Beginning today, The Patient Protection and Affordable Care Act Health Insurance Exchange Marketplaces are open. The marketplaces allow individuals to learn about and enroll in affordable health coverage. Consumers can create an account and enroll online, by phone, or in person. Enrollment ends in the exchanges on March 31, 2014. Coverage begins January 1, 2014.
Before you begin the process, identify yourself and your family members. You’ll need birthdates and Social Security numbers for each person, and it will help to have a copy of last year’s tax return available to provide income, alimony, pensions and other financial information. Depending upon your income level, you may qualify for a tax credit to help pay for your premiums; you may earn up to 400% of the poverty level to receive a credit.
Set your budget and make sure you understand things like premiums, deductibles, out-of-pocket costs, etc.
To apply by phone, call the marketplace at (800) 318-2596 and a Navigator and In-Person Assister (IPA) or a Certified Application Counselor (CAC) will take you through the process.
To apply online, go to www.healthcare.gov
and click on “get insurance.” You will need to set up an account and a password and provide contact information. The website is very user-friendly and has answers to almost every question about health insurance and the process.
To apply in person, go to the nearest community health center and an IPA or CAC will assist you. You can find a center by going to www.findahealthcenter.hrsa.gov; Family First is located in the Peebles Shopping Center in Gettysburg and their Hanover Center is on High Street in Hanover. Local insurance agents and brokers may also be able to help you.
Regardless of how you apply, there are four levels of coverage—bronze, silver, gold and platinum. All cover the same benefits; only how much they cost and whether your doctors and hospitals are in the plan differ.
Bronze plans cover an average of 60% of medical costs, silver 70%, gold 80% and platinum 90%; the specifics details are dependent upon the plan you choose and other factors. All plans must cover: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health treatment; prescription drugs; rehab services and devices; lab services; chronic disease management; and pediatric care, including dental and vision.
If you have health insurance provided through your employer, you will receive a letter from the insurance carrier stating the tax credit you are eligible to receive.
There are penalties for not having insurance on January 1, 2014. The fine is $95 per adult and $47.50 per child, up to $285 for a family or 1 percent of family income, whichever is greater.
For more information, go to www.healthcare.gov