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Health Insurance Law for 2013 and 2014
Programs you may be eligible for:
You’ll find out what plans are available and whether you qualify for lower costs
when you fill out your Marketplace application. You’ll also find out if you
qualify for Medicaid or the Children’s Health Insurance Program (CHIP).
Marketplace plans provide complete coverage
Even if you don’t qualify for lower costs on Marketplace insurance, you can
still buy a plan. All Marketplace plans cover essential health benefits, offer
many preventive services for free, and include coverage for pre-existing health
conditions.
Here's a link for some options: http://getprotected.us
Getting help with Marketplace costs
As you get ready to apply, remember: If you have household income between
$11,490 and $45,960 for individuals ($23,550 to $94,200 for a family of 4),
you’ll get lower costs on your monthly premiums.
Top Information for You
How can I get lower costs on Marketplace coverage?
When you use the Health Insurance Marketplace you may be able to get lower costs
on monthly premiums or out-of-pocket costs, or get free or low-cost coverage.
What if I have a pre-existing health condition?
Starting in 2014, most health insurance plans can't refuse to cover you or
charge you more just because you have a pre-existing health condition.
Being sick doesn't keep you from getting coverage
Starting in 2014, being sick won't keep you from getting health coverage. An
insurance company can't turn you down or charge you more because of your
condition.
Once you have insurance, the plan can't refuse to cover treatment for pre-
existing conditions. Coverage for your pre-existing conditions begins
immediately.
This is true even if you have been turned down or refused coverage due to a pre-
existing condition in the past.
One exception: Grandfathered individual health insurance plans
The only exception is for grandfathered individual health insurance plans--the
kind you buy yourself, not through an employer. They do not have to cover pre-
existing conditions.
If you have one of these plans you can switch to a Marketplace plan during open
enrollment and immediately get coverage for your pre-existing conditions.
Be sure not to miss open enrollment
You can apply for Health Insurance Marketplace insurance now. Coverage starts as
soon as January 1, 2014.
Open enrollment ends on March 31, 2014. Outside of open enrollment, you can't
enroll in Marketplace coverage unless you have a qualifying life event.
Open enrollment will begin again in October 2014.
Here's a link to some options: http://getprotected.us
Find out what you can do now to get ready to enroll.
Pre-existing conditions with Medicaid and CHIP
Medicaid and the Children's Health Insurance Program(CHIP) also can't refuse to
cover you or charge you more because of a health condition.
Questions? Call 1-800-318-2596, 24 hours a day, 7 days a week. (TTY: 1-855-889-
4325)
What if I need coverage that starts before January 2014?
You can buy individual insurance that starts before January 1, 2014. We can help
you find your options. But some rights and benefits won’t apply yet.
What if I'm self-employed?
If you're self-employed with no employees, you're not considered an employer.
You can use the Marketplace to find coverage that fits your needs.
What if someone doesn't have health coverage in 2014?
https://www.healthcare.gov/what-if-someone-doesnt-have-health-coverage-in-2014/
When the uninsured need care
When someone without health coverage gets urgent’often expensive’medical care
but doesn't pay the bill, everyone else ends up paying the price.
That's why the health care law requires all people who can afford it to take
responsibility for their own health insurance by getting coverage or paying a
penalty.
People without health coverage will also have to pay the entire cost of all
their medical care. They won't be protected from the kind of very high medical
bills that can sometimes lead to bankruptcy.
The fee in 2014 and beyond
The fee in 2014 is 1% of your yearly income or $95 per person for the year,
whichever is higher. The fee increases every year. In 2016 it is 2.5% of income
or $695 per person, whichever is higher.
In 2014 the fee for uninsured children is $47.50 per child. The most a family
would have to pay in 2014 is $285.
It's important to remember that someone who pays the fee won't get any health
insurance coverage. They still will be responsible for 100% of the cost of their
medical care.
After open enrollment ends on March 31, 2014, they won't be able to get health
coverage through the Marketplace until the next annual enrollment period, unless
they have a qualifying life event.
If someone can afford it but doesn't have health insurance coverage in 2014,
they may have to pay a fee. They must also pay for all of their care.
