Still need Health Insurance? What You Need to Know About ObamaCare
If you are one of the many Americans that still doesn’t have health insurance, your last chance to take advantage of the Affordable Care Act, also known as ObamaCare, is just a few days away. Open enrollment ends on March 31st.
A key requirement of the Affordable Care Act mandates that all Americans must have health insurance or they may face a penalty. Penalties are:
• $95 per person
• $47.50 per child
• or 1% of an individual’s annual income penalty, whichever is higher.
So, if you’re one of the millions of Americans that still hasn’t signed up for health coverage, here are a few key things you need to know about obtaining healthcare under the Affordable Care Act.
First, let’s start with the basic elements:
• Under the Affordable Care Act, all plans must cover the ten essential health benefits, including mental health services, preventive care, and maternity care.
• An insurance company can’t turn you down based on a preexisting condition
• Many people who buy insurance through the Affordable Care Act’s federal and state will be eligible for some sort of financial assistance.
If you’re an individual who earns $45,900 a year or less, or a family of four earning under $94,200 a year, then you may qualify for premium subsidies that can lower your healthcare costs.
Out-of-Pocket Costs
There are five types of plans – bronze, silver, gold, platinum and catastrophic. While all marketplace plans essentially offer similar core benefits, the difference between the available plans concerns out-of-pocket expenses. If you choose a “bronze” plan, you’ll have a lower premium, but you’ll end up paying more for medical services you may need. If you were to choose a “platinum” plan, your premium might be slightly higher, but it will cover a greater amount when you receive services. Regardless of what plan you choose, all plans have a maximum out-of-pocket cost limit, which is no more than $6,350 for an individual plan and $12,700 for a family.
Research the Provider Network
If going to a particular hospital or seeing a certain doctor is important to you, make sure they are in your provider network before purchasing a plan. In order to keep costs down, some health insurance companies are offering narrow networks in their exchange plans. This means that you have to do your research before you purchase a plan.
If your preferred healthcare provider isn’t in the plan you choose, you can always go out-of- network for care, but depending on what plan you have, you’ll have to pay more or all of the costs.
If you still have questions, the good news is, there is a lot of help!
Every state has resources available to residents who need help enrolling in a health plan. If you need help, go to localhelp.healthcare.gov and enter your ZIP code to find assistance near you.
Or you can call toll-free 1-855-355-5777 to speak to trained representatives who can answer any questions you may have.
You can also check out the following websites to learn more about the Affordable Care Act:
Healthcare.gov — The federal government’s official health insurance website.
Kff.org — The Kaiser Family Foundation, a nonprofit focusing on major health care issues, offers a treasure trove of information and helpful online tools, including an animated video on the Affordable Care Act and a health insurance subsidy calculator
Remember, the deadline to sign-up is March 31st, with coverage starting May 1st. The next open enrollment period will be November 15, to obtain coverage in 2015. You can sign-up for coverage after March 31st, but only under a special circumstance such as marriage, divorce, loss of a job, or birth of a child.
