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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

11. My employer offers insurance, but I can't afford to pay for my husband's coverage. Can I use the marketplace?

Yes, but financial assistance depends on whether the government considers your employer's plan "affordable." To qualify, your employer's plan must require you to pay more than 9.5 percent of your total household income for your own coverage. And you can use the marketplace if your employer's plan doesn't meet certain minimum standards and doesn't pay at least 60 percent of your expected health care costs.

If you and your husband's total household income is $80,000, the cost of your own employee coverage must be more than $7,600 annually to get help paying for your premiums.

(Tip: Fill out the Employer Coverage Tool at

12. Will I pay more or less for insurance when I buy through my state's marketplace?

That depends. An analysis by the Kaiser Family Foundation found prices varying widely from state to state. Several states, including California and New York, are projecting lower rates. Maryland and Connecticut also revised their estimates downward, by 33 percent and 36 percent, respectively.

A report by the U.S. Department of Health and Human Services found that the average silver plan many people are expected to buy may be much less expensive than anticipated in 11 states studied. Insurers are permitted to charge higher rates for older people — though less than what many companies charge older people now — and may charge smokers a 50 percent premium surcharge. But six states and the District of Columbia are prohibiting all or part of the smokers' surcharge.

13. What happens if I don't buy any kind of health insurance and remain uninsured?

You may have to pay a tax penalty on your federal income tax. The law exempts from penalty religious groups opposed to accepting insurance benefits, Indian tribes and people whose household income is below the threshold for filing a tax return, among others. The phased-in penalty for not having insurance in tax year 2014 is $95 per adult or 1 percent of income, whichever is more, and for a family, the higher of $285 or 1 percent of income.

(Tip: There's a grace period of three months every year, so you won't get fined if you are uninsured for short periods of time.)

Marsha Mercer is a freelance writer in the Washington, D.C., area who covers health policy.

Member Discounts! Save on eye exams, prescription drugs, hearing aids and more


Make a list of your questions: For example, "Can I stay with my current doctor? Will I be covered when I travel?"

Gather your key personal information: Your paycheck stub or 2012 tax return, Social Security number, insurance policy numbers

Watch out for scammers: Don't give money or personal information to people who call or show up at your door, claiming to be from the marketplace

Bring your patience: This is a huge new program and — as when Medicare Part D prescription drug coverage was first rolled out — there have been glitches

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