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Commonly Asked Questions

Find answers to commonly asked questions about Obamacare, the new marketplaces, Medicaid, Medicare and Ryan White below. We have made every effort to provide accurate information in these questions, but you should contact the health insurance marketplace or Medicaid agency in your state for guidance on your specific situation.

The Basics

If I don’t currently have insurance, what are my options through Obamacare?

If I already have insurance (including through Medicaid or Medicare), do I need to do anything or will anything change for me?

What is health insurance and how do I know if I have it?

Am I required to have health insurance?

How do I sign up to get health insurance?

Can my wife/husband/partner/children get the same insurance as me?

What if I am lesbian, gay, bisexual, or transgender (LGBT)? Will that affect my health insurance coverage and options?

Can I be denied health insurance because I have HIV (or another pre-existing health condition)?

How much does health insurance cost?

Will I be charged more for insurance because I have HIV (or another health condition)?

What if I can’t afford insurance?

How do I determine my income?

Are my insurance options different because I am a person living with HIV?

Will my HIV medications be covered if I sign up for health coverage through Obamacare?

If I have Medicare, does Obamacare provide any support for prescription medications?

Is dental coverage available when I sign up for health coverage through Obamacare?

If I sign up for health insurance coverage will my HIV status be kept confidential?

When can I sign up for health coverage through Obamacare – officially known as the Affordable Care Act (or ACA)?

By when do I have to sign up?

Once I have enrolled, when does my new coverage begin?

The Ryan White HIV/AIDS Program and AIDS Drug Assistance Program (ADAP)

If I receive services from Ryan White or AIDS Drug Assistance Program (ADAP), do I still need insurance?

If I currently receive financial support from the Ryan White Program or AIDS Drug Assistance Program (ADAP), will that support still be available?

Can I still see my Ryan White/ADAP services provider under Obamacare?

Expanded Coverage through Medicaid

Who is eligible to get insurance through Medicaid?

What benefits are offered under Medicaid in a state that is expanding Medicaid?

What benefits are offered under Medicaid in a state that is not expanding Medicaid?

If my state is not expanding Medicaid and I can’t afford to buy insurance on my own what are my options?

Insurance Coverage through an Employer

Is my employer required to provide insurance?

If I don’t want to get insurance through my employer, do I have other options?

Does insurance coverage through an employer differ from coverage provided through other sources (such as purchased from a marketplace/exchange)?

If I lose my job, what are my insurance coverage options?

Insurance Coverage through New State Marketplaces/Exchanges:

Who is eligible to buy insurance through the new state marketplaces/exchanges?

How does health insurance purchased from a marketplace/exchange compare with that provided through other sources, like an employer?

What is the difference between the bronze, silver, gold and platinum plans offered in the marketplace?

Is there a limit on out-of-pocket expenses for insurance through the marketplace?

How do the different plans in the marketplace compare in terms of coverage of benefits for someone with HIV?

How do I know if I am eligible for additional financial support to help pay for a plan in the marketplace/ exchange?

If I move to another city/state do I need to change coverage in the marketplace/ exchange?

Can I keep my own doctor when I buy insurance in the marketplace/ exchange?

Will my prescription drugs be covered by my plan in the marketplace?

Problems and troubleshooting

Where can I get help enrolling?

What if I am denied insurance coverage?

What if I am denied a medication or a service I believe I need?

What if I believe my health plan does not understand my needs or is treating me unfairly?

I still can’t afford insurance, even with a subsidy. What can I do?

What is...

What is health insurance?

What is a state marketplace/ exchange?

What is Medicaid?

What is Medicare?

What is the Ryan White HIV/AIDS Program?

What is the AIDS Drug Assistance Program (ADAP)?

What is the Federal Poverty Level (FPL)?

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Your Insurance

What you need to know

We have made every effort to provide accurate information on this portal, but you should contact the marketplace or Medicaid agency in your state for guidance on your specific situation. Click here to find contacts in your state. All data on the site were updated April 2014 and are subject to change.

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