Multiple Question Form Determines Eligibility

Application for Health Insurance

Note: as of 2015 there have been a lot of changes to the healthcare website, and its usefulness, since the time that it rolled out on October 1, 2014. Paper forms for the Affordable Care Act are most often found at insurance agencies or other venues where you can sign up for your plan the old fashioned way. Nonetheless, your healthcare navigator or helper is most likely to provide you with a computer, or use one while filling out the info, so you can shop for the best rates. A streamlined 21 page application, which cuts down the standard 200 page form for health insurance, is designed to determine your eligibility for coverage under the Affordable Care Act.

One of the defining features of this form is the number of questions designed to actively disqualify you from subsidies and coverage if you could potentially get your healthcare from anywhere else, or if your income would be too high to get coverage. The form itself is fairly long and may discourage people from using it, especially since a typical tax form is only a few pages.

Multiple Exclusions Apply.

At first, it would seem that qualification is easy, since a family of 4 can get coverage if they make as much as $92,000 per year. You or your family may qualify for free or low cost insurance under CHIP (the Children's Health Insurance Program) or private plans using a special tax credit. You will need social security numbers, birthdates, income and employer information for everyone in the family, which come in the form of W2 and pay stubs, and current policy numbers for health insurance as well as details of any job-related health plans for which your family may qualify. What is strange about the application is that it says that if you do not have all of the information, you should sign and submit it anyway. Very few government documents will let you get away with providing incomplete information.

Lots of Questions

Application for Health InsuranceOne of the first questions on the form is whether or not you are pregnant, and how many children you are expecting. (Finally, a form designed for Octomom!) There are questions about whether you plan to file a tax return, whether the people in your family are citizens, and what average wages for each 2 weeks are. There are questions about whether someone may have changed jobs, stopped working, and worked fewer hours in the past 6 months. There are even questions about how much money people may make from self-employment, in the event that Walter White is looking for cheap healthcare. If any member of the household is eligible for healthcare, it is important to get the details for this as well. One of the questions "Do you think the employer's coverage is affordable" is always good for a laugh. All of this information is used to determinal eligibility under the Health Insurance Marketplace which is cross-referenced with your tax return. Good Luck!

For the 2015 filing year, which ends soon, there has been a lot of intellectual horsepower added to the website but you are still advised to see if you can get healtcare through an employer given that you will have to prove your income after you get your subsidies under Healtcare.gov. Many people are finding out in the 2014 tax year that they are on the hook for all the subsidies that they got over the months that they were signed up, though some in fact are getting more back if they overestimated their incomes. Others may find that people advised them to claim a lower income, but are those "experts" going to front you the money that you have to pay back? However you get your legally mandated health insurance, you need to understand your income level, how much insurance you really need to have, and how much you can afford to pay. Even though there is a penalty for not having coverage, you may be one of those types that would rather pay 2.5% than a much higher price for healthcare, despite the fact that a catastrophic illness or injury might cost the equivalent of several years' salary.