Are You Covered?

With the March 31st deadline looming, have you enrolled in a health plan through the health care marketplace yet? If not, don’t be surprised. According to a National Journal article, approximately one-fourth of uninsured Americans are not even aware that the health exchanges exist! There are a number of reasons for the lack of access to this information, but the major factor is poverty.  In an effort to make sure our A+J readers are informed, here is what you should know about signing up for Obamacare:

1.     The deadline for signing up is March 31, 2014

They’ve extended the deadline due to website glitches and to allow more time for young, healthy Americans to sign up. It is critical that more healthy people enroll than those with chronic conditions. That’s the only way this program will remain viable. According to the Congressional Budget Office (CBO), approximately 6 million people will have to be enrolled…so sign up folks!

FYI – If you enroll by March 31st deadline, your coverage should become effective on May 1, 2014.

 2.     Big name private health insurers are options on the Exchanges

Big companies like Blue Cross and Blue Shield  and Aetna have entered the marketplace, so it’s not like formerly uninsured Americans will be subjected to cut-rate insurance. These insurers, by law, are required to provide and cover preventive services, pre-existing conditions, and essential health benefits for individuals and family plans. Now I could talk about all three key requirements for coverage all day, but if you click on the links above, it will take you to a list of services considered part of every benefit offering from every insurer.

 3.     Affordability

The jury’s still out on whether coverage is affordable, but healthcare.gov does provide an excellent chart to demonstrate if you would qualify to “save money” on health insurance coverage. I put the term save money in parenthesis because while you might qualify for a subsidy (money the government will put towards your premiums each month), someone is paying and not necessarily saving (i.e., the tax payer). Click on the chart below to see if you qualify:

4.     Choosing a Benefit Level

Determining how much you want to pay out of pocket for medical expenses is another important thing to consider. Benefit levels are organized by metal levels (bronze, silver, gold, and platinum). As you can guess, those who enroll in bronze level coverage can expect to pay the most out of pocket and those who spring for the platinum plan will pay the least. Here is an example of the metal system from the state of Maryland (click on the image to see complete table):

5.     What Happens if You Do Not Enroll?

First, you’ll have to wait until the next open enrollment period (November 15, 2014 to January 15, 2015) with a possible effective date of February 1, 2015. There are exceptions that may allow you to enroll outside of the open enrollment period. One might qualify for a special enrollment period or may sign up after experiencing a Qualifying Life Event (or QLE) such as marriage, divorce, birth, or loss of a job.

Secondly, if you do not have a QLE and just decided not to enroll…you will owe Uncle Sam 1% of your income or $95 if your income is not greater than the amount of income above the tax-filing threshold (as of now $10,150 for an individual). Confusing, right? Visit https://www.healthcare.gov/what-if-someone-doesnt-have-health-coverage-in-2014/ for the complete breakdown of what you can expect to pay if you do not elect coverage during the established open enrollment period. The fines only become worse as time goes on, so avoid the tax bill and enroll!

Now that you have the basics of what the health care exchanges are all about, be sure to visit the healthcare.gov website to consider whether it is a good option for you. If you are eligible…meaning you do not have other coverage (job-sponsored plan, Medicare, or Medicaid), then you only have 23 more days to do some research and select a plan.

Happy shopping!

Image: healthcare.gov

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