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AARP Bulletin

The Affordable Care Act's Insurance Marketplace Opens for Business

Americans can now shop for health coverage in a new way. Here’s what you need to know

5. I'm a 63-year-old widow making $50,000 a year. My employer doesn't offer insurance. Do I qualify for financial help in the marketplace?

No, unfortunately, your income puts you over the limit for help. You will be responsible for paying all of your premium costs.

6. When do I need to sign up?

Open enrollment runs Oct. 1, 2013, to March 31, 2014. People who enroll by Dec. 23 will have coverage as of Jan. 1. Enrolling after that means coverage begins about a month after signing up. The application form has just three pages for individuals and seven pages for families — much shorter than the typical insurance form. To get started, go to HealthCare.gov or telephone the 24/7 call-in number 800-318-2596.

(Tip: You'll learn what financial help you qualify for when you fill out your application. You can also learn about what the law means to you and your family at HealthLawAnswers.org.)

7. What if I don't use a computer?

You can shop by phone at 800-318-2596. In many states, trained "navigators" will provide assistance. You also can shop with the help of licensed insurance agents and brokers.

(Tip: Foreign language assistance will be available in 150 languages.)

8. I have cancer, and my wife has diabetes and high blood pressure. Can we get insurance through the marketplace?

Yes, even if you've been turned down before, you can use the marketplace to buy coverage. Nearly half of Americans 55 to 64 have a preexisting condition that in the past could lead to denial of coverage. As of 2014, insurance companies are prohibited from denying coverage because of preexisting conditions.

(Tip: The only exception is grandfathered individual plans — which someone buys directly, not through an employer. If you have such an individual plan with coverage restrictions and you develop a medical condition it won't cover, you can use the marketplace to switch plans.)

9. I'm turning 65 this year. Can I use the marketplace if I want to?

Only if you are not eligible for Medicare. The marketplace is primarily for people under age 65 who need insurance.

(Tip: If you have Medicare, or if you turn 65 in 2013 and enroll in Medicare, you don't need to buy insurance through the marketplace.)

10. I lost my job and now work part time. My employer doesn't offer insurance for part-timers. Can I use the marketplace?

Yes, and you may qualify for financial aid. For example, a single, 61-year-old nonsmoker making $35,000 would be eligible for a subsidy and pay about $277 a month in premiums for the mid-level silver plan.

Pick the Best Coverage Level For You

  • Plans sold in the marketplace will offer the same set of essential health insurance benefits — doctor visits, emergency services, lab services, hospital stays, preventive services, prescription drugs, mental health and other categories of care.

  • You can choose from four levels of coverage: bronze, silver, gold and platinum.

  • The least-expensive premiums come with a bronze plan that pays about 60 percent of the cost of care, with the consumer paying about 40 percent out of pocket. The more costs that are covered, the higher the premiums: A silver plan will pay 70 percent, gold 80 percent and platinum 90 percent of the cost of care.

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