Now that the holidays are over and we have returned to our daily routines, it is a good time to review what has transpired since I last posted.
On January 1, the individual requirement to have health insurance went into effect. As I have written before, this means that individuals who are currently uninsured or who have insurance policies that are not considered compliant with the Affordable Care Act’s provisions must purchase a qualified insurance plan if they do not qualify for some form of government-funded insurance. Otherwise, they will be assessed a penalty fee. Completing an application on healthcare.gov will tell you what plans are available to you, whether you or your family may be eligible for Medicaid/CHIP, and whether or not you are eligible for a premium tax credit. Some individuals and families may be eligible for an exemption. You can see the eligibility rules for exemptions here.
As a reminder, the Affordable Care Act implements many consumer protections and more comprehensive coverage benefits than have ever been available before—no denied coverage for a pre-existing health condition, no lifetime or annual limits on coverage, expansion of essential health benefits, preventive services at no cost, review of provider premium increases, requirements for how insurance companies spend premium dollars, and much more.
According to Marilyn Tavenner, Administrator, Centers for Medicare & Medicaid Services, the most recent data for enrollment tells us that through the month of December at least 2.1 million people enrolled in a private health insurance plan through the federal or state marketplaces and 3.9 million people learned of their eligibility for Medicaid/CHIP coverage.
Individuals have until the end of the open enrollment period on March 31, 2014 to enroll in an insurance plan. In order to have coverage start at the 1st of the following month, you need to enroll by the 15th of the prior month. So, to have coverage by February 1, an individual would need to enroll by January 15.
Guidance has also been released which offers an additional option for those who may have received a policy cancellation letter for their individual insurance and have found all alternative coverage to be unaffordable. These individuals can apply for a hardship exemption, which will make them eligible to purchase catastrophic coverage that generally offers much lower premiums but higher deductibles.
The need for reaching out and educating others about this law and for encouraging others to enroll in insurance is just as important now as it was before January arrived. There are still many people out there who will benefit from having comprehensive health insurance coverage made available through the Health Insurance Marketplace.
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