It’s that time of year again! Get ready to start thinking about open enrollment and what you need to do to make sure you and your family have health insurance coverage.
Here is what you need to know!
Open enrollment for 2016 is CLOSED. BUT, If you still need coverage for the rest of 2016, you can get it but, only if you qualify.
To qualify you need to meet one of these two criteria:
- Special Enrollment Period due to a life event — like losing health coverage, getting married, or having a baby.
- You qualify for Medicaid or the Children’s Health Insurance Program (CHIP).
You can apply for these programs any time throughout the year.
Let’s Brush Up On The Marketplace
About The Marketplace:
Who is it for? The Marketplace is for individuals who do not have health coverage for the coming year. That means, you do not have coverage through:
- Your employment
- The Children’s Insurance Program (CHIP)
- Another source providing qualifying coverage
How Much It Costs:
Health insurance through the Marketplace depends on your estimated income for the coverage year. Did you know? In 2017, roughly 8 out of 10 of uninsured people who are eligible for Marketplace coverage will qualify for financial assistance.* The financial assistance provided goes towards lowering the cost of the monthly premiums and in some cases is can also help with things like deductibles and copays. Get an idea of what that could mean for you HERE.
Discover What The Marketplace Insurance Covers:
Essential health benefits – Every plan must include the following:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
- Pre-existing conditions, including pregnancy
- Preventive care
- Birth control coverage
- Breastfeeding coverage
Pre-existing conditions, including pregnancy
Get a list of what that includes for:
What If You Do Not Get Health Insurance?
If you can afford health insurance and fail to obtain qualifying health coverage for the 2017 year, you may be fined. This fine is referred to the “individual shared responsibility payment”.
Fees are calculated in two different ways. They are:
- A percentage of your house hold income
- Per person
You will be required to the highest rate calculated.
Fines for 2017 have not been released as of yet.
Do you have questions about your health insurance coverage for 2017? I can help! Contact me, Your Obamacare Guy! I can be reached at: (813) 391-3448 or email address: dave@YourObamacareGuy.com
* source: http://www.HealthCare.gove/quickguide