If you don’t have health insurance and want it, now is the time to act. The deadline to sign up for coverage under Obamacare is fast approaching.
Experts have many suggestions.
Some recommendations are as easy as calling the state insurance exchange, insurers, insurance brokers or one of many enrollment counselors hired to help you. But have patience. It could involve a long wait.
Here are things to consider.
Know the deadline. You have until March 31 to buy a private health plan that will take effect by May 1.
If you miss the deadline, you won’t be eligible to buy insurance again until open enrollment returns in November, and that coverage won’t take effect until 2015.
There are special circumstances under which you can buy a plan outside open enrollment. If you lose your job, for example, experience a death in the family, get married or divorced, move out of state or have a baby, you’ll be able to pick up a policy. For low-income Californians who qualify, Medi-Cal is also available year-round.
Beware of penalties. There are penalties for going without insurance. They would be part of your 2014 tax bill due about a year from now.
For 2014, adults will pay the greater of $95 (plus $47.50 for each child who goes uninsured) or 1% of household income, whichever is greater.
A lot of people are surprised to learn they’ll pay much more than the often-cited $95, says Aaron Martinez, master tax advisor with H&R Block. “Most people are going to pay 1% of their household income,” he says. There are also caps on the penalties and some exceptions.
If looming deadlines and the threat of penalties have suddenly persuaded you to buy insurance, here’s what experts say you should keep in mind.
Know what you’re entitled to. The health reform law makes subsidies available for individuals earning up to roughly $45,000 per year, and helps lower out-of-pocket expenses for those with incomes just below $29,000. California has also expanded Medi-Cal, the state’s health insurance for people with low incomes — those earning less than about $16,000 per year.
Many people eligible for financial assistance, however, still don’t know about it. A recent survey by Bankrate.com, a consumer financial services company, found that 70% of the uninsured are unaware of the tax breaks available to them.
Check for yourself before deciding insurance is too costly. Online calculators can help you figure out whether you are eligible for subsidies and how much. But don’t rely only on subsidy calculators to determine what you’re eligible for, says JoAnn Volk, senior research fellow with the Georgetown University Health Policy Institute. You should actually start the application process to determine any subsidy.
Then pick a plan. You’ll be able to select from four plan types, some with higher costs and more options, others with lower monthly costs and less coverage. People younger than 30 can also choose a low-cost catastrophic policy.
Experts say you need to carefully examine both the monthly cost of your plan and out-of-pocket expenses, such as deductibles, co-pays and co-insurance. If you want specific doctors, make sure they are in the network.
“Don’t just look at the price of the plan,” says Carrie McLean, director of customer care at EHealth, an online private health insurance exchange. Many Bronze plans come with high deductibles that you must pay out of your own pocket before your insurer helps you with your medical bills, McLean says.
You can shop on or off the exchange. If you qualify for a tax subsidy, you must buy your plan through the state’s health insurance exchange, Covered California, to take advantage of it.
But if you earn too much to qualify for financial help, you can search beyond the health plans offered by Covered California to get a wider range of options.
Health insurance websites such as GetInsured and EHealth can help you buy insurance. You can also work with an insurance agent. To find one, search the website of the California Assn. of Health Underwriters.
Switch plans before you’re stuck. If you’ve already signed up for a plan and you’re not happy with it, in California you can switch to a new one — as long as you do so by March 31.
If you bought your plan through Covered California and qualified for a tax subsidy, don’t wait until the last minute to make the switch — the process takes time. “Our experience is it takes 24 hours or longer for the system to recognize that you’re canceling a plan and signing up for another,” McLean says.
You can also contact Covered California at (800) 300-1506 to get assistance making the switch, or your insurance agent can help if you worked with one.
Get help now:
Volk’s parting advice to those who still want insurance for 2014: Don’t wait until the very last minute. It’s not yet clear, she says, what will happen to the applications started on March 31 that might not get completed in time. “Get in line now.”
Here are websites to help you with last-minute sign-ups:
California’s health insurance exchange: Covered California, (800) 300-1506.
H&R Block offers free assistance signing up for health insurance.
Health insurance exchange information outside California: HealthCare.gov.
Zamosky is the author of a new book, “Healthcare, Insurance, and You: The Savvy Consumer’s Guide.”