No comments yet

Affordable Care Act/Obamacare Q and A updated

Affordable Care Act/Obamacare Q and A updated              2/1/2018

By Rick Howie




Q: Did I miss the open enrollment deadline? 

A:  Yes, the deadline for 2018 coverage for all qualified health plans (metal level) was January 31, 2018 and there was no extension granted this year.   However, even though Open enrollment is now over, many people are still eligible to get coverage.  For details please read below, and/or, call us at 914-968-4717 to make an appointment with one of our Navigators.


Q: What are the tax penalties for not having health insurance?

A:  For tax year 2017, the penalty is $695 per adult plus $347.50 per child, pro-rated, (with a maximum of $2,085 per family) or 2.5% of family income, whichever is greater.   However, it appears that these penalties may have been put on hold and may be ended in the future.


Regardless of the penalty, could you or your family afford an un-insured hospitalization?


Q: Can I still get medical insurance?

A: This depends:

  • If your projected 2018 income is below $24,120 (single), $32,480 (couple), $40,840 (couple + child), $49,200 (family of 4) you may qualify for Medicaid or an Essential Plan.
  • Children or pregnant women – yes.
  • If you meet any of the “Special Enrollment Exceptions” listed below you may also be eligible:


Special Enrollment Exceptions:

Individuals and families can enroll in a private health plan after January 31, 2018 if they have had a Qualifying Life Event.  Qualifying Life Events Eligible for a Special Enrollment Period include:

  • Loss of minimum essential coverage
  • Marriage or domestic partnership, birth, adoption, or placement in foster care
  • Becoming a citizen, national, or lawfully present individual
  • For those already enrolled in a QHP (qualified health plan), becoming newly eligible or ineligible for tax credits; or eligible for a different amount of cost sharing reductions (ie job loss)
  • Permanent move to NY, or permanent move from one county to another within NY

Not considered a Qualifying Life Event:

  • Voluntarily dropping other health coverage
  • Being terminated for not paying your premiums

What numbers do I call:

  • Customer Support Center at 1-855-355-5777 for more information and help applying.
  • Westchester Disabled On the Move (WDOMI) – 914-968-4717 for face to face Navigator assistance in applying at no cost to you. This service is open to all New Yorkers.

Post a comment