Minimum essential coverage
To avoid the fee in 2014 you need insurance that qualifies as minimum essential
coverage. If you're covered by any of the following in 2014, you're considered
covered and don't have to pay a penalty:
Any Marketplace plan, or any individual insurance plan you already have
Any employer plan (including COBRA), with or without “grandfathered“ status.
This includes retiree plans
Medicare
Medicaid
The Children's Health Insurance Program (CHIP)
TRICARE (for current service members and military retirees, their families,
and survivors)
Veterans health care programs (including the Veterans Health Care Program,
VA Civilian Health and Medical Program (CHAMPVA), and Spina Bifida Health Care
Benefits Program)
Peace Corps Volunteer plans
Other plans may also qualify. Ask your health coverage provider.
Here are some health care options: http://getprotected.us
Learn about getting exemptions from paying the fee..
What kinds of health insurance don't qualify as coverage?
Health plans that don't meet minimum essential coverage don't qualify as
coverage in 2014. If you have only these types of coverage, you may have to pay
the fee. Examples include:
coverage only for vision care or dental care
workers' compensation
coverage only for a specific disease or condition
plans that offer only discounts on medical services
What is the Health Insurance Marketplace?
The Marketplace is a new way to find health coverage that fits your budget and
meets your needs. With one application, you can see all your options and enroll.
Try some of these options here: http://getprotected.us

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Health insurance law for 2013 and 2014

  • 1. Health Insurance Law for 2013 and 2014 Programs you may be eligible for: You’ll find out what plans are available and whether you qualify for lower costs when you fill out your Marketplace application. You’ll also find out if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP). Marketplace plans provide complete coverage Even if you don’t qualify for lower costs on Marketplace insurance, you can still buy a plan. All Marketplace plans cover essential health benefits, offer many preventive services for free, and include coverage for pre-existing health conditions. Here's a link for some options: http://getprotected.us Getting help with Marketplace costs As you get ready to apply, remember: If you have household income between $11,490 and $45,960 for individuals ($23,550 to $94,200 for a family of 4), you’ll get lower costs on your monthly premiums. Top Information for You How can I get lower costs on Marketplace coverage? When you use the Health Insurance Marketplace you may be able to get lower costs on monthly premiums or out-of-pocket costs, or get free or low-cost coverage. What if I have a pre-existing health condition? Starting in 2014, most health insurance plans can't refuse to cover you or charge you more just because you have a pre-existing health condition. Being sick doesn't keep you from getting coverage Starting in 2014, being sick won't keep you from getting health coverage. An insurance company can't turn you down or charge you more because of your condition. Once you have insurance, the plan can't refuse to cover treatment for pre- existing conditions. Coverage for your pre-existing conditions begins immediately. This is true even if you have been turned down or refused coverage due to a pre- existing condition in the past. One exception: Grandfathered individual health insurance plans The only exception is for grandfathered individual health insurance plans--the kind you buy yourself, not through an employer. They do not have to cover pre- existing conditions. If you have one of these plans you can switch to a Marketplace plan during open enrollment and immediately get coverage for your pre-existing conditions. Be sure not to miss open enrollment You can apply for Health Insurance Marketplace insurance now. Coverage starts as soon as January 1, 2014. Open enrollment ends on March 31, 2014. Outside of open enrollment, you can't enroll in Marketplace coverage unless you have a qualifying life event. Open enrollment will begin again in October 2014. Here's a link to some options: http://getprotected.us
  • 2. Find out what you can do now to get ready to enroll. Pre-existing conditions with Medicaid and CHIP Medicaid and the Children's Health Insurance Program(CHIP) also can't refuse to cover you or charge you more because of a health condition. Questions? Call 1-800-318-2596, 24 hours a day, 7 days a week. (TTY: 1-855-889- 4325) What if I need coverage that starts before January 2014? You can buy individual insurance that starts before January 1, 2014. We can help you find your options. But some rights and benefits won’t apply yet. What if I'm self-employed? If you're self-employed with no employees, you're not considered an employer. You can use the Marketplace to find coverage that fits your needs. What if someone doesn't have health coverage in 2014? https://www.healthcare.gov/what-if-someone-doesnt