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What are my insurance options without the Affordable Care Act?

Q6: I don’t want to use the Affordable Care Act. What are my insurance options?

A: “I don’t want anything to do with Obamacare.” “I don’t want to sign up for health insurance through the government!” We hear these concerns and understand, but the law is not a health plan, or coverage, ACA contains the rules that govern health insurance in America. The new laws focus on two key elements:

  1. If you have a pre-existing health condition, you will not be denied or charged more for coverage.
  2. Depending on household income and access to coverage through your employer you may have access to a credit that will reduce your healthcare costs.

We are not here to debate the merits of the ACA, but rather, we want to find the ways it can best work for you. Don’t wait or get penalized for not having health insurance in 2015. Give us a call at 888.788.1565 today or submit a request for a quote online to discuss the options available currently and what you can do to cover yourself, your family or business.

 

 

 

So, do I really need health coverage?

In the past buying your own health insurance was difficult. Those looking to get covered would have to answer questions about their age, height, weight, mediations, health history and then at the end of a long underwriting process, premiums would be increased based on these factors or, in some cases, people would be denied coverage all together.

Millions of Americans continue to go without health insurance, hoping they won’t get sick or have an accident. Sure, if you do have a medical emergency, you can go to the emergency room without health insurance and you will be treated. However, you will be expected to cover the entire cost of your treatment yourself.

As you may know, the Affordable Care Act (ACA) has a law in place (often referred to as the Individual Mandate) that now makes enrollment into a “qualified health plan” a requirement.

If you didn’t have coverage in 2014, you’ll have to pay one of these two penalties when you file your 2014 federal tax return:

  • 1% of your yearly household income.
  • $95 per adult and $47.50 per child (under 18).The maximum penalty per family using this method is $285.

Despite the debate, the Affordable Care Act can make getting health insurance easier and more affordable for many Americans. There are two man reasons.

  1. Coverage Is Guaranteed!

Along with the requirement for everyone to enroll in health coverage, the Affordable Care Act also changes the way individuals and families qualify for health insurance. Starting in January of 2014, individual and family health plans were guaranteed issue without underwriting. That’s right! Insurance companies can’t base your premium costs on your health history. The only factors they can use are: age, tobacco use and factors for the area in which you live.

  1. Premium Tax Credits

If you’re an individual or family without access to employer sponsored health insurance, there’s a new tax credit available to that can reduce your monthly premium AND potential reduce your deductibles and copayments on your qualified health plan. To be eligible for the premium tax credit, you’ll need to meet these 5 requirements.

  • Your household income is 100 to 400 percent above the Federal Poverty Level (chart below).Most people in this range will be eligible, but not everyone. We can help you determine eligibility, just request a free quote!
  • Your employer doesn’t offer health insurance that pays for at least 60% of your benefits and costs you less than 9.5% of your income.
  • You are not able to use other government health programs, such as Medicaid or Medicare.
  • You file a joint return if you’re married.
  • Another person does not claim you as a dependent.

 Household Size

 100%

 133%

 150%

200%

250%

 300%

400%

 1

$11,670

$15,521

$17,505

$23,340

$29,175

$35,010

$46,680

 2

15,730

 20,921

23,595

  31,460

39,325

47,190

62,920

 3

19,790

 26,321

29,685

  39,580

49,475

59,370

79,160

 4

23,850

 31,721

35,775

  47,700

59,625

71,550

95,400

 5

27,910

 37,120

41,865

  55,820

69,775

83,730

111,640

 6

31,970

 42,520

47,955

  63,940

79,925

95,910

127,880

 7

36,030

 47,920

54,045

  72,060

90,075

108,090

144,120

 8

40,090

 53,320

60,135

  80,180

100,225

120,270

160,360

Chart c/o http://familiesusa.org/product/federal-poverty-guidelines. Source: Calculations by Families USA based on data from the U.S. Department of Health and Human Services.
*If you find your income outside of the above chart there are many options for health coverage but you just won’t qualify for the premium tax credits. The guarantee issue laws still apply and you will have access to purchase plans on or off the marketplace in your state.

Now that you know a little more about ACA and some ways it can help your family, knowing when and how to enroll can be tricky. Most people will enroll in a new 2015 health plan during the Open Enrollment Period starting November 15th, 2014 and ending February 15th, 2015. If you miss the enrollment period, you may not be eligible to enroll again for a while.

You can apply for coverage outside of open enrollment periods due to: getting married, having a baby, a loss of coverage, moving from one state to another, adoption, divorce, a significant change in income and a few other reasons. All of these situations are called Qualifying Life Events. Typically–you only have 60 days to make a change or enroll in a plan due to a Qualifying Life Event.
Have you decided to get covered but aren’t sure how to find a plan? That is where Crosspointe Insurance Advisors can help. Our advisors are here to work with and for you to determine the insurance program that best fits your needs. The consultation and great advice come at no cost to you. Give us a call today at 888.788.1565 or request a quote online and we’ll find the best plan for you!