One of the confusing factors with Obamacare starting in 2014 is how do you buy coverage on the NC health care exchange? The main determining factors are whether or not you have health insurance options from an employer (either through you or a spouse) and what is the modified adjusted gross income (MAGI) for the household.
Here is a flow chart that tries to simplify this mess a little bit (click on picture to make bigger so you can see it):
To determine if your MAGI qualifies you for a government subsidy click here. Once this is determined then you will know whether or not you qualify for the premium reduction. All this will be a pretty seamless process behind the scenes since you will not see the subsidy; it will just be subtracted from your monthly premiums. These reductions for many will be substantial allowing for affordable coverage.
If you have employer coverage available chances are you would not qualify to buy coverage inside the exchange for anyone in the family. Why is this? Well by law your employer has to pay at least 50% of the employee’s premium. With the employer covering such a high percentage this will make most employee’s coverage be lower than the 9.5% used to determine affordability by CMS. We think this is a flawed measure by not counting in what it costs for the family to be on the plan….but it is what it is at the time.
Click here to learn more about your NC health care exchange options.