PLEASE NOTE! The Health Insurance Marketplace Open Enrollment period ended February 15th. If you do not have a qualifying life event, you are unable to purchase an Obamacare ACA insurance plan. With that said, Short Term Health Plans have become the primary product in the market, providing insurance coverage until the next open enrollment period. Please consider purchasing a Short Term Health Plan until the next Open Enrollment period. Open Enrollment for 2016 coverage starts November 1, 2015.
The Affordable Care Act (commonly referred to as Obamacare) has introduced a number of changes to the health insurance market that you need to be aware of. Due to problems with Obamacare, such as website issues and uncertainty about options and rates, meaning there is still significant confusion that can prevent you from finding individual health insurance plans that meet your health care needs and budget. Read on to discover critical Obamacare information that affects your health care.
Many individuals are still asking “how does Obamacare work?” Under Obamacare, nearly everyone must have health insurance or pay a tax penalty. For individuals, there are a lot of changes introduced in health insurance you should be aware of:
- Mandatory Coverage: You are now required to obtain health insurance coverage or pay a tax penalty. It used to be that many individual policies were either expensive or did not offer the breadth of coverage available in most group health insurance plans. Today, a variety of insurance plans exist to provide you the coverage you need at an affordable rate.
- Prescription Drug Coverage: Health plans now offer various prescription drug coverage options to make medications more affordable for individuals.
- Pre-existing Conditions: Individuals with a pre-existing conditions or disabilities can no longer be denied health insurance or be charged more for coverage than others who are in the same age area without such conditions.
- Preventive Services: Preventive services and tests are free in most health plans (no deductibles or copayments) under the Affordable Care Act. The covered preventive services include mammograms, various cancer screenings, tests for diabetes and heart disease, and more.
- Making Coverage Affordable: Individuals who cannot afford health care insurance may qualify for subsidies where the federal government pays part of the premium. If you are self-employed, there are tax credits available to help with the cost of insurance.
- Tax Penalties: Most adults who go without health insurance will now pay a tax penalty. In 2014, it is $95 per person or 1 percent of the household income, whichever is higher to a set threshold. The penalty jumps to $325 per person or 2 percent of the household income in 2015. By 2016, the penalties are much steeper. Those who did not obtain coverage will pay either 2.5 percent of their household income or $695 per adult and $347.50 per child (with a maximum of $2,085 per family), depending on which is higher.
- Payment Limits: Health insurers can no longer establish dollar limits, whether per year or over a lifetime, on the coverage for essential benefits. In the past, they would set limits on the total amounts they would pay. They can still put limits, however, on how many times you obtain certain services in a given year.
- Health Savings Accounts (HSAs): Obamacare did not create health savings accounts, but it did lead to their becoming increasingly popular as employers and individuals look for lower premium options that provide tax advantages. HSAs are offered with a high-deductible health plan and offer premium reductions of 25 to 40 percent. The savings account portion gives the insured a pool of money to control and budget as they see fit, while paying for medical, vision and dental care before the deductible is met.
- Health Insurance Marketplaces: The Affordable Care Act established state health insurance marketplaces (also known as exchanges) where individuals, families and small businesses can shop health insurance and get possible income-based subsidies. With the subsidies and choices offered, some are better off buying Obamacare plans from the healthcare marketplace (if their state has one). For others, however, purchasing coverage on the health insurance marketplace is a better choice. Contact us today to get a variety of policy/price proposals to compare and see which option best meets your budget and specific needs.
- Enrollment Period: Now, health insurance can only be purchased at specific times, called Open Enrollment periods. When the Open Enrollment period is closed, you can still purchase an individual plan if you have a Qualifying Life Event. Otherwise, contact us today to get a Short Term Health Plan to provide health insurance coverage until the next Open Enrollment period.
This Affordable Care Act information should help you make a more informed decision about your health care plan. For many individuals, Obamacare health insurance will be more expensive than open market plans. To get started searching for health care, use our quote engine.
While Open Enrollment has closed, there are still several Qualifying Life Events that can enable you to get an individual health insurance plan. If you do not qualify during the special election period, a Short Term Health Plan will get you the coverage you need until the next Open Enrollment period. Either way, contact us today to get started with individual health insurance!