Basics
- Obamacare Basics for Iowa - (Basics)
Rates
- Obamacare Rates for Story County - (Rates)
How to Enroll
- Obamacare Enrollment - (How to Enroll)
Financial Help
- Obamacare Financial Assistance - (Financial Help)
Life Situations
- Obamacare for Different Life Situations - (Life Situations)
- Using Your Obamacare Health Insurance Plan - (Using Your Plan)
- Obamacare News - (News)

ADVERTISEMENT

Iowa Obamacare FAQ

ADVERTISEMENT

Answers to Your Questions About the Affordable Care Act in Iowa

ADVERTISEMENT

 

Updated: 2021-05-04 by

ADVERTISEMENT

 

<   FAQ Contents

What is Obamacare and the Affordable Care Act?

Obamacare is the shorthand name for the federal Affordable Care Act (ACA), which was signed into law by President Barack Obama in 2010.

This wide-reaching law does many things, but most significantly it:

  • protects consumers -- for example, by requiring insurance companies to cover people with pre-existing conditions and preventing them from arbitrarily canceling your coverage
  • allows states to expand Medicaid coverage
  • creates marketplaces (also called "exchanges") for health insurance plans that meet the requirements of the ACA, and
  • establishes new funding for public health and prevention.

Until 2019, the law also required most U.S. citizens and legal residents to have health insurance or, if they didn't, to pay a tax penalty. Beginning in 2019, however, the penalty goes away in all states except those that have enacted their own penalties. Currently, the list of states with health insurance requirements includes California, D.C., Massachusetts, New Jersey, Rhode Island, and Vermont.

At ObamacareByZipCode, we focus on helping you understand how the Affordable Care Act works in Iowa, to help you get the coverage you need.

Learn More

Here are some topics that answer frequently asked questions about Obamacare.

Do I Have to Get Obamacare in Iowa?

How Much Does Obamacare Cost?

How Can I Save Money on Obamacare?

How Do I Sign Up for Obamacare in Iowa?


ADVERTISEMENT

 

<   FAQ Contents

Is Obamacare different from the Affordable Care Act?

They are identical. Obamacare is just a nickname for the Affordable Care Act (ACA). 

Here are some articles that answer frequently asked questions about Obamacare and the ACA.

What Is Obamacare and the Affordable Care Act?

Do I Have to Get Obamacare in Iowa?

How Much Does Obamacare Cost?

How Can I Save Money on Obamacare?

How Do I Sign Up for Obamacare in Iowa?


ADVERTISEMENT

 

<   FAQ Contents

What do Obamacare health insurance plans cover?

All health plans purchased through Healthcare.gov, the health insurance marketplace for Iowa, must include the following benefits whether or not you have a pre-existing health condition.

These are known under the Affordable Care Act  as “essential health benefits”:

  1. Ambulatory patient services (meaning outpatient care you receive without being admitted to a hospital)
  2. Emergency services
  3. Hospitalization (including surgery)
  4. Maternity and newborn care
  5. Mental health and substance use disorder services (including counseling and psychotherapy)
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices (for people with injuries, disabilities, or chronic conditions, to strengthen their mental and physical skills)
  8. Lab services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services (including oral and vision care)

Companies that offer plans through Healthcare.gov will compete on price and quality of service in delivering these benefits.


ADVERTISEMENT

 

<   FAQ Contents

Will I be penalized if I don't have health insurance?

Prior to 2019, if you didn't have health insurance and didn't qualify for an exemption, you would owe a penalty when you filed your federal tax return. For now, at least, that penalty has gone away. You must still report your coverage status on your federal tax return, but you won't have to pay a penalty if you aren't covered.

For more health insurance basics, see What Iowa Residents Need to Know About Obamacare.


ADVERTISEMENT

 

<   FAQ Contents

What if I already have health insurance?

If you used the marketplace to purchase a plan last year. Most people who purchased their 2020 insurance plan from an online marketplace will be able to automatically renew their coverage for 2021. While automatic renewal sounds convenient, it has serious downsides:

  • If your insurer decides to cancel your current plan, you could be switched to another plan without warning. The new plan may cost you more or change your eligibility for financial assistance.
  • Automatic re-enrollment could mean you aren't getting the right subsidy package. That could leave you facing higher monthly premiums now or -- if you take more assistance than you're eligible for -- a big tax bill later.
  • You may miss out on a better deal or better coverage if you don't compare all available plans to your current plan.

While allowing yourself to be automatically re-enrolled is better than going without insurance, it's best to take advantage of open enrollment and research your options. Shop around and evaluate new plans and costs. Even if you decide to stay with the plan you have, you can use open enrollment to confirm your personal information and ensure you're getting the right amount of financial aid.

