it represents the most significant regulatory overhaul of the country’s healthcare system since the passage of Medicare and Medicaid in 1965.[4]

The ACA aims to increase the quality and affordability of health insurance, lower the uninsured rate by expanding public and private insurance coverage, and reduce the costs of health care for individuals and the government. It provides a number of mechanisms—including mandates, subsidies, and insurance exchanges—to increase coverage and affordability.[5][6] The law also requires insurance companies to cover all applicants within new minimum standards and offer the same rates regardless of pre-existing conditions or sex.[7][8] Additional reforms aim to reduce costs and improve healthcare outcomes by shifting the system towards quality over quantity through increased competition, regulation, and incentives to streamline the delivery of health care. The Congressional Budget Office projected that the ACA will lower both future deficits[9] and Medicare spending.[10]

On June 28, 2012, the United States Supreme Court upheld the constitutionality of most of the ACA in the case National Federation of Independent Business v. Sebelius. However, the Court held that states cannot be forced to participate in the ACA’s Medicaid expansion under penalty of losing their current Medicaid funding.[11][12] The ACA continues to face challenges in Congress, the Courts, and from some state governments.


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Q?What If I need coverage before Jan 1 , 2014
A.

You can buy individual insurance that starts before January 1, 2014. We can help you find your options. But some rights and benefits won’t apply yet.

Having health insurance is important

Having health insurance is important to your health and financial security. If you don’t have coverage now and need it before the Marketplace is open, you have several options. You can buy directly from an insurance company, with the assistance of a broker or agent, or using an online service.

You can also use our Plan Finder website to get information on available plans in your area and compare costs and benefits. You can then contact the insurance company directly to buy a plan.

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Q?What If I don’t have coverage in 2014?
A.

If someone can afford it but doesn’t have health insurance coverage in 2014, they may have to pay a fee. They must also pay for all of their care.

When the uninsured need care

When an uninsured person requires urgent—often expensive—medical care but doesn’t pay the bill, everyone else ends up paying the price.

That’s why the health care law requires all people who can afford it to take responsibility for their own health insurance by getting coverage or paying a penalty.

People without health coverage will also have to pay the entire cost of all their medical care. They won’t be protected from the kind of very high medical bills that can sometimes lead to bankruptcy.

The fee in 2014 and beyond

The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher.

In 2014 the fee for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285.

It’s important to remember that someone who pays the fee won’t get any health insurance coverage. They still will be responsible for 100% of the cost of their medical care.

After open enrollment ends on March 31, 2014, they won’t be able to get health coverage through the Marketplace until the next annual enrollment period, unless they have a qualifying life event.

Minimum essential coverage

To avoid the fee in 2014 you need insurance that qualifies as minimum essential coverage. If you’re covered by any of the following in 2014, you’re considered covered and don’t have to pay a penalty:

  • Any Marketplace plan, or any individual insurance plan you already have
  • Any employer plan (including COBRA), with or without “grandfathered” status. This includes retiree plans
  • Medicare
  • Medicaid
  • The Children’s Health Insurance Program (CHIP)
  • TRICARE (for veterans and veteran families)
  • Veterans health care programs
  • Peace Corps Volunteer plans

Other plans may also qualify. Ask your health coverage provider.

Who doesn’t have to pay the fee

Uninsured people won’t have to pay a fee if they:

  • are uninsured for less than 3 months of the year
  • are determined to have very low income and coverage is considered unaffordable
  • are not required to file a tax return because their income is too low
  • would qualify under the new income limits for Medicaid, but their state has chosen not to expand Medicaid eligibility
  • are a member of a federally recognized Indian tribe
  • participate in a health care sharing ministry
  • are a member of a recognized religious sect with religious objections to health insurance

If you don’t qualify for these situations, you can apply for an exemption asking not to pay a fee. You do this in the Marketplace.

What kinds of health insurance don’t qualify as coverage?

Health plans that don’t meet minimum essential coverage don’t qualify as coverage in 2014. If you have only these types of coverage, you may have to pay the fee. Examples include:

  • coverage only for vision care or dental care
  • workers’ compensation
  • coverage only for a specific disease or condition
  • plans that offer only discounts on medical services
Q?9 Ways Health reform protects
A.

