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Take advantage of help enrolling in health insurance
Tamera Manzanares/For the Saturday Morning Press
If the thought of finding health insurance makes your blood pressure rise, it’s understandable. The process can be confusing and complex. The insurance marketplace, where many people will need to get their health insurance for 2016, is not open long; you need to enroll by Dec. 15 to be covered at the beginning of New Year. The following are answers to frequent questions about open enrollment. The most important thing to know is that free, in person assistance is available locally to help you find the right plan.
What is open enrollment and the health insurance marketplace?
The Affordable Care Act requires everyone have health insurance. There is a marketplace in each state with insurance options. The marketplace in Colorado is Connect for Health Colorado. Anyone who does not have health insurance through their employer or public insurance (Medicaid or Child Health Plan Plus) needs to get covered through the health insurance marketplace by Jan. 31, 2016.
What happens if I don’t get health insurance?
Individuals who don’t enroll in health insurance by Jan. 31, 2016 will face tax fines in 2017. The fine is $695 per adult or 2.5 percent of income, whichever is more. A person making $50,000 per year, for example, would pay $1,250. There may be additional fines for children who are not covered. Exclusions may apply to individuals experiencing certain hardships, financial changes or other life change events. These circumstances will qualify a person to enroll in or change insurance plans outside the open enrollment period.
What type of financial help is available?
Some people may qualify for free or low cost health insurance through Medicaid or Child Health Plan Plus (CHP Plus). In Colorado, Medicaid provides health coverage for some low-income individuals, families, children, pregnant women, the elderly and people with disabilities. CHP Plus is health coverage for pregnant women and children in families who earn too much to qualify for Medicaid. For those that do not qualify for Medicaid or CHP Plus there may be tax credits available to help offset the monthly cost of premiums.
What types of plans are available? What will they cover?
All plans cover the most important services like doctor visits, hospitalizations, prescriptions, maternity and infant care and mental health care. Many preventative services, such as immunizations, colon cancer screenings, mammograms and Pap tests are covered at no cost. Doctor visits and other services may involve out-of-pocket costs such as co-pays (a set amount you pay for a healthcare visit), deductible (the amount you pay each policy period for some services before your insurance kicks in) and coinsurance (the portion of health care costs you pay once you’ve met your deductible). Some plans may have a lower monthly premium but higher copays, which can be a good option for people who don’t go to the doctor often and want low monthly costs. Other plans have higher monthly premiums but lower out-of-pocket costs.
What if I’m already enrolled in health insurance?
You will need to update your financial information to make sure your plan is still right for you. Plans and pricing change every year, so it’s a good idea to review other options. This will ensure your plan is appropriate for your circumstances and prevent you from paying too much or having to pay money back due to inaccurate income information.
How do I enroll?
Every person’s healthcare situation is different. Although you can compare health insurance plans and enroll online, the process can be complicated. Health coverage guides are available in our communities to walk you through your options. Insurance brokers also can advise you on your insurance options; they do not charge for this service. Health coverage guides are available at the Northwest Colorado VNA. Call 970-871-7324. Drop in enrollment events will be held 5:30 to 7 p.m. Dec. 14 and Jan. 14 at YampaCare Family Medicine, 595 Russell St. For more information, go to nwcovna.org/health insurance.