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Health Care Reform 101: FAQs

Posted by on in Insurance Talk - Archive
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If you’re feeling a little lost when it comes to the Affordable Care Act and what it means to you, you’re not alone. Last week I introduced some facts and resources you need to know to be better informed and to take action on October 1st, which is tomorrow. Today I have compiled some of the questions our members have been asking. I hope these FAQs will help you decide what steps you need to take next. 

What is a Health Insurance Marketplace?

Health Insurance Marketplaces are competitive marketplaces where consumers can shop for and purchase private health insurance. The Marketplace will help you get coverage that meets your needs and fits your budget. 

How can consumers afford the health insurance offered in the Health Insurance Marketplace?

Financial help is available to many consumers who are uninsured and have low income through tax credits and cost-sharing reductions. Taxpayers with household incomes between 100 percent and 400 percent of the Federal Poverty Level will qualify for a premium tax credit for themselves and member of their family who don’t qualify for other health coverage. Tax credits are based on household income and family size for the taxable year.

When can consumers enroll in a plan through the Health Insurance Marketplace?

The first open enrollment period will be October 1, 2013 through March 31, 2014. Consumers must select a plan by the 15th of the month for coverage to start on the 1st of the following month. No coverage will start before January 1, 2014.

What if I have a pre-existing health condition?

Starting in 2014, health insurance plans cannot refuse to cover you or charge you more just because you have a pre-existing health condition. Once you have insurance, the plan can’t refuse to cover treatment for pre-existing conditions and coverage for these conditions begins immediately. This is true even if you have been turned down or refused coverage due to a pre-existing condition in the past.

Why should I have health coverage?

Plans available in the Marketplace and most other plans provide free preventive care, such as vaccines, screenings and check-ups. Health coverage also protects you from high, unexpected costs like hospitalization.  When you purchase a health insurance policy the company agrees to pay part of your medical costs when you are sick or have an accident. As a reminder, the individual mandate requires most individuals to have minimum essential coverage in 2014 or pay a penalty. The penalty is called a shared responsibility payment. 

What if I have Medicare? Do I need to do anything?

Medicare isn’t part of the Health Insurance Marketplace so you don’t need to make any changes. If you have Medicare you are protected under the Affordable Care Act. 

Remember to consult with a licensed health care insurance agent if you have questions or if you are interested in receiving help to decide which policy is best for your personal needs. 

Special Note: Recently, the national news has reported that consumers are receiving phone calls from solicitors claiming to be health care insurance agents. Their goal is to get consumers to enroll and pay for a healthcare policy over the phone. These calls are scams. No one should be calling you to encourage you to make a decision for a particular health care policy. 

Refer to the online Marketplace at to review available coverage and visit to review more information. 

Brandei Burridge, LHIC, CBC, SGS, is a TDECU Insurance Agency licensed health care agent. 

If you wish to contact Brandei, call TDECU Insurance at 888.833.7358

Insurance products are not deposits; not NCUA insured; and not guaranteed by TDECU Insurance Agency, LLC or TDECU.

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  • Guest
    Caite Wednesday, 16 October 2013

    Good info - especially about the scam calls.

  • Guest
    Brandei Burridge Wednesday, 16 October 2013

    Thank you Caite for the great feedback! I'm so glad you enjoyed the article. If you have any questions about the Health Care Reform, I'd be happy to answer them for you. Have a wonderful day!

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Guest Wednesday, 23 April 2014
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