THE HEALTH CARE LAW
The nation’s health care insurance system is undergoing major changes. The Affordable Care Act (also known as Obamacare) is expected to expand health care insurance coverage, with more benefits for more people, and more affordable coverage for many.
The law keeps today’s job-based, private insurance system and the Medicare system for those age 65 and older. It will also offer new ways to get health care insurance for those who are not able to do so due to health problems or price. There are four key features of the law:
- Coverage will be guaranteed and required.You will be able to get health care insurance coverage, even with a pre-existing condition. What’s more, you won’t have to pay more to have pre-existing medical conditions covered. Most Americans will be required to have health care insurance coverage or pay a penalty.
- All new plans will include coverage for essential health benefits.These are a comprehensive package of benefits, including preventive services, maternity and newborn care, and emergency services.
- You may qualify for cost assistance.Based on your income, you may now be able to get help paying for health care insurance coverage. Premium tax credits and help with cost-sharing are available to those who qualify.
- The Health Insurance Marketplace in Illinois will offer a new way to shop.You will be able to compare plan prices and benefits from a number of health care insurance companies offering coverage on the marketplace. However, you will still be able to buy directly from an insurance company or broker if you’d like. It’s your choice.
HOW WILL THE AFFORDABLE CARE ACT AFFECT ME?
- If you have health insurance.If you buy coverage yourself or have insurance with an employer or government program, you may not experience many changes. But your coverage may have some new benefits that the law puts in place, like free screenings for some preventive services and the ability to continue to insure your adult children up to age 26.
- If you don’t have health insurance.Your job might not offer health insurance. You may have had problems getting coverage because of an existing health problem. Or, you may not have been able to afford health insurance. The new health care law provides options for many individuals and families to get coverage who have not had and could not afford health insurance. Starting in 2014, you will be able to buy some form of health insurance if you are a U.S. citizen or a legal resident. There will be health plans that offer coverage to people with existing health problems. There may be help to pay for health insurance premiums.
- Almost everyone can get health insurance.Under the new law, health care insurance plans won’t be able to deny coverage to people for health reasons.
WHAT HAPPENS IF I DON’T GET HEALTH CARE INSURANCE?
Those who can afford but do not buy health care insurance will face penalties of $95 a year or up to 1% of their yearly income, whichever is greater. By 2016, the penalties rise to $695 or 2.5% of their yearly income. For families, the penalty is up to $285 in 2014, but will rise to $2,085 or 2.5% of their yearly income in 2016. Penalties will be collected by the Internal Revenue Service via annual tax returns.
TAX PENALTIES FOR FAILURE TO GET HEALTH INSURANCE
A percent of your income or a flat fee – whichever is higher
|Year||% of Income||Flat Fee|
|2014||1% of taxable income or||$95|
|2015||2% of taxable income or||$325|
|2016||2.5% of taxable income or||$695|
|After 2016||The tax will increase each year following the cost-of-living adjustment|
- November 1, 2016: Open Enrollment starts — first day you can enroll in a 2017 Marketplace plan
- January 1, 2017: First date 2017 coverage can start.
- January 31, 2017: 2017 Open Enrollment ends.
Special Enrollment Periods
Did you miss your opportunity to enroll? Well there are certain “Life Events” that may qualify you to enroll in the Affordable Care Act outside of the enrollment dates. Learn about the Special Enrollment Period and if you qualify here.
WHEN AND HOW SHOULD I BUY 2017 HEALTH CARE INSURANCE?
The sale of 2017 policies will begin on November 1, 2016.
If your current health care insurance is from your employer, you may not have to do anything. Ask your employer if changes will be made to your health care insurance plan and consider if it is best for you.
If you have an insurance agent that has helped you find insurance coverage in the past, you can still work with the agent. You can also buy directly from health care insurers.
You can also go to the Health Insurance Marketplace in Illinois. The Marketplace will give comparisons and have online calculators to help determine if you can get help paying for insurance.
WHAT IF I CAN’T AFFORD HEALTH CARE INSURANCE?
The new health care law may make health care insurance easier to afford. Tax credits will help people pay for premiums (monthly payments) when they buy coverage on the Marketplace.
Payment assistance may also be available for expenses that you pay when you receive medical treatment (such as deductibles, copays or coinsurance).
for a step by step guide to see if you qualify for a subsidy for payment assistance.
Then follow the steps to enroll online.
HEALTH INSURANCE PLANS TO FIT EVERY BUDGET
Whether you choose your health insurance on the Health Insurance Marketplace or elsewhere, you have many options to find the one that works best for you.
WHAT ARE THE DIFFERENT LEVELS OF
Blue Cross Blue Shield of Illinois has four levels of health care plans available through the Affordable Care Act — Bronze, Silver, Gold, and Platinum. All plans will have similar benefits, and all will include essential health benefits. Where they differ is on how the costs of the benefits are applied.
- 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 BCBSIL, with both the highest premium but also the richest benefits.
STILL HAVE QUESTIONS?
Don’t worry that is what Integrity is here for. Request a call at a time of your choosing and one of Integrity’s licensed agents will call you personally to answer any questions you may have about the Affordable Care Act. To request a phone call please click here.