The new health care law has expanded health insurance with more benefits for more people and more affordable coverage for many who were unable to afford health insurance previously. One of the key goals of the new law is to give many Americans who have been uninsured a way to get health insurance. Below are some key dates and facts:
The three major parts of the new Health Care Act are:
1. Guaranteed Coverage:
This means that you will be able to have a health insurance plan regardless of health conditions when you apply for it, during an open or special enrollment. Open enrollment for 2013/2014 is from October 1, 2013 through March 31, 2014.
2. Cost Assistance:
If you’ve been unable to afford health insurance, you may qualify to get premium assistance now. There are tax credits and monetary assistance to help eligible people pay for health insurance when they buy coverage through the new Health Insurance Marketplace in Illinois, and are based on your total household income.
3. The Individual Mandate:
The new law requires most Americans to have health insurance. Failure to have coverage, or apply for coverage by March 31, 2014, may result in a penalty you will pay on your federal income tax return.
If you have insurance now?
If you buy your own insurance or have insurance with your employer or a government agency, you may not experience any major changes. However, you may be able to access some new benefits that the new law provides, like free preventive wellness screenings, the ability to insure your adult children up to age 26, unlimited lifetime limits, and no denials for pre-existing medical conditions.
If you don’t have health insurance now?
The new 2014 Health Care law provides options for many individuals and families to get coverage who have not had health insurance in the past because of pre-existing conditions, or could not afford health insurance. Beginning in 2014, there is also help available to pay your health insurance premiums for those who qualify based on their annual income.
New 2014 Health Insurance Plans
What are the Different Levels of Insurance Plans?
There are four levels of health care plans available — bronze, silver, gold and platinum. All plans will have similar benefits, and all will include essential health benefits. Where they differ is on the costs, and on the benefits.
| Bronze | Will have the lowest monthly premium, but also could be the highest out-of-pocket costs. |
| Silver | This level has slightly higher monthly premiums than bronze but also richer benefits. |
| Gold | Gold has even higher level of benefits than silver, but also a higher monthly premium. |
| Platinum | This is the highest level offered by the insurance companies, with both the highest premium but also the richest benefits. |
What is the Health Insurance Marketplace?
The Health Insurance Marketplace is a new way for you to compare benefit packages and prices.
You can learn if you are eligible for a government program, and you can find out if you qualify for help paying for the coverage you choose.
You can apply online, or you can also apply for coverage over the phone or by submitting a paper application.
What if insurance is too expensive for me?
Certain individuals and families will be able to get a new kind of tax credit that lowers their monthly premium. You may also qualify for lower out-of-pocket costs to help cover expenses like deductibles, copays and coinsurance.
You’ll be able to see what your premium, deductible and out-of-pocket costs will be before you make a decision to enroll.
Do I have to purchase health insurance on the marketplace?
While most people will be required to purchase health insurance in 2014, you do not need to visit the marketplace to do so. You should work with a licensed independent insurance agent.
While tax credits only apply to plans offered through the marketplace, you can work with a licensed independent agent to help you through the process.
Health Insurance Marketplace/Exchanges
Open Enrollment for Qualified Health plans and premium Assistance has been extended to March 31, 2014.
These plans will not start until the next month after you apply. The deadline to apply is March 31, 2014 and the last effective date is May, 1, 2014.
If you currently do not have health insurance now, you won’t be penalized if you apply by March 31, 2014.
How can I get coverage outside of open enrollment?
You can apply to the Marketplace any time outside of open enrollment, however, the coverage you can get depends on your situation and the coverage for which you qualify.
- Outside open enrollment, you can enroll in a private insurance plan through the Marketplace only if you have certain life events that give you a special enrollment period.
- You can apply for Medicaid or the Children’s Health Insurance Program (CHIP) any time and you can enroll right away.
Buying a Marketplace plan outside open enrollment
In order to buy a Marketplace health insurance plan outside the open enrollment period, you must have a qualifying life event. Qualifying life events that create a special enrollment period include:
- Getting married
- Having, adopting, or placement of a child
- Permanently moving to a new area that offers different health plan options
- Losing other health coverage (for example due to a job loss, divorce, loss of eligibility for Medicaid or CHIP, expiration of COBRA coverage, or a health plan being decertified). Note: Voluntarily quitting other health coverage or being terminated for not paying your premiums is not considered loss of coverage. Losing coverage that is not minimum essential coverage is also not considered loss of coverage.
- For people already enrolled in Marketplace coverage, having a change in income or household status that affects eligibility for tax credits or cost-sharing reductions
Special enrollment periods
If you have a qualifying life event, you get a special enrollment period. This means you can enroll in or change your health insurance plan outside the open enrollment period.
Most special enrollment periods last 60 days from the date of the qualifying life event.
Open enrollment for Marketplace coverage ends March 31, 2014. The next open enrollment period is November 15, 2014 – January 15, 2015.
The most important thing to remember is to utilize a licensed insurance agent like myself, who can work with you in understanding your health insurance needs and find the plan that best meets your overall needs.
Anna Minkina
Healthcare Benefits Consultant
9501 W.144th Place, #303
Orland Park, IL. 60462
Mobile: 708-426-3680
Office: 708-361-0351
Fax: 708-361-3231
http://www.healthcaresolutionsteam.com
Reference and information provided by www.healthcare.gov and BCBSIL.