If you purchased an individual or family insurance plan outside the online marketplace. As long as the plan meets Iowa’s coverage requirements, you can keep it. Or, you may use Healthcare.gov to compare plans and replace it. If you keep your current plan, you won't be eligible for the cost-saving subsidies available for plans purchased through the exchange.

Be sure to check with your current insurance provider before canceling a health insurance policy; you may have to wait until the end of your current policy year to make a change.

If you have insurance through an employer. As long as you're happy with your plan, you can keep it. You're considered covered under the Affordable Care Act. On the other hand, if you're not satisfied with the coverage you have, you may be able to switch to an individual plan through Healthcare.gov.

Keep in mind that if you buy a plan through the exchange:

  • Your employer will not have to pay a portion of your monthly premiums.
  • You may not qualify for cost-saving subsidies, even if your income falls within the eligible range. If your employer offers coverage that is considered affordable and sufficient under the law, you won't qualify to save on premiums or out-of-pocket costs for plans purchased through Healthcare.gov.

ADVERTISEMENT

 

<   FAQ Contents

Where can I get in-person help with my application?

In Iowa, if you need help understanding your options for coverage under the Affordable Care Act (Obamacare) or signing up for a plan, you can get assistance from a trained enrollment assistant or from a health insurance broker or agent.

An enrollment assistant (sometimes called a navigator, enrollment counselor, or something similar) can explain your options, answer your questions, and help you apply for the plan you choose -- but they can't recommend a specific plan for you. 

Private insurance agents or brokers can also help you understand your health care coverage options under Obamacare. Unlike government-trained navigators and counselors, they are allowed to suggest the best plan for you.

To find an assister in your area, go to Find Local Help at HealthCare.gov. There, you can enter your zip code to get a list of helpers near you.

Talk to a licensed broker. To directly connect with a Iowa insurance broker who can help you evaluate Affordable Care Act insurance plans and choose a plan that's appropriate for your situation, call 800-943-6832. (We receive advertising income from the licensed brokers who offer their services through this telephone number.)

For more information, see How To Sign Up for Obamacare in Iowa.


ADVERTISEMENT

 

<   FAQ Contents

What does "open enrollment" mean?

"Open enrollment" is the period of time, once a year, when you can choose or change your insurance provider or what kind of plan options you want -- for example, monthly premium and annual deductible amounts -- for the upcoming calendar year.

For the dates of the next open enrollment period, see What You Need to Know About Obamacare in Iowa.

Choose your health care plan carefully, because after you make your choice, you must usually live with it until the next open enrollment period.

"Special enrollment" is an exception to the usual enrollment rules. If you qualify for special enrollment, you can sign up during a time period outside of the open enrollment period. The circumstances under which you may qualify for special enrollment include:

  • moving to a new state
  • having a baby or adopting a child
  • getting married or divorced
  • leaving a job and losing your insurance
  • losing coverage under your parents’ plan
  • losing coverage because someone on your plan has died
  • losing other types of health insurance
  • gaining status as a member of an Indian tribe
  • becoming an American citizen, or
  • getting out of prison.

ADVERTISEMENT

 

<   FAQ Contents

What if I live in more than one state?

Purchasing a new individual insurance plan under the Affordable Care Act can be complicated if you spend a significant amount of time in more than one state or travel frequently. Here’s an overview of points to consider.

If You Live in More Than One State

If you truly split your time between two states, the federal regulations covering plans offered through an ACA marketplace say that you can purchase health insurance in one or both places. This is true as long you spend “an entire season or other long period of time” in your second home.

Keeping insurance in just one state. It’s undoubtedly easier and less expensive to buy and keep health insurance in only one state. If you go this route, you’ll be covered only for emergency care when you are outside of that state. And even in an emergency, charges may swell beyond your insurer’s limits for “reasonable and customary” care, leaving you at risk for a big medical bill in the event of a medical crisis.

Getting insured in two states. If you want to establish residency in both of the states where you live, you can buy a new insurance policy every time you move. That’s possible because your move is considered “permanent” under federal regulations. As long as you were insured in the first state, you’ll qualify for a special enrollment period to buy a new policy in the second state.

However, in addition to giving you a paperwork headache, buying insurance twice each year could turn out to be a very expensive arrangement. For example, your deductible and out-of-pocket max will restart every time you move—and maybe even a third time, if your stay in one state crosses into the month of January, when all plans restart for the calendar year.

Carefully consider your situation and talk with potential insurers—then read policies carefully—to be sure you understand your options, potential expenses, and the true extent of your coverage as you move from state to state.

