Southern Utah News Articles
Top Stories for October 17, 2013
What you need to know about health insurance under the Affordable Care Act
As of October 1, everyone who is currently without health insurance can now sign up through the Health Insurance Marketplace under the Affordable Care Act (ACA). Some who are already insured may be able to find more affordable plans. (However, if your current plan was in effect prior to March 23, 2010, your plan is “grandfathered” and exempt from some of the changes required under the ACA. Your insurer must notify you if your plan is considered to be “grandfathered”.)
If you are currently uninsured, you can now shop for health insurance much the same way you buy a car: comparing features and prices. You can learn about programs you may qualify for based on your family income – all by going to one website or making one phone call. In addition, those who have been turned down by insurance companies in the past will now be accepted due to ACA requirements. Insurance companies now must:
•Cover people with pre-existing conditions
•Never cancel policies because you get sick
•End lifetime and annual dollar limits on essential health benefits
•Provide free preventive care
•Give you the right to appeal an insurance claim that has been denied
If you have private insurance now, you can also check to see if you can get lower costs for your plan. You simply fill out one application for these services.
In order to discover your options and apply for an insurance plan, go to www.healthcare.gov, or call trained advisors and counselors at 1-800-318-2596 (TTY: 1-855-889-4325). Both avenues are available 24 hours a day, seven days a week. Once in the website, you will be clearly led through the process, one step at a time, and your plans will be based on which state you live in. If you are applying for small business health insurance, those plans in Utah are available through Avenue H, which is clearly linked through the website.
The enrollment periods are October 1, 2013, through March 15, 2014. In subsequent years, enrollment periods will begin October 15 and end December 7. Plans purchased by December 15 of this year will begin your coverage on January 1, 2014.
The minimum benefits you will receive, based on ACA requirements, include the following:
•Maternity and newborn care
•Rehabilitation services and devices such as wheelchairs)
•Substance use services including counseling/psychotherapy
•Preventive/wellness services, such as annual health checkups
At the time of this writing, the website has been swamped with people attempting to get through to sign up for insurance plans. The website experienced seven million unique hits the first two days, so be patient. Any website would be slowed under these circumstances.
So, what happens if you do not purchase health insurance and opt to remain uninsured? Starting January 1, 2014, if someone doesn’t have a health plan that qualifies as minimum essential coverage, he or she may have to pay a fee which increases every year: on the 2014 income tax return (filed in 2015), that amount will be 1% of income per adult or $95, whichever is higher; for the 2015 tax return filed in 2016, that amount rises to 2.5% of income or $695 per adult, whichever is higher. The fee for children is one-half that amount.
People with very low incomes and others may be eligible for waivers. To see whether you are exempt from the fee, go to www.healthcare.gov and click on Health Insurance Marketplace, then click on How do I Get an Exemption from the Fee?
While some states have made available in-person counselors and advisors, Utah has not. Remember, if you do not want to sign up via the website, you still have the option to do so by telephone. Health insurance is your financial security against the unanticipated illness or emergency. Be aware there are scam artists out there; hang up on any unsolicited phone calls and ignore texts, e-mails, or alternative websites offering you help in navigating the healthcare insurance process.