Free Obamacare Frequently Asked Questions

The Inflation Reduction Act (IRA) of 2022 extended the enhanced ACA premium subsidies through 2025, allowing eligible individuals to receive lower premiums based on income¹.

The 2025 federal ACA Open Enrollment period ran from November 1, 2024, to January 15, 2025 ². We know life is hard and enrolling in an Obamacare healthcare coverage plan shouldn’t be so we are here to help.

In short, the “metal” rankings break down how much of the cost that you (the insured) pay. Currently, the breakdown is: (Source: Healthcare.gov)

• Bronze plans pay ~60%, you pay ~40%
• Silver plans pay ~70%, you pay ~30%
• Gold plans pay ~80%, you pay ~20%
• Platinum plans pay ~90%, you pay ~10%

We know that all of the different kinds of plans can be confusing which is why you should call us to help you determine which insurance is best for you.

One of the large impacts of this legislation is health insurance and the marketplace because the American Rescue Plan has made a lot of changes in the affordability of insurance, who can qualify for help and much, much more.

Under the American Rescue Plan (ARP) enhancements, many individuals with income below approximately 150% of the Federal Poverty Level (FPL) may qualify for a Silver-level plan with $0 monthly premium, depending on plan premiums in their area and household size. Not everyone under 150% FPL will qualify, as eligibility depends on actual plan costs³.

To be eligible for ACA premium subsidies, you must²:

• Live in the U.S. and be a U.S. citizen, U.S. national, or lawfully present non-citizen
• Not be incarcerated
• Have household income between 100% and 400% of the FPL (in most cases)
• File federal income taxes and not be claimed as a dependent on another tax return

We would love to help you check your ability to get Free Obamacare and Insurance under the Affordable Care Act. Please call us at 877-561-3360.

The ACA Open Enrollment period is the annual window—typically November through January—when individuals and families can sign up for or renew Marketplace medical coverage. Some plans may include optional vision or dental².

ACA is an acronym that stands for the Affordable Care Act, otherwise known as “Obamacare.” The Affordable Care Act was a sweeping healthcare reform law passed in 2010 that made affordable healthcare attainable to all citizens of the United States.

ACA Open Enrollment began November 1st, 2024! Open Enrollment ends on January 15, 2025.

Can I apply for ACA anytime?

You can qualify outside of open enrollment if you have a qualifying life event or qualify for Medicaid or CHIP (Children’s Health Insurance Program).

There are a few different types of qualifying life events that will allow you to enroll in Obamacare outside of the enrollment period²:

• Losing health coverage (e.g. losing a job)
• Getting married, having a baby, or adopting a child
• Permanently moving to a new area
• Gaining U.S. citizenship or lawful presence
• Changes in income affecting subsidy eligibility
• Errors by the government or marketplace.

The purpose of the ACA (or Obamacare) was to ensure that everyone would have access to affordable health care. There are many plans to choose from and because subsidies are provided for Obamacare then the majority of people can find an affordable healthcare plan that meets their needs. If you need assistance navigating the healthcare marketplace, please call us at 877-561-3360 and let us help you find the coverage you need.

Unless it is currently an open enrollment period or you meet one of the many “Qualifying Life Events” qualifications, pregnancy alone does not make you eligible to enroll in Obamacare.

Under the ARP subsidies, the maximum percentage of income paid toward benchmark plan premiums was capped at 8.5%, regardless of income above 400% FPL. However, plan costs vary, and actual premium percentage may be lower depending on income and subsidies⁴. Please call us at 877-561-3360 so we can help estimate the cost.

Under the ARP subsidies, the maximum percentage of income paid toward benchmark plan premiums was capped at 8.5%, regardless of income above 400% FPL. However, plan costs vary, and actual premium percentage may be lower depending on income and subsidies⁴.

You may need identification and immigration documents such as: Green Card (I-551), I-94, EAD, passport, as well as income verification (e.g. pay stubs, tax returns). Requirements vary based on immigration status².

