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Health Insurance 101: FAQs for 2015

The Patient Protection and Affordable Care Act (PPACA) was signed into law during 2010. Since then it has caused a LOT of confusion, all the way up to the Supreme Court. Don’t let healthcare reform strike fear into your heart, we’re here to help! Our Benefits Specialists Robyn Sczepanski and Corrie VanEck work with health insurance every day and can walk you through the process.

Here are 5 Health Insurance FAQ’s…

Q: I don’t have health insurance, what should I do?

A: Don’t worry, you have options! During the annual open enrollment period you can purchase any health plan you choose. This runs from November 15th – February 15th each year. There are also some life events that qualify you to get insurance outside of open enrollment – having a baby, losing coverage through a job, getting married, etc. You may also be eligible to receive a tax credit to help pay for your health insurance.  

Q: What good does a tax credit do me? Is that what people call Obamacare?

A: You can purchase insurance directly with a carrier or you can shop for health insurance plans through the Federally Facilitated Marketplace at www.healthcare.gov. It is one website that lists all the plans you and your family are eligible for based on where you live. It includes major carriers like Blue Cross Blue Shield, Priority Health, and HAP. When you’re looking at your options, they already reflect the reduced amount and show the difference you would be responsible for. Hint: Plan Premium - Tax Credit = what you pay. Sometimes plans are even $0.00 a month!

Q: Why wouldn’t everyone want a tax credit? $0.00 sounds great!

A: There are some restrictions on who qualifies for the tax credit. There is a process for determining your eligibility based on your household income and size. If you exceed a certain amount, you do not receive a tax credit but you can always shop via the marketplace. If you are below a certain amount, you would be automatically referred to your state-run Medicaid program. For those who fall within the bracket of eligibility, there are two conditions: 1. You must file a joint tax return with your spouse (if married) 2. You cannot have employer coverage available to you.   

Q: What if I don’t want to purchase health insurance?

A: As part of Health Care Reform, if you do not have health insurance coverage for three months or longer during the year, you will pay a fine. This will come into play when taxes are filed – below is a chart that shows the penalty amount by year.

Q: I have a lot of health issues, can I still get health insurance and will I have to pay more?

A: Yes! A great part of all the recent changes is that health insurance companies can no longer deny coverage or rate premiums based on pre-existing conditions. You may be required to inform them of any cancer, heart disease, etc. but it is illegal to use this for a price increase. All health insurance rates are based on the person’s age, where they live (zip code), and whether or not they use tobacco.

Deciding on a health insurance plan that is right for your family can be difficult and costly. Let us take out the hard part and help you fully understand your choices. The deadline for coverage in 2015 is February 15th. Call our office today to set up a consultation with our benefits professionals.