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obamacare sign up

November 19, 2014 By Utahhealth

ObamaCare enrollment sign up

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Some Facts about ObamaCare Marketplace

Q:What are the main companies in Utah that offer health insurance with the marketplace?

A:Select health, Blue Cross, Humana one, Arches health plan, Bridge Span, and Altius

1.Parents or single parents can add their adult children (up to age 26) to their plans.
2.If anyone in the household gets sick, the insurance company can’t drop them from the plan regardless of what it is.
3.If any children are chronically ill, a new insurance company can’t deny coverage regardless of health issue.
4.Most families will find that wellness or pregnancy exams are now free. In other words, they no longer have to make co-payments.
5.Insurance companies can’t raise premium payments without getting the OK from the state government.
6.Some families received a check from the insurance company. That’s because Obamacare says that companies must spend at least 80% of
premiums on providing actual medical services. If they spent it on advertising or executive salaries, they have to pay the excess back.
7.Open enrollment is the only time you can apply for cost assistance or change plans without qualifying for special enrollment. The amount of insurers offering plans through the marketplaces has increased by 25% this year. Make sure to compare plans during open enrollment 2015, even if you already have a qualified health plan.
8.Private insurance outside of the health insurance marketplace, Medicaid and CHIP don’t have open enrollment periods. The health insurance marketplaces, Medicare and employer based insurance all have unique open enrollment periods. Please be aware that although individual policies have no official open enrollment period, you won’t be able to get minimum essential coverage (major medical that protects you from the fee) in most cases as insurers have unofficially adopted the Affordable Care Act’s marketplaces enrollment periods
9.Cost sharing subsidies are only available on silver plans.
10. The official name for “ObamaCare” is the Patient Protection and Affordable Care Act (PPACA). It is also commonly referred to as Obama care, health care reform, or the Affordable Care Act (ACA)

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What are insurance subsidies?

• Tax credits can be applied in part or in full in advance to lower your premiums or adjusted on your federal income taxes.

• If your income changes, report it so the marketplace can adjust your subsidies. You may qualify for bigger subsidies if your income decreases and you will save yourself from having to repay advanced tax credits if your income increases.

At anytime if you need help please call

 

If anyone can’t get insurance because of a pre-existing condition, Obamacare allows them to apply to the state to get temporary health insurance coverage until 2014. That’s when insurance companies can no longer deny coverage to adults.

People on Medicare – Obamacare allows seniors on Medicare to receive wellness and preventive care visits for free. See Medicare Preventive Services for the full list.

Those who are on Medicare Part D, which paid for some but not all the costs of prescription drugs, received $250 in 2010 if they needed it. In 2011, they received 50% off of brand-name prescription drugs, and a 7% discount for generic drugs. For more, see Drug Discounts. By 2020, Obamacare will pay 100% of prescription drug costs for those on Medicare Part D.

Those Who Earn $200,000 a Year or More – Taxes increased for individuals who earn $200,000 or more, and families who earn $250,000 or more. To find out more, see Obamacare Taxes.
Important Changes That Happen in 2014

Obamacare required everyone to enroll in health insurance by March 31, 2014. Those that didn’t are taxed about 1% of their 2014 income. Find out exactly how this affects you in How Much Will It Cost Me?

Anyone can still compare plans on the exchanges, which is a website run by their state or the Federal government. These exchanges also let people know when they qualify for tax credits. Obamacare is paying for most of the cost to operate these exchanges.

All health insurance plans must provide 10 essential health benefits. The only exceptions are plans that were in existence before March 23, 2010, and were “grandfathered in.”

 

Families Without Health Insurance – Obamacare allows more people to get Medicaid. Anyone who makes less than $15,281 a year, or a family of four that makes less than $31,321.50 a year, can apply for Medicaid on the exchange. (Note: The eligible income is actually 133% of the Federal poverty level, so it will increase with inflation). The Federal government will pay all the additional cost for the first three years. After that, the states will pay 10%. Find out more about Medicaid.

Most families that make too much to get Medicaid will still get help. If their incomes are less than $45,960 for an individual, or $94,200 for a family of four, they can get tax credits every month or even reduced copayments and deductibles. (Note: This eligible income is 400% of the poverty level, and it will also increase with inflation).

Many indiviudals don’t think the Federal government should have the right to force people to get health insurance. Why is the Federal government requiring it? The thinking is that If everyone has health insurance, more people will go to the doctor when they are getting sick, instead of waiting for their illness to turn into an expensive emergency. This should lower health care costs for everyone. Over time, health insurance should cost your family less. That’s because more healthy people will pay more premiums to insurance companies, who will then make more money. They will be competing with each other on the exchanges, so will want to charge less to get more business. older people on Medicare will have more of their drug costs covered, meaning they can afford to take all their medicine as they should, and stay out of the hospital.

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Common questions about the obamacare health plan

When is the deadline to sign up? The open enrollment period ends on Feb 15th 2015 to sign up. So, consumers have until then to sign up for coverage this year. Those who do not have health insurance before then–whether it was purchased on the marketplace or through their employer– will be required to pay a penalty. The next open enrollment period opens November 15, 2014.

Consumers must sign up by February 15 to have coverage take effect on March 1. You can still enroll after that deadline; you just won’t have health coverage until April 1. Originally, those without active coverage on March 31 would pay a penalty, but now, as long as you’ve signed up and paid for your plan before then, you will avoid the tax penalty. Please check your local office as effective dates can always change.