We would love to review your situation and see if you qualify for Obamacare, the best solution is to call us at 877-561-3360.

To qualify for ACA premium subsidies, you must generally file a federal tax return; most married couples will need to file jointly².

Due to more people being eligible, even small business owners are thinking about Individual plans and with the Health Reimbursement Arrangement (HRA) rules in place, this is definitely something to consider. Please call us at 877-561-3360 so we can discuss possible options.

A Health Reimbursement Arrangement (HRA) is an employer-funded benefit that reimburses employees tax-free for medical expenses, which can include ACA Marketplace premiums if structured properly (e.g., QSEHRA or Individual Coverage HRA). Employers control the allowance; unused amounts may roll over depending on plan rules⁵.

Yes! You can still get health coverage if you meet any of the life events that will allow you to qualify for a Special Enrollment Period. Some examples include marriage, moving, having a baby, and more. More people than ever before qualify for help paying for health coverage, even those who weren’t eligible in the past!

When we help you apply for Marketplace coverage, you’ll find out if you qualify for a premium tax credit that lowers your monthly premium.
The amount of your premium tax credit depends on the estimated household income for 2024 that you put on your Marketplace application.
Find out if your estimated 2024 income is in the range to qualify for a premium tax credit toward your Obamacare.

There are some situations where you may qualify. Please call us at 877-561-3360 and let us discuss the coverage your employer is offering and whether or not you qualify for free Obamacare.

Later this year, you may be able to get another increase in premium tax credits. HealthCare.gov will have more information available in the summer once these additional savings are available to those who got unemployment compensation during 2021. At that time, you can go back to HealthCare.gov to update your Obamacare application and current plan with more tax credits to lower your premiums for the rest of the year.

Yes, you can purchase Marketplace coverage and qualify for subsidies based on your income but premiums for Marketplace plans can and do vary by age.

We would recommend you maintain your Medicare coverage. Companies selling plans from the Marketplace are not allowed to sell them to you if they know you have Medicare. Remember that just like the Marketplace, Medicare has general enrollment periods as well. This period begins January 1st and ends on March 31st and coverages take effect in July of the same year. If you happen to miss your initial enrollment, you may even get penalized:

• If for whatever reason you sign up for Part B after you are initially eligible (or drop it and re-sign up at a later date), you may see an increase in your monthly premium of 10% (multiplied by however many years you could have had the coverage but did not).

• There is also the possibility of a late enrollment penalty if you did not have Part D coverage. This penalty is about 1% of the national average premium amount and is multiplied by every month you didn’t have coverage equal to the standard Part D.

As you can see, it is in your best interest to maintain your Medicare benefit but if you still are not certain, please call us at 877-561-3360.

No, plan cancellation is not automatic and you must contact your Marketplace policy issuer to have your plan canceled when your Medicare coverage is set to begin.

Yes. If you’re turning 65 and do not qualify for premium-free Medicare Part A, you can apply for an ACA Marketplace health plan—as long as you’re lawfully present in the U.S. (undocumented immigrants are not eligible for Marketplace coverage).

You may also qualify for premium tax credits to reduce your monthly premiums, depending on your income and household size. In 2024, eligibility starts around $14,580 for an individual, and enhanced subsidies are available through at least the end of 2025 under the Inflation Reduction Act.

If you’re physically able, you can continue working to earn enough work history to eventually qualify for premium-free Part A. Until then, you can stay covered through the Marketplace. Just remember: Once you become eligible for premium-free Medicare Part A, you are no longer eligible for ACA premium subsidies—Medicare becomes your primary coverage⁶.

You are not eligible for premium tax credits if you have other forms of minimum essential coverage such as affordable employer-sponsored insurance, Medicare, Medicaid, CHIP, TRICARE, or VA benefits².

