Affordable Care Act Deadlines You Need To Know

Time is running out for individuals who want to enroll in an Obamacare plan.  Enrollment so far has been lagging, and it will be interesting to see if people are not interested in enrolling or if there is not enough information available.  In any event, if someone does not have coverage by March 31 they will be required to pay a tax for not having heatlh insurance.  In order to avoid inadvertently being left out in the cold, here are some dates to be aware of.

February 15, 2014

Deadline for March 1 Enrollment

As a general rule, an individual must be signed up by the 15th of a month in order to have coverage start on the 1st of the following month.  Therefore, if you need coverage on March 1, you need to have signed up for an exchange plan by February 15.  Even if you miss this deadline by 1 day, you will most likely have to wait until April 1 to have health insurance.

Technically, since enrollment after February 15 would result in coverage that would not begin until April, the individual would be subject to the penalty for not having coverage if he or she was without coverage since January 1 (i.e. 3 consecutive months).  However, the federal government has said that as long as someone enrolls during the Open Enrollment period (through March 31) that person will not have the penalty applied.  Be aware that a hardship waiver may be required when filing 2014 taxes.

March 15, 2014

Deadline for April 1 Enrollment

As mentioned above, if you want coverage by April 1, 2014, you must be enrolled by March 15.  If you enroll between March 16 and March 31, you will still be in the Open Enrollment timeframe, but now you have pushed your effective date of coverage back to May 1.  And you’ll probably be required to complete a hardship waiver at tax time.

March 31, 2014

Last Day of Open Enrollment

In order to completely avoid a penalty for not having health insurance you must have your enrollment completed by March 31, 2014.  The first day of coverage will be May 1.

Do Not Wait

If you are wanting to enroll in an exchange plan, do not wait until the last minute to complete your enrollment.  While the marketplace websites are vastly improved over what was rolled out in October, there is no guarantee that you will not experience technical difficulties when trying to sign up.

Also, if you want the coverage, why wait?  Get signed up and covered as soon as possible.

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How to Find Health Insurance That Is Affordable Under Obamacare

Beginning on January 1, 2014, most of the provisions of the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare will go into full effect.  One of these provisions is the requirement that every American have health insurance or pay a fine.  Therefore, it is very important to find health insurance that gives you the coverage you need at a price you can afford.  But how do you do this?  Despite the controversy about the overall cost of the Affordable Care Act, there are some new ways to find affordable health insurance on an individual level.  Here are 4 ways that you can find health insurance that fits your budget and medical needs.

Reformed Group Insurance through an Employer

Obamacare has reformed the group insurance model.  While originally set to be implemented in 2014, the employer mandate to provide health insurance has been postponed until 2015.  Still, once it is put in place, you will be able to find health insurance through your employer that puts limits on what you pay for the plan and what your out of pocket limits will be.

The Affordable Care Act requires that employers with more than 50 full-time employees offer medical insurance to all of their full-time employees.  Full-time is defined as anyone who works at least 30 hours per week.  There are different calculations that go into the full-time definition, but just know that if you average 30 hours per week, you must be offered coverage.

The coverage that you are offered must have at least a 60% actuarial value, meaning that on average, for every dollar that the insurance covers, the insurance plan must pay for at least 60 cents.  One of the ways this is achieved is by limiting the individual’s out of pocket maximum.  In 2014, the limit is $6,350 and includes deductible, coinsurance, and copays.

Also, the employer cannot make an employee pay more than 9.5% of their salary to participate in the plan.  If you make $2,000 per month, the most you can pay for your insurance is $190.  Having said this, there is no cap on the cost of insurance for a dependent.

Still, with these provisions in place, you can find health insurance that is probably cheaper and better than before.

Health Insurance Marketplaces

Obamacare created health insurance marketplaces – originally called exchanges – to help people find health insurance plans quickly and efficiently online.  The marketplaces will make the search for a good plan easier than looking for individual insurance on your own.  Everything will be in one place.

While it will be interesting to see if the actual premiums of the plan are any cheaper than pre-Obamacare, some people will get help paying their premiums by way of tax credits (see here for tax credit eligibility).

If someone can find health insurance and use a tax subsidy, a good plan at a low rate will be available.

Parent’s Plan

The Affordable Care Act requires insurance companies to allow children to enroll in their parent’s insurance plan until age 26.  This is very advantageous because many times the cost to add a dependent to a plan is lower than the cost of an individual plan.  In fact, many times a new dependent can be added at no cost since some plans have one premium rate for all children on a plan.  In that case, someone under age 26 can effectively find health insurance that is free.

Medicaid

When Obamacare was passed, it required Medicaid to be expanded in every state.  This expansion will make it easier for adults to find health insurance through this government program.  The Supreme Court took away the requirement, and as a result, many states will not be expanding this coverage.