How much is the penalty for not having obamacare? Under the ACA’s individual mandate, the penalty in 2014 for not having health insurance is $95 per adult and $47.50 per child. The alternative is 1 percent of your total household income, whichever is greater up to a maximum equal to the national average annual premium for a “bronze” health insurance plan. The CBO estimates this to be approximately $5,000 for an individual in 2016 and $12,000 for a family. If you fail to obtain coverage, the fee will be applied to your annual taxable income for each month you don’t have health insurance beginning after March 31. In 2015, the penalty increases to 2 percent of your income. In 2016, it’s 2.5 percent of your income; by 2017, it will increase by the rate of inflation.

Can I qualify for an exemption so I don’t have to pay for insurance. The ACA’s so-called “hardship exemption” that exempts people from the penalty. (This is made on a case-by-case basis and ruled through the marketplace.) Some examples are below

You’re uninsured for less than 3 months of the year
The lowest-priced coverage available to you would cost more than 8% of your household income
You don’t have to file a tax return because your income is too low (Learn about the filing limit (PDF)
You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
You’re a member of a recognized health care sharing ministry
You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
You’re incarcerated (either detained or jailed), and not being held pending disposition of charges
You’re not lawfully present in the U.S.
You qualify for a hardship exemption

What kinds of health plans are offered under the obamacare health plans ? There are four types of plans available. They are referred to as the metallic plans. The bronze plan pays 60 percent of medical costs and has the lowest premiums; the silver plan—the standard plan– pays 70 percent of costs; the gold plan pays 80 percent; and the most robust plan, the platinum, pays 90 percent of costs and has the highest premiums. In all cases, the lower the premium, the higher the deductible. There’s also the catastrophic plan offered only to those 30 and under or those with the hardship exemption. These plans contain very bare bones coverage and have very narrow provider networks.

Filed Under: Uncategorized Tagged With: health insurance in utah, healthcare marketplace, obama health plans, obamacare, obamacare insurance, Utah health insurance, utah health insurance marketplace, utah insurance exchange

Utah health insurance premiums

January 21, 2014 By Utahhealth

Balancing monthly premiums with out-of-pocket costs

As with all Utah health plans, you’ll have to pay a monthly premium each month. But it’s also important to know how much you have to pay out-of-pocket for services when you get care.
Plans in the health care marketplace are separated into 4 different categories: Bronze, Silver, Gold, and Platinum
  • Premiums are usually higher for plans that pay more of your out-of-pocket medical costs when you get care. For example, if you have a Gold plan 80%, you’ll likely pay a much higher premium, but may have lower costs when you go to the doctor or use another medical service. So ask yourself how much you go to the doctor, will you need future surgery. Do you have on going health issues?
  • With the Bronze plan 60%, you’ll likely pay a much lower premium, but you’ll pay a higher share of costs when you get care.
  • Platinum plans 90% will likely have the highest monthly premiums and lowest out-of-pocket costs. The plan will pay more of the costs if you need a lot of medical care. These plans will most likely only be offered off the exchange meaning most companies will not be offering these plans on the marketplace.
  • Remember the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium cost, the lower the out-of-pocket costs when you need care
  • If you happen to qualify for out-of-pocket savings, you must choose the Silver plan to get the savings. If you qualify for these savings, you’ll get the out-of-pocket savings benefits of a either the Gold or Platinum plan for the Silver plans price.  It is quite amazing the plan you can get for the price if you qualify for the silver plans out of pocket savings. But remember, you can choose any category of plan, but you’ll get the out-of-pocket savings only if you enroll in a Silver plan.
  • Overall just think about the health care needs of your household when considering which Marketplace insurance plan to buy in Utah. Also you will want to think about which company and what doctors are on that list. Certain companies on the exchange will only cover a certain area. And with most of them they will all be HMO Plans. Call our office at 801-900-5636 or see our free informational site at Utahhealth.com to find out which plans and doctors are covered on the exchange and off the exchange. Get started now and review over 150 health plans in Utah.

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Filed Under: Uncategorized Tagged With: Utah health insurance, utah health insurance costs, utah health insurance premiums

What is a co-pay, co-insurance and OOP mean?

January 21, 2014 By utahhealth

1. What is a Copay

A Co-pay is your portion of the bill after the deductible has been meet. In  most cases you will have a $25 co-pay to see your primary doctor and if it is a specialist it maybe higher such as 40 or even 50.

2.What is Coinsurance

Most people are familiar and know what a co-pay is, but what about coinsurance?
Coinsurance is similar as to co-pay. Basically It’s your portion of a medical bill after your main deductible has been meet.
The difference between the two is that coinsurance is a percentage such as 90/10 or 80/20 while a co-pay is a fixed amount such as $25
What do these number mean? It’s very simple these numbers mean you pay for 10 percent or 20 percent of the bill after your deductible has been meet
After that your insurance company will pick up the tab for the rest of the approved amount up to the OOP or out of pocket maximum

3. What does Maximum out-of-pocket or OOP mean?

The  Maximum out-of-pocket annual spending means that once you have paid a certain amount for the year, your insurance company will begin paying 100 percent for all covered services.
One important thing to look out for when looking at the OOP or out of pocket maximum is that if your making a claim on an “out-of-network” you will most likely be paying a complete separate OOP and deductible
so be careful to stay inside your network so you’re not paying 2 deductibles. This could get very expensive.
What to know how much health insurance costs in Utah? enter your zipcode below to find out.

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Filed Under: Uncategorized Tagged With: co insurance, co pay, oop, out of pocket maximum, Utah health insurance

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