The initial open enrollment period under the Affordable Care Act, which many commonly refer to as “Obamacare”, began at midnight on October 1, 2013 and will end at midnight on March 31, 2014. If you don’t have health insurance coverage, now is the time to purchase it to avoid a tax penalty.
Here are 10 things you need to know TODAY about the open enrollment period:
- The Affordable Care Act includes an “individual mandate” which required most everyone to have “Minimum Essential Coverage” by January 1, 2014 or pay a tax penalty. Minimum Essential Coverage, or “MEC” plans, can be purchased on a government insurance exchange or from a private insurance carrier.
- If you have currently coverage from your employer, or through a government program like Medicare or Medicaid, it will meet the requirements for the individual mandate and you will not have any tax penalty.
- MEC plans purchased during the open enrollment period will be “guarantee issue” which means that coverage cannot be denied to anyone regardless of their medical history or current health status.
- With the exception of the catastrophic plans generally only available to individuals age 30 or under, MEC plans fall into one of four metal levels—bronze, silver, gold or platinum. A Bronze plan generally has the lowest monthly premium but the highest out-of-pocket medical expenses up to the annual maximum. As you move up the metal levels, premiums go up and out of pocket medical expenses go down.
- Regardless of the MEC plan you choose, your maximum out-of-pocket medical expenses in 2014 will be $6,350 for an individual and $12,700 for a family (not including premium costs).
- The earliest date coverage can begin for a metal-level plan is January 1, 2014.
- Many Americans will be eligible for a subsidy from the government to help pay part of their premium cost. If you are eligible to receive a subsidy, you must select one of the qualified health plans offered on your state’s insurance exchange. To find out if you are eligible, visit www.healthcare.gov or talk with a local insurance agent.
- If you are not utilizing a federal subsidy, you can select an MEC plan from the insurance exchange or from any health insurance carrier in your state.
- If you don’t get health insurance during the initial open enrollment period, you may not be able to get an MEC plan later in 2014. Outside of open enrollment, your ability to apply for this type of coverage will be limited to the occurrence of a qualifying event, such as the loss of a employer-based coverage, a marriage or divorce, a move, or the birth of a child. You may be able to purchase other coverage such as a short-term health insurance plan, but these won’t meet MEC requirements and you will likely have to pay a tax penalty.
- An insurance agent can help you understand your health insurance options, select the plan that meets your needs and budget and help you apply for coverage. There is no additional cost for this assistance.
To find a qualified agent who can help you sort through your options, feel free to visit HealthMarkets.com or call (800) 304-3414.
It’s a new day in the world of health insurance. So it’s far better for every individual to get coverage now.