Health Care Reform and Your Options Now and in 2014
With the Supreme Court's June 28, 2012 decision to uphold the Health Care Reform mandate, most American citizens and legal residents will soon either have health insurance or pay a penalty. If you are not yet insured or looking to understand what makes the best sense for your situation, follow this easy-to-follow road map.
I'm Uninsured Now:
The Health Care Reform does not require you to have health insurance now, but if you want to give yourself or your family some peace of mind from unexpected medical expenses, you can get coverage now. Here are your options -
- Get medical coverage protection now. Apply today for individual-family health insurance or small group health insurance. To begin, get quotes by entering your zip code on the right side of this page and clicking "Go".
- Get health insurance anytime between now and January 1, 2014. You can wait to get coverage privately or through the new health insurance exchanges that will be available to start quoting on October 1, 2013.
I Can Wait for 2014 to Buy or Change Health Plans:
In 2014, when the Affordable Care Act is implemented, you can avoid Health Care Reform penalties by applying for coverage under any of these options, as applicable -
- Medicaid or Medi-Cal if you are a California resident. In 2014, you may be eligible for coverage under Medicaid if your state agrees to the new expansion plan that extends Medicaid to all ages, and if your income is 138 percent of the federal poverty level. Currently, the income threshold for Medicaid is $14,856 for one person or $30,656 for a family of four. Some states are opting out of the Medicaid expansion due to the cost it will eventually bring to their citizens, so stay tuned to current events in your state, to find out if this option is available to you.
- Health Insurance Exchange Plans. If you are not eligible for Medicaid in 2014, you can contact a health insurance exchange then, to see if you qualify for an individual-family plan, a small business plan, or another government plan other than Medicaid. Depending on your income, you could qualify for tax credits or government subsidies. You can get health insurance exchange quotes starting October 2013.
- Private Health Plans. If you make too much money to qualify for the above options, you can enroll for an individual or family health plan or small group plan directly with any of the insurance carriers or through a health insurance broker. This particular option is the way most people get insurance now. In 2014, the health plans are expected to be different than the ones currently in the market, due to the minimum benefits required under Health Care Reform. For details, click Health Insurance Exchange Plans.
- Group Insurance. If your employer offers health benefits and you are eligible, this would be a great way to comply with the mandate. Bear in mind that small businesses are not obligated to provide health coverage, so availability of this option rests solely on the business owners.
I Have Insurance but Want a More Affordable Health Insurance Option Now:
These are options you can consider today -
- If you're on a private individual or family health plan, get quotes for a higher deductible option. If you tend to get medical services often, this may not be the best direction for you, so be sure to weigh your out-of-pocket costs before switching.
- If you're on a group plan, get quotes for an individual or family plan. Remember that you can still get denied coverage due to health status. So if that's you, then, your best bet may be to check with your employer about switching to a more affordable health insurance plan. Note that in 2014, you can switch more easily to an individual or family plan because you can't be denied for medical reasons, plus you could be eligible for tax credits under Health Care Reform.
- If you've been denied previously and are not eligible for group insurance, look into a health plan through the government. In California, consider Medi-Cal (Tel: 1-888-747-1222) if you're low income, or MRMIP (Major Risk Medical Insurance Program- Tel: 1-800-289-6574) if you've been denied previously.
Health Reform Penalties for Uninsured and Exemptions
In 2014, if you are uninsured and you do not meet any of the exemptions below, you will be penalized. The Health Reform penalties for uninsured people will be $95 or 1 percent of an individual's annual income, whichever is more. The penalty will increase every year. By 2016, the Health Care Reform penalty will be $695 or 2.5 percent, whichever is greater. People without insurance in 2014 will be exempt from the Health Reform penalties for uninsured if:
- He or she had medical coverage nine months of the year.
- Due to religious reasons. The government is in the process of determining which religious groups or sects will qualify for this exemption. Clarification is anticipated as we get closer to 2014.
- The individual is a Native American Tribe member.
- There is a financial hardship.
- The individual is incarcerated.