If You Travel Frequently

An insurance plan that meets the requirements of the ACA should cover you if you have to get emergency care out of state. For other types of care, your coverage will depend on the particulars of your plan.

You may want to read the article, Don't Forget to Pack Health Insurance, from HealthInsurance.org for a deep dive into options for travel health insurance.

Learn More

For more health insurance basics, see What Iowa Residents Need to Know About Obamacare.


ADVERTISEMENT

 

<   FAQ Contents

Information & Documents to Have on Hand

Here's the information to gather before you visit Healthcare.gov to apply for health insurance:

  • Your household size. HealthCare.gov offers a tool to help you figure out who to include in your household.
  • Birth dates, Social Security numbers, and addresses for everyone in your household applying for coverage.
  • Proof that you are a U.S. citizen, U.S. national, or "lawfully present" in the United States.
  • Employer and income information for each member of your household. Include all income sources, such as your earnings from work, pensions, alimony, rental property, and other income. If you have a job, gather together pay stubs or W-2 forms. If you’re self-employed, have last year’s tax return handy, as well other records that can help you estimate your yearly income.
  • Your estimated household income for the coverage year. (For example, if you're applying in November of 2020 for coverage the next year, estimate your household income for 2021.)
  • Policy numbers and any Plan ID numbers for current health insurance plans covering you or other members of your household.
  • If you or anyone in your household is eligible for job-based health insurance, information about the plan costs and coverage for each available plan. (The Employer Coverage Tool offered by HealthCare.gov can help with this step.)
  • A good idea of your budget for health insurance, so you know how much you can afford to spend each month. This will help you choose the best plan from among those offered to you.

Finally, keep a list of any questions you want answered before you sign up for a health insurance plan. To get answers to many basic questions or for information on signing up for a plan, see How Do I Sign Up for Obamacare in Iowa?


ADVERTISEMENT

 

<   FAQ Contents

Glossary of Obamacare and Affordable Care Act Terms

Glossary

Glossary source: HealthCare.gov


ADVERTISEMENT

 

<   FAQ Contents

About This Website

We built this website to get people the answers they need about the Affordable Care Act (Obamacare). Our goal is to guide you to reliable, local information about your new health insurance options.

When you choose your state or enter your zip code here, you will quickly learn:

  • whether or not you're required to get health insurance

  • what the available plans cover

  • how much coverage will cost, and

  • how to sign up in your state.

For those concerned about cost, we show you how to determine whether you qualify for subsidies.

Why We Care

This site was created by Albin Renauer, founder of LegalConsumer.com, and is coauthored by Renauer and legal editor and writer Shae Irving. LegalConsumer, which originally concentrated on consumer bankruptcy, began in 2005, when Congress overhauled federal bankruptcy laws.

“When politicians tried to make it harder to file bankruptcy, I vowed to make it easier. When I read about politicians making it hard to get information about Obamacare, it got my blood boiling -- and I realized I could help folks find that information the same way I do with bankruptcy.”

Some states hide the ball when it comes to options for health care coverage under the Affordable Care Act. We want to guide you to all the official local resources you need to make sure you get the maximum benefits under the law.

Who We Are

LegalConsumer.com has helped more than a million consumers navigate the bankruptcy process by providing a free online “means test calculator,” which shows people whether or not they’re eligible to file for bankruptcy.

Albin Renauer

Albin Renauer is an independent web and database developer and Webby Award judge. He created LegalConsumer.com as an online companion to his book, How to File for Chapter 7 Bankruptcy, to help people file for bankruptcy.

After receiving his J.D. from the University of Michigan Law School in 1985, Albin Renauer worked for various public-interest law firms in the Bay Area and as a staff attorney for Chief Justice Rose Bird of the California Supreme Court.  He spent 17 years as an editor at leading do-it-yourself legal publisher Nolo, where he helped create numerous books and software programs, including the bestselling Quicken WillMaker. He also edited Law on the Net, the first online directory of legal resources, and was the architect of Nolo's Webby Award winning website.

Shae Irving

Shae Irving has been a legal editor and writer since 1994, when she joined Nolo, specializing in estate planning, health care, and family law issues. For almost a decade, she was the managing editor of Nolo’s bestselling Quicken WillMaker software. Her books include Living Wills and Powers of Attorney for California and Prenuptial Agreements: How to Write a Fair and Lasting Contract. Shae graduated from Berkeley Law and briefly practiced at a large San Francisco law firm before becoming an editor and author.

For More Information

Contact Albin Renauer.


ADVERTISEMENT

 

 

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Ames, IA: Law

ADVERTISEMENT