However, if you live in a state that is expanding Medicaid, check to see if you are eligible for this low cost way to care for medical needs.

Find Health Insurance at an Affordable Rate

When you try to find health insurance at an affordable rate, make sure to be patient and look at all your options.  Good coverage at a reasonable price is available.

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Subsidy for Health Insurance – How to Qualify for Assistance

On October 1, 2013, the health insurance marketplaces, also known as exchanges, created by the Patient Protection and Affordable Care Act (Obamacare) will go live for Open Enrollment.  The exchanges will be a great way for individuals and small businesses to find a variety of health plans from a variety of health insurance companies at (hopefully) a competitive cost.

One of the things that helps people, especially young people, afford the premiums on the marketplaces is a tax subsidy for health insurance plans.  Some people will be eligible for this assistance, but not everyone.  Here is how you can have a rough idea if you are eligible for the tax credits.  You must meet all of the following criteria.

No Employer Provided Health Insurance

Obamacare made it mandatory for employers with at least 50 employees to provide all full-time employees with the option of enrolling in their group medical plan.  The plan must pay for at least 60% of allowed charges and no employee may pay more than 9.5% of their salary to purchase the plan.  If an employer offers a plan that fails those two standards, there is a fine they must pay.

The definition of a full-time employee is important in figuring out if you are eligible for a subsidy for health insurance through the exchange.  A full-time employee is defined as someone who average 30 hours per week or more.  There are some calculations that your employer will do to determine hours worked, but in general, 30 hours is a full-time employee.

So, all this to say, that if you are offered coverage at work that meets the two standards above, then you are NOT eligible for a tax subsidy.  If you are not offered coverage, then you still may be eligible for the subsidy.

Annual Earnings

Subsidies are only available to households that earn less than 4 times the federal poverty level. In addition, the amount of the subsidy depends on the household income.  Folks that make less can get a larger subsidy for health insurance in the marketplaces.

Medicaid and Medicare Eligibility

If someone is eligible for Medicaid and Medicare, two government programs that help pay the cost of medical expenses, then that person is not eligible for a subsidy.  A tricky aspect of this rule is that while Obamacare expanded Medicaid coverage, not every state expanded Medicare coverage.  So your eligibility for Medicaid depends on where you live.  You could be eligible in one place, but not eligible in another place.

Medicaid is administered by the states, so check with your local Medicaid office for more information.

How are Subsidies Applied?

For the most part the subsidy for health insurance bought on the exchanges is in the form of tax credits in the following year.  For example, you pay your premium in 2014 and the tax credit is applied on your 2015 tax form.  However, if this arrangement causes a hardship, there are ways to reduce the actual premium.

How to Apply for the Subsidy for Health Insurance

The subsidy for health insurance on the exchanges is designed to be a quick and easy process.  Someone can apply right on the marketplace’s website and find out if they are eligible.  In fact, here is a nifty calculator from Kaiser to help determine if you fit the eligibility requirements.

Find the Best Option for You and Your Family

The marketplaces and the subsidy for health insurance purchased through the marketplaces are designed to make affordable health insurance more available.  However, that does not mean that the exchanges are your best option.  Take a look around to see how you can find the best coverage at a price you can handle.

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Is Affordable Medical Insurance Available to Young People?

There are not many problems with being young.  One of them, however, is that it can be difficult to find affordable medical insurance.  A good health insurance plan is not cheap and will still usually leave you with a large medical bill if you use the plan.  But that doesn’t mean that you have to pass up the opportunity to buy coverage for yourself and/or your family.  There are ways to be able to afford a good plan.  Here are some of best.

Why it is Important to Have Medical Insurance

There are a couple of big reasons to have medical insurance.  For one, in the event that you need medical services, you will owe less out of pocket if you have an insurance plan.  With an insurance company, you will get the benefit of having bills discounted, which you will not receive if you are not covered.  You will be responsible for the entire bill and having to negotiate with the doctor or hospital on your own.

Second, the Patient Protection and Affordable Care Act (Obamacare) requires every American to be covered by a health insurance plan, or else face a tax.  The requirements for this mandate are not too strict, so finding affordable medical insurance and avoiding the penalty is possible.

Health Insurance Marketplaces

The Affordable Care Act created health insurance exchanges, online marketplaces where individuals can compare plan designs and premiums for plans from various insurance companies.  The idea of the marketplaces is that with a level plan design playing field, insurance companies will get competitive with each other to drive down the cost of insurance.  While the jury is still out on this, the law created another way to find affordable medical coverage on the exchanges.

That would be by giving tax credits to help offset the cost of the insurance premiums.  If you make less than 400% of the federal poverty level and are not eligible for Medicaid, you will receive assistance to pay for the coverage.