Whether you need health insurance coverage or have it already, the health care law offers important rights and protections.

Here are 10 ways the health care law protects you today and in 2014:

  1. Creates the Health Insurance Marketplace, a new way for you to get health coverage
  2. Requires insurance companies to cover you if you have a pre-existing health condition
  3. Provides free preventive care
  4. Covers young adults under age 26
  5. Helps you understand what you’re getting with a clear Summary of Benefits and Coverage
  6. Holds insurance companies accountable by reviewing rate increases and making sure you get more value for your premium dollars.
  7. Makes it illegal for health insurance companies to arbitrarily cancel your health insurance just because you get sick
  8. Protects your choice of doctors
  9. Ends lifetime and yearly dollar limits on coverage of essential health benefits
Q?Why should people with insurance pay to cover those who don’t have it? They are already paying for the uninsured.
A.

American families with insurance pay a hidden tax of roughly $1000 for the cost of caring for people without insurance. As more Americans become insured, that hidden tax will begin to disappear. In addition, covering everyone will put downward pressure on costs. Bringing younger, healthier people into the system will spread the risk. As more Americans become covered, insurance companies will compete for their business. That will begin to lower costs. And health insurance reform will create stability and security for everyone. If you lose or change jobs you will have the peace of mind of knowing that you will always be able to find an affordable health insurance option for your family.

Q?You keep talking about expanding insurance coverage by cutting Medicare. Why would health reform be good for seniors?
A.

The savings being proposed from Medicare won’t harm patient care. In fact it will improve it. We are talking about eliminating billions of dollars in overpayments to insurance companies that do nothing except benefit the insurers’ bottom lines. We will go after waste, fraud and abuse that do not improve care for seniors. Not only will these changes enable us to improve the quality of care for seniors, they will stabilize Medicare and put it on better financial footing.

What’s clear is that if we don’t begin to rein in escalating health care costs, Medicare will be threatened over the long-run.

Health reform will benefit seniors in many ways:

We are committed to shrinking the donut hole in Medicare Part D that has forced so many seniors—more than 4 million every year—to pay exorbitant costs out of pocket or go without the drugs they need.
We are also committed to creating a pathway for the approval of generic biologic drugs. Cutting-edge biologic medications are currently very expensive and are out of reach for many seniors. It is important to make generic versions of these drugs available as soon as possible.
For those of you who retire between the ages of 55 and 64, health reform will provide financial assistance to employer health plans that cover early retirees, bringing down health costs and premiums by as much as $1,200 per family per year for some plans.
We want to strengthen preventive care under Medicare—no co-payments for checkups and wellness visits. Much of the money we spend on health care goes to treat chronic diseases which could be prevented from becoming more serious if patients received more preventive care. Preventive care is especially important for seniors, because it will increase the chance that your doctor can catch an illness in its early stages.
Most importantly, by reducing waste and improving the efficiency of Medicare, the Administration will strengthen the program to be sure it is always there for you and the generations to come. As you know, the Medicare Trust fund is projected to run out of money in about 8 years. Health insurance reform would extend the life of the fund for additional years—through at least 2022—and give it greater stability and security.

Q?What Is an Insurance Exchange?
A.

The health insurance exchange is a marketplace that will offer affordable high-quality health insurance options. It will provide relief to families who have no insurance or do not get adequate insurance at work and cannot afford to buy it in the costly individual or small group market. It is also for small businesses that cannot afford small group health insurance. It is one-stop shopping that will enable you and your family to find a plan that is right for you.

For workers at big companies with group coverage, you can keep what you have with new protections against unfair insurance regulations that could limit your coverage if you get sick. And if you lose your job, move or decide to leave that company, you will know that there will be high-quality affordable health insurance options available for you on the exchange.

Q?What are the benefits of the public option?
A.

Health reform must be built on three fundamental principles: It must lower the skyrocketing cost of health care; guarantee choice of doctors and plans; and assure quality affordable health care for every American. A public option would achieve those goals and give the American people more choices. It would foster greater competition; lower costs; and give consumers a greater variety of affordable choices.