Take advantage of new health insurance exchanges

Cons umer tips

A s major por tions of the Patient Protection and Affordable Care Act— commonly referred to as Obamacare—are set to roll out beginning this fall, it’s an important time to understand how these changes will affect a significant number of currently uninsured Americans.

Unless Congress takes action to delay the implementation of the “individual mandate,” Americans who fail to purchase insurance coverage by Jan. 1, 2014 are subject to a fine of $95 per uninsured person or 1 percent of the household income. Fines will increase in 2015, eventually maxing out at $695 per uninsured person or 2.5 percent of household income in 2016.

To assist consumers in avoiding fines for non-compliance with the individual mandate, the department of Health and Human Services is launching a national Health Insurance Marketplace, also known as a “health insurance exchange,” on Oct. 1 of this year (more information at www.healthcare.gov).

The Marketplace will provide consumers with a central point to apply for health insurance and view a variety of options for purchase. It will also alert you if you qualify for free or low-cost coverage available through Medicaid or the Children’s Health Insurance Program.

If you live in the United States, are a U.S. citizen or national (or lawfully present), and are not currently incarcerated, you qualify to enroll in program.

The new insurance programs offered through the Health Insurance Marketplace are different from what you might have experienced in the past. Many consumers who have been denied insurance coverage previously due to preexisting conditions will notice the biggest change.

Beginning in 2014, health insurance plans can’t refuse to cover you or charge you more just because you are currently sick. Further, all plans offered through the Marketplace must cover many preventative care services at no out-of-pocket cost to you, including blood pressure, cholesterol, depression, diabetes and HIV screening, as well as immunization vaccines, among others.

Preventative care services for children, including autism screening and behavioral assessments, will also be offered without cost to the insured.

If you are a small business owner (50 or fewer full-time employees) and are interested in offering or changing your employees’ health insurance coverage to a plan in the Health Insurance Marketplace, you can enroll through the Small Business Health Options Program (SHOP). If you secure employee coverage through the SHOP marketplace and pay at least 50% of your full-time employees’ premium cost, you could qualify for the Small Business Health Care Tax Credit, which can add up to 50% of your contribution to employees’ premium costs (35% for tax-exempt employers).

It’s important to note that, as all of these changes are currently under way, now is an ideal time for scammers to capitalize on the opportunity. If you receive a phone call from anyone claiming to represent a government agency, do not give out your Social Security number or banking information. Doing so will not enroll you in the Health Insurance Marketplace or allow you to purchase insurance and could jeopardize your personal financial information.

When enrollment begins on Oct. 1, please visit www.healthcare.gov, call 1-800-318-2596 or contact a health insurance broker for more information. This information is provided as a public service by the Independent Bankers Association of Texas (IBAT) and the IBAT Education Foundation. This article is not intended as legal advice with the understanding that the association is not engaged in rendering specific legal, accounting or other professional services. Each state has specific laws governing the creation and use of a power of attorney. If specific expert assistance is required, the services of a competent, professional person should be sought.


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2013-08-29 digital edition



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