No matter your personal political views on the Affordable Care Act of March 2010 (ACA), there is some good news if you need to purchase health insurance for either your family or yourself for 2015. The website that hosts the Exchange (where you apply for health insurance) has fixed some of its previous bugs and added some new features that make the site much easier to use. This year you can easily preview the rates, policies, and tax credits (which are applied in advance) you are eligible for merely by answering a few simple questions before going through the entire formal application process. If you enter your zip code into HealthCare.gov it will guide you to your state’s personal exchange if they have one (only thirteen states plus the District of Columbia have their own exchange). The SHOP (Small-Employer Health Option Program) allows the owners of small businesses with 50 or less employees to insure their employees. Small businesses with less than 25 full time employees may qualify to receive tax credits. There is an employee choice option that allows a business’ employees to choose amount a vast amount of plans in a selected tier, but it is only available in 14 states as of 2015. However, employee choice has been delayed in 18 federal exchange states until 2016. In those 18 states, employers will only be able to offer their employees a single health and a single dental plan. Applying for health insurance is a pretty complex process, so you may want to get started early (as in now). For coverage starting on January 1, 2015, the enrollment process began on November 15, 2014. February 15, 2015 is the last day to enroll for 2015 coverage. However, there are a few key things that individuals must know to avoid frustration during the applying process and get the insurance they need.
Be Sure you’re Eligible to Apply
Whether you’re a 55 year old who lost employment or health coverage, a parent who needs affordable coverage for your family, or a 26 year old just now coming off your parents policy, you may be eligible for significant tax credits (which are delivered in the form of reduced premiums) which will help you to afford the coverage you need. People who cannot use the marketplace include people who have an employer-sponsored health plan, including COBRA, or people who have TRICARE for military families, Medicaid or Medicare.
Understand That Health Conditions Do Not Raise Rates
The best part of the Affordable Care Act (aka Obamacare) is that insurers cannot reject applicants or charge them anymore because of their gender or pre-existing health conditions. But keep in mind that rates still vary based on whether the applicant uses tobacco, whether you’re buying individual or family coverage, where you live, and your age.
Collect Key Information before You Start
When you begin the application process, you’ll be asked many questions. The first few will be about your household size and income. While some of these questions may seem straight forward, there are permutations. For example, the phrase “Household size” actually means “dependents” not actually the number of people who live in your home. When you apply for health coverage, you’ll be asked to estimate your income for 2015 and your credits will be based off of this. Estimate this number carefully because if you make more money than you estimate, you may have to pay back when you file your next tax return.
Choose the Right Plan for Your Needs
Every plan offers the same essential health benefits, including coverage for laboratory and wellness services, prescription drugs, mental health and substance use services, maternity and newborn care, hospitalization, emergency services, and outpatient care. The differences involve cost (obviously) and optional other health benefits the health insurance may cover.
Avoid Penalties for Being Uninsured
The Affordable Care Act requires all citizens to obtain at least the minimum standard health insurance starting in 2014. The penalty for not having health insurance in 2015 is $325 per adult and $47.50 or 2% of your total income, whichever is greater. The penalty will increase every year, with 2016 penalty being $695 per adult, $347.50 for every child, or 2.5% of family income with a maximum of $2,085 per year. However, certain groups of people are exempted from the penalty.
If you are just too intimidated and confused by the idea of purchasing health insurance, there are many insurance agents and brokers who can help you get through it. Just remember to remind them that if you think you could qualify for tax credits, they’ll need to enroll you into a marketplace plan. If you get on the HealthCare website, you can look at all of the plans that you qualify for and sort them in order of their deductible and premium amounts. If you have any difficulty with the enrollment process, you can call a hotline number 24/7. 1-800-318-2596