Health Care Reform – Act Now, Don’t Wait

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It’s been all over the news: confusion, delays, people have been getting health insurance cancellation notices. The healthcare.gov website is not functioning well, at best. Phone ins to HealthCare Reform (ACA) only delay the process as these call must be enrolled through the same site that doesn’t work. So what should a person do?

What is ACA? It is where private insurance companies sell policies with federally mandated benefits. ACA is not a government health care plan. First, this is the law of the land and I do not think it will “go away”. There will be changes made to ACA, but a healthcare reform format will remain. All people who have individual health plans that were taken out or substantially changed after 3/23/2010 are included in those who must secure an ACA plan. So, to make this simple, I will give you my thoughts in outline form:

  • If you have employer sponsored health insurance, you may not need to act.
  • You may have received a 12/31 cancelation notice – if so you will need to act by 12/15 for the 1/1/2014 effective date on a new ACA plan.
  • If your current individual health plan continues past 1/1/14, find out when/if it will terminate.
  • Until healthcare.gov is running smoothly you should still research the plans best for you.
  • Use subsidy “estimated” calculators to explore if you are entitled to a subsidy. Look at plan designs. Do not wait until the last few days.
  • Know what PPO you use and gather information on plans directing people to that PPO (e.g. OSF or Methodist)
  • If your income is at or below 138% of the federal poverty level ($32,499 for a family of 4), your choices are to go onto Medicaid or apply off exchange for a plan. If Medicaid qualified , any subsidies you receive would be deducted for your next tax return.

Here’s what I recommend you do…

Anyone can logon to Blue Cross using my link. Here are the steps:

  • Go to this site- https://retailweb.hcsc.net/retailshoppingcart/IL/census?ExpressLinkedAgentId=241200.
  • Enter your family data
  • Click on the income subsidy “estimator” link and list your income to see if you qualify for Premium Tax Credits. This is not the official calculator – That should be done later.
  • If you do not qualify for Premium Tax Credits you will proceed directly to their quotes (You can bypass the Public Exchange/Marketplace for your coverage.)
  • If you qualify for assistance, enter your income in the estimator, not the official calculator.
  • Products will then be shown with their net cost after the premium tax credit is applied (When you’re ready to apply you will have to spend the extra time to use the official calculator.)
  • Note that over and above medical, you are now required to carry qualified dental insurance on children – either with your medical carrier or a qualified third-party dental plan.
  • You can apply for either on and off the exchange. Remember, plans and costs are the same whether you go directly to a carrier, the federal site, or use an agent.
  • I recommend that you use an ACA agent and get started ASAP.

Written by

Steven A. Buttice is the president of Medical Reimbursement & Management Services, Inc., a firm specializing in issues affecting seniors, including seminars and consultation on Medicare Plans, Long Term Care and other types of insurance, claims issues, and sales/service of insurance products since 1984.

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