By Frances Chaves
When your COBRA runs out, purchasing health insurance on the open market might become cripplingly expensive for you – especially if you’re still unemployed. By the way, in case you are curious, COBRA stands for the Consolidated Omnibus Budget Reconciliation Act.
However, all that changed this month with the introduction of the Individual Health Coverage (IHC) Program. The new Health Insurance Marketplace helps uninsured people find medical coverage. Under so-called “Obamacare,” people without access to employer, or government-sponsored health care programs can purchase affordable coverage for themselves, and their families, from different private insurance companies at affordable group rates.
Affordable is the key word here. The theory is that, with so many people in the market, insurance prices will naturally go down. Regardless of your age, or health condition, you will have the option to purchase guaranteed renewable health coverage under standard individual health benefit plans designed by the Individual Health Coverage Program Board, as well as under the Basic and Essential (B & E) plans sold by insurance carriers.
Insurance rates, information, and enrollment are available by going to: https://www.healthcare.gov/. The site has options to “Apply Now” or “Learn More First.” The site has been improved since it first went live such that I had no problem accessing it recently. Here’s what you need to know about the health insurance “exchange:”
Follow the links for more information on each topic.
Fill out the Marketplace application to be told if you qualify for:
• Private insurance plans, including lower costs based on your household size and income. Plans cover essential health benefits, pre-existing conditions, and preventive care. If you don’t qualify for lower costs, you can still use the Marketplace to buy insurance at the standard price.
• Medicaid and the Children’s Health Insurance Program (CHIP). These programs provide coverage to millions of families with limited income. If it looks like you qualify, they will share information with your state agency and they will contact you. Many, but not all, states are expanding Medicaid in 2014 to cover more people.
No matter what state you live in, you can use the Marketplace. Some states operate their own Marketplace. In some states, the Marketplace is run by the Federal government. Find the Health Insurance Marketplace in your state.
Most people must have health coverage in 2014 or pay a fee. If you don’t, you’ll have to pay a penalty of $95 per adult, $47.50 per child, or 1 percent of your income (whichever is higher). The fee increases every year. Some people may qualify for an exemption to this fee.
You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE (a health care program of the United States Department of Defense Military Health System), Veterans Administration (VA) health coverage, or some other kind of health coverage.
If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. However, you won’t qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn’t meet minimum requirements. You also may lose any contribution your employer makes to your premiums.
If you have Medicare, you’re considered covered and don’t have to make any changes. You can’t use the Marketplace to buy a supplemental or dental plan.
Marketplace open enrollment ends March 31, 2014. If you enroll by December 15, 2013, coverage can begin as soon as January 1, 2014.
Call 24 hours-a-day, seven days-a-week: 1-800-318-2596 (TTY: 1-855-889-4325)
What can you do until January 1, 2014?
Your children may be eligible for NJFamilyCare, which covers children in families with an income of up- to 350% of the federal poverty level. For more information about NJFamilyCare, call 1.800.701.0710 or visit www.njfamilycare.org.
NJFamilyCare Advantage is available for children in families with incomes above 350% of the federal poverty level. For more information about NJFamilyCare Advantage, call 1.800.637.2997 or visit www.horizonnjhealth.com/ourplans/njfamilycareadvantage/about-plan-affordable-healthcare-your-children.
For those who live in Somerset County and need medical care, a free health care clinic, the Zarephath Health Center, is available in Somerset, New Jersey. For more information, go to www.zhcenter.org or call (732) 537-0737. The center is located at 95 Weston Canal Road in Somerset New Jersey 08873.
By Frances Chaves