Here are answers to some frequently asked questions about the exchanges.
Q. Who can buy on the marketplace? Can I buy on the exchange even if I am not eligible for subsidies?
A. The exchange can be used by individuals, families and small business owners who have 50 or fewer employees.
Q. If I have insurance from my employer, do I have to do anything?
A. You don’t have to, but if you choose to do so, you can drop your employer’s coverage and buy a plan from the exchange.
Keep in mind, depending on the type of employment coverage available to you, you might not qualify for certain savings offered by the exchanges.
Q. Can I buy insurance through the marketplace if I already have a serious health problem?
A. Yes. The amount you pay for a health plan will not be affected by your health status.
This means that you can’t be charged more because of your health problem.
It also means you will not have to wait to get the coverage you need.
Q. If I have Medicare, can I purchase a plan on the exchange?
A. Yes, but you can’t get help paying for it.
Also, getting extra coverage on the exchange may not make sense.
That’s because Medicare will be your main coverage, but you would still have to pay for a full health plan at New York State of Health.
Talk about this with an exchange helper to figure out the right strategy for you.
Q. Some groups are exempt from being required to have coverage. Who are they?
A. The categories include people who would have to pay more than 8% of their income for health insurance, people with incomes below the threshold required for filing taxes, those who qualify for religious exemptions, members of Indian tribes, undocumented immigrants, and people who are incarcerated.
Sources: New York State of Health, Kaiser Family Foundation, HealthCare.gov
