Home > Flustered by Finances? Ask Ellen Le
Flustered by Finances? Ask Ellen Le
Flustered By Finances? Ask Ellen
GENERAL THINGS YOU SHOULD KNOW ABOUT OBAMACARE
(Patient Protection and Affordable Care Act/PPACA)
• Anyone under age 65 can apply for individual coverage through his/her state exchange.
If you already have insurance you like, you don’t need to apply.
1. Applying online: www.heathcare.gov.
2. Open enrollment is 10/1/13 – 3/31/14.
3. Insurance is effective 1/1/14.
• The Kaiser Family Foundation has a nifty calculator that gives you an estimate of what your premium would be. Click LINKS on our website’s homepage.
• If you don’t have insurance in 2014, you will be fined $95 per adult and $47.50 per child. Penalties will increase in 2015 and 2016.
• You will be asked if you have insurance when you file your 2014 IRS tax return. Your insurance plan (or company) will provide you with a form proving you have insurance which will need to be filed with your taxes. (People who don’t have any reportable income will not be penalized if they don’t have insurance.)
• Exchanges will offer 4 levels of coverage - Bronze, Silver, Gold, and Platinum –ranging from lowest coverage and premium to highest coverage and premium.
• Sizable income-based subsidies are available towards insurance premiums bought through state exchanges only. Assets are not considered but income from assets is.
• All insurance plans (on state exchanges or not) will have to provide standard essential coverage, accept a participant despite pre-existing1. EXCEPT for grandfathered plans (plans that existed since 3/23/10) that won’t have to meet all the requirements of PPACA …as long as those plans don’t change their coverage or premiums drastically.
2. Grandfathered plans will have to meet much of the new law’s requirements; a few examples of what they will not have to provide:
a. They can charge for preventive care on a cost-sharing basis
b. They can impose annual benefit limits
c. They can lock out children with pre-existing conditions.
• Taking subsidies out of the equation, older individuals (over the age of 50) will typically have lower premium costs than they had before and younger individuals (under age 50) will have higher costs. Also, premium costs will vary geographically depending on how many insurance providers participate and what the average costs were prior to PPACA. (DE: 3 participating insurance providers; PA: 8; NJ: 4; NY:16.) The average monthly premium in all states (and all ages under 65) for a comparable Silver plan will be $328.
• Premium costs for individual insurance not bought through state exchanges will be driven higher in some states.
Ellen will consider all legitimate questions and prioritize those of broadest concern. Please be patient if your question is not answered immediately. Email your questions to:WilmingtonChapter@hadassah.orgwith Ask Ellen as the subject. If Ellen selects your question, it will appear in her “Flustered By Finances?” column in the bulletin and/or on her webpage on our website.