While the future of the Affordable Care Act (also known as Obamacare) may be uncertain, most people are still required to have coverage (or pay a fine) for the 2015 calendar year. If you don’t have coverage through your employer, you can sign up at www.healthcare.gov.
What you need to know
- Most Americans are required by law to have health insurance. Those who don’t, unless granted a hardship exception, will have to pay a fine.
- Many Americans who don’t have health insurance through their employer will qualify for premium subsidies. The site provides a chart that will let you know whether you qualify for a subsidy and what your subsidy will be.
- The law makes it illegal for insurance companies to deny coverage based on pre-existing conditions.
- The law also allows young adults to stay on their parents’ insurance plans until they’re 26 years old.
- Americans who don’t have coverage through their employer can compare plans and rates through www.healthcare.gov.
- All plans must cover at least a portion of the following: preventive care, doctor visits, maternity care, prescription coverage, and hospitalization.
- The portion covered depends on what level of insurance you choose: bronze, silver, gold, or platinum. Each level varies as to the amount of the premiums as compared to the out-of-pocket cost. For instance, a bronze level plan would have lower premiums but higher copays and deductibles. A platinum plan, on the other hand, would have higher premiums but would cover more of your expenses. In general, it breaks down like this:
- Bronze plan: Insurance pays 60%; you pay 40%.
- Silver plan: Insurance pays 70%; you pay 30%.
- Gold plan: Insurance pays 80%; you pay 20%.
- Platinum: Insurance pays 90%; you pay 10%.
- Catastrophic plans are available only to those who have a hardship exemption based on income or who are under age 30. These plans aren’t intended to cover things like prescriptions or regular doctor visits; they’re meant to prevent accidents and major illnesses – like cancer – from destroying your financial health.
- You have until February 15, 2015, to sign up.
How to enroll
- When you go to www.healthcare.gov, you’ll be prompted to enter your state and/or your postal code.
- Next, you’ll be asked to enter some information about family members and household income.
- Next, you’ll see some information about whether you qualify for premium subsidies.
- Before you’re taken to the page that lists the plans available in your state, you’ll see a screen that advises you as to what all healthcare plans are legally required to cover.
- After that, you’ll be taken to the lists of plans available in your state. Each one will be labeled bronze, gold, silver, platinum, or catastrophic.
- The next step is to complete your application. The site provides a link to a checklist of the documents you’ll need.
- Once you’ve completed your application, you’ll see your results. They’ll tell you what kind of coverage you’re eligible for, including any subsidies.
- The final step is to contact the insurance company you choose and arrange to make your first month’s premium payment. They can also fill you in on anything you need to know to begin using your coverage.
Enrolling for health insurance can be complex and frustrating. However, healthcare.gov has made enormous improvements in the last year and is committed to continue improving in ways that will make health insurance easier and more affordable for all Americans.
Image: flickr via Shawn Campbell, 2009