• Employer-sponsored coverage, unless you can’t afford it because you have to contribute more than 9.83% of your household income or it doesn’t meet the minimum required coverages. There are some special considerations made in regard to family coverages as well. Please call us at 877-561-3360 for more assistance.
• Medicare, Medicaid, Children’s Health Insurance Program (CHIP), Veterans insurance, TRICARE, etc.
• Peace Corps volunteers insurance

But even with some coverages, you may still be able to get premium tax credits, given certain requirements are met:

• Individual health insurance
• Student Insurance
• Covered by your parent’s group health plan (you must be under 26 and not claimed as a dependent).
• Former employer’s retiree health insurance
• COBRA

• Any change to the amount of income you expect for the year. To see how to estimate your income and what you need to include go to healthcare.gov
• If anyone in the household has been offered health coverage at work, regardless of enrollment.
• If anyone in the household starts receiving Medicaid, Medicare, Children’s Health Insurance (CHIP), etc.
• If anyone in the household suddenly loses coverage due to loss of job or Medicaid.
• Any changes in the household (birth, adoption, death, marriage, divorce, pregnancy, child reaching the age of 26).
• Moving to a different coverage area.
• If there are any corrections to your vital statistics (name, date of birth, or social security number)
• If your status changes (disability, tax filing, citizenship/immigration, American Indian/Alaska Native/Tribal Member, Incarceration/release)

To report changes, you only need to update your application. There are several ways you can update your application: online, by phone, or in person. Unfortunately, you are not able to update your application by mail.

Yes, you can. You can collect the credit as a refundable tax credit once you file and reconcile your federal tax return.

Yes! You can claim it when you file your federal taxes because the premium subsidies are going to be available for 2021 through 2022.

For the year 2021 only, the following were true:

1. Marketplace – You could qualify for enhanced subsidies for plans on the Marketplace and eligibility was based on your annual income. BUT, for 2021 only, even if you received unemployment benefits for only a single week then your income above 133% of the federal poverty level would be ignored. With that and your tax credit, you could qualify for the zero-premium, benchmark silver plan and you would probably qualify for reduced cost sharing which brings your plan deductible down to less than $200 on average.

2. COBRA – You may have been qualified for up to 6 months of FULL COBRA premium subsidies if you lost group plan coverage after losing your job due to the American Rescue Plan. But, this particular assistance was only temporary and only for 2021. 

Unfortunately this one-time extra savings is no longer available for Marketplace coverage so you may get less financial help.

COBRA, or Consolidated Omnibus Budget Reconciliation Act, is insurance coverage offered that helps certain individuals who have recently become unemployed and lost their medical coverage.

It is possible you could afford a plan with a lower deductible using the increased premium tax credits. Even state-based marketplaces may let you switch to a more affordable plan that includes lower deductibles.

We can assist you in locating coverages through most major insurance groups.

Once you have signed up for Obamacare it typically takes effect the following month.

The ACA(Obamacare) is what helped make it possible for everyone to have access to affordable healthcare. When we help you apply for Marketplace coverage you’ll find out if you qualify for a premium tax credit that will help lower your monthly premium as well, so please call us at 877-561-3360 for more assistance.

You may still be eligible for an affordable healthcare plan because your employment status does not factor into whether you are eligible. Your Obamacare insurance coverage eligibility is based on your household size and income.

Yes, Obamacare covers all pre-existing conditions, including cancer. No one can be denied coverage or charged more because of a health condition. Your monthly premium will depend on your age, county of residence, tobacco use, and the plan level (bronze, silver, gold, or platinum).

If you miss Open Enrollment, you may still qualify for coverage through a Special Enrollment Period (SEP) if you experience a Qualifying Life Event like losing other coverage, getting married, having a baby, or moving. Also, the American Rescue Plan’s enhanced subsidies are available through August 2025, which may help reduce your monthly premiums if you qualify.

You may be able to keep your doctor, but it depends on the plan’s network. ACA plans vary, and not all doctors accept every plan. When enrolling, you can check the provider network of each plan to see if your preferred doctors or clinics are covered. Financial assistance through the Marketplace does not restrict you from choosing your doctor—it just lowers your monthly cost.