The marketplaces are administered by the states.  You can find your exchange here.

Group Coverage

Group coverage has always been a decent way to receive affordable medical insurance.  Employers typically subsidize the premiums and offer a reasonable plan.  Obamacare has made it even easier to afford the cost of a group plan.  The law states that an employer can only charge an employee up to 9.5% of the employee’s salary.  So for someone making $20,000 per year, 9.5% equals $158 per month.  That sounds like a lot, but it is a small percentage of the actual premium.

The Affordable Care Act also states that an employer must offer a plan that pays for at least 60% of the cost of the claims (with the other 40% paid by the member).  A 60% plan will have a large out of pocket exposure, but will keep you from going broke in the event of a major illness or sickness.

Catastrophic Health Insurance

Another way to find affordable medical insurance is catastrophic health insurance.  Catastrophic health insurance has large out of pocket limits, but the premiums are small.  So while the coverage is affordable on a month-to-month basis, it will not be affordable if you have a significant claim event.  But at least you’ll have medical coverage.  Most catastrophic plans will meet the requirements of coverage needed to avoid the individual mandate penalty.

A Parent’s Plan

Obamacare allows children to remain on their parent’s plan until age 26.  Not only is this a way to find affordable medical insurance, it can be a way to get free health insurance.  If a child is already on the plan, there is usually no additional cost to add another child.  This can be a great way for young people to get covered.

Affordable Medical Insurance is Available

Affordable medical insurance is available to young people.  However, affordable can be a relative term.  Healthcare is expensive, and so is the insurance to cover it.  But with some work, you can find a plan that fits your needs and your budget.

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Options to Access Health Insurance for Young Adults

With the requirement of the Patient Protection and Affordable Care Act (PPACA), also known as Obamacare, that every American purchase health insurance or face a tax, there are many young adults that will be looking to access health insurance for the first time in their lives.  There are so many options out there, it can be difficult to choose which is the best way to cover them and their families.  With that in mind, here are some of the best ways to access health insurance that is comprehensive and affordable.

An Employer’s Plan

The Affordable Care Act expanded the eligibility requirement of group plans.  Under Obamacare employers must offer medical coverage to all of their full-time employees, defined as employees working at least 30 hours per week.  If the employer refuses, they will pay a fine.

There are some formulas to determine the hours an employee works, but as long as a worker meets the 30 hours per week mark they will be offered the same coverage options as everyone else.

In addition to being offered coverage, the law requires that the insurance be affordable.  An employer cannot charge more than 9.5% of an employee’s monthly salary to access health insurance at the workplace.  If more than 9.5% is kept out of a paycheck, the employer will face a fine.

A Parent’s Plan

Another big advantage of Obamacare is the requirement that children be allowed to enroll in a parent’s plan until age 26.  Before the legislation was passed it was up to the insurance plan to decide how long children could be covered.  Now, a dependent can be enrolled long enough to give him or her time to establish their own means for paying for a medical insurance plan.

A parent’s plan can be an inexpensive way to access health insurance since many employers subsidize the cost of children on a plan.  If another child is already enrolled, then there usually is no extra cost to add another.

Health Insurance Marketplaces

Obamacare established health insurance marketplaces, online sites designed to help individuals and small businesses access health insurance with ease.  The marketplaces, also called exchanges, will offer 4 levels of plan design from various health insurance companies.  The exchanges are the responsibility of each state, and some states have built their own exchange.  Some others are sending their residents to a federal exchange.

If someone does not have coverage offered at work, earns less than 400% of the federal poverty level, and purchases insurance on the exchange, they will be eligible for tax credits to help offset the cost of the premium.

Individual Insurance

If group insurance and the health insurance marketplaces are not a viable option, there is still the possibility of finding individual insurance on your own.   There will be some legwork involved, as it is not necessarily easy to sort through plan designs from different companies.  However, you will have more options as to which level of insurance plan you would like than you will on the exchange. The coverage bar required to satisfy the individual mandate is not very high, and you can find plans that meet the requirements at a low price, albeit without much coverage.

If you do not want to find individual insurance on your own, you can hire a broker to access health insurance for you.

Medicaid

Before 2014, it was hard for adults in many states to qualify for Medicaid.  However, Obamacare expanded Medicaid to make it much easier to be eligible for assistance through this program.  Like the exchanges, Medicaid is administered through the states, so check with your state’s Medicaid office for more information.

No Pre-Existing Condition Exclusions

Being able to access health insurance is much easier post-2013 than it was before due to the fact that insurance companies cannot deny coverage to people due to pre-existing conditions.  This has made it less complicated to find a quality plan at a reasonable price.

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