- Open Enrollment Deadlines
Many Americans without health insurance do not know that the deadline to sign up for coverage is March 31, 2014. If you do not have health insurance by April 1st, you will pay a fine under the new healthcare law unless you qualify for an exemption. If you do not have health insurance by March 31st, the law requires you to pay a penalty of $95 per person ($47.50 per child) or 1 percent of your annual salary in 2014, whichever is higher. The penalty increases each year. In 2015 it is 2 percent of income or $325 per person. Go to https://www.healthcare.gov to shop for a plan.
Although insurance companies can no longer deny people who have preexisting conditions, studies show that there are still at least 16 percent of Americans who are not insured. Many people simply can not afford to pay for health insurance. If you are one of these people, you might qualify for an exemption. (A list of exemptions is at the end of this article) Even after promised tax credits/subsidies, the cost of even the cheapest insurance plans can be up to 8 percent of a family's annual salary. After subsidies are applied, low and middle class families still pay up to 8 percent of their income for a plan that does not pay a penny towards the care they need until racking up $6350 or more in medical bills. The low end plans have deductibles of $6350 for singles and $12,700 for families.
Many health insurance plans don't cover benefits such as doctor visits and prescription drugs until you meet your deductible. A deductible is an amount of money that you are required to pay out of pocket each year before your health insurance company will begin to pay for items and services you receive. More than half of the bronze plans in the marketplace require policyholders to meet high deductible before insurers help with the cost of a doctor visits and prescription medications. The law does require Marketplace plans to cover certain preventive services, such as some screenings and vaccines, even if you have not met your deductible.
In a majority of states, Medicaid has been extended to cover more low income people. The Medicaid Expansion Package which was included with "Obamacare", was not adopted by Florida. The goal of the Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges. However, you might not have to pay the fine if "You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act."
Insurance companies are trying to attract young and healthy Americans in order to offset the costs of coverage for older adults, and people with medical conditions who tend to rack up higher medical bills. If this doesn't happen, the cost to purchase health insurance will significantly increase. So far, a majority of people who filled out application on the Healthcare.gov website have not yet purchased a plan. After the application is completed, you are given a list of plans and the cost you will pay after tax credits are applied. For whatever reason, most people abandon the shopping cart.
You must have health coverage or pay a fine (the “individual shared responsibility payment”). You can get an exemption in certain cases. If you qualify for an exemption, you may also be allowed to purchase a "Catastrophic" plan. There are also some plans outside the Marketplace you can purchase. However, plans purchased outside the Marketplace generally do not qualify for tax credits, and they might not provide enough coverage to avoid paying a fine. To avoid paying a fine, you need insurance that qualifies as minimum essential coverage.
You may qualify for an exemption if:
- You’re uninsured for less than 3 months of the year
- The lowest-priced coverage available to you would cost more than 8% of your household income
- You don’t have to file a tax return because your income is too low
- You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
- You’re a member of a recognized health care sharing ministry
- You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
- You’re incarcerated, and not awaiting the disposition of charges against you
- You’re not lawfully present in the U.S. Hardship exemptions If you have any of the circumstances below that affect your ability to purchase health insurance coverage,
- Hardship Exemptions
You may qualify for a “hardship” exemption:
- You were homeless.
- You were evicted in the past 6 months or were facing eviction or foreclosure.
- You received a shut-off notice from a utility company.
- You recently experienced domestic violence.
- You recently experienced the death of a close family member.
- You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
- You filed for bankruptcy in the last 6 months.
- You had medical expenses you couldn’t pay in the last 24 months.
- You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
- You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
- As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
- You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.
- Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable.