The Affordable Care Act’s health insurance exchanges opened for business earlier this month. Beginning November 1, 2015, consumers were able to obtain quotes for the ACA health plans and either switch plans or enroll in a Covered California health insurance plan. Apply by Dec. 15 for coverage to begin on Jan 1. This open enrollment period will end on January 31, 2016. No one can be turned down for medical reasons. Also, you may qualify for government subsidies if you meet the income requirements.
Enrollment Deadline
Those who currently lack insurance should sign up without delay. If you meet the Jan. 31 enrollment deadline, you will avoid owing a tax penalty for being uninsured. Those who had coverage this year may be able to find a better deal available to them for coverage starting in 2016. Others with special qualifying life events can enroll at any time of the year. Medi-Cal enrollment is also year-round.
Estimate of Premiums
To get an estimate of the price you would pay is to use the Covered California “Shop and Compare Tool.” The price is based on your estimated income for the coverage year, your ZIP code, your household size and your age. If you are a low- or moderate-income Californian, you may get help through monthly subsidies that lower your premium costs.
Penalties for No Insurance
Insurance also keeps people from having to pay the Affordable Care Act’s penalty for not maintaining coverage — a penalty that increases dramatically in 2016. This year, those who were uninsured paid either $325 per adult and $162.50 per child, up to a maximum of $975, or 2 percent of their income — whichever was greater.
In 2016, those who don’t secure coverage will pay much more. The per-person rates will more than double to $695 per adult and $347.50 per child, up to a maximum of $2,085 or 2.5 percent of their income – is greater. That’s a lot of money to spend for no insurance.
Grandfathered Insurance Plans
If you’ve been on the same health insurance plan since March 23, 2010, your California plan is grandfathered if there were no considerable benefit or contribution changes. If your health insurance plan qualifies, you are not required to switch to an Obamacare plan and you meet the mandate for individual health insurance.
Enrollment and Subsidies
If you are not already enrolled on a health plan that meets the Affordable Care Act minimum essential benefits requirement, you will need to switch plans. Federal tax credits subsidizing coverage are available through the exchanges for low-income individuals. In 2015, 85 percent of those who bought private plans through Obamacare exchanges got financial assistance.
Selecting a health plan can be confusing. The cost for the plan you choose in California varies by Region of which there are 19 with Santa Cruz County in Region 9. The Affordable Care Act provides two types of incentives for buying insurance – carrots in the form of subsidies to those with low incomes, and sticks in the form of ever-increasing penalties for those who fail to sign up.
•••
Covered California Website: www.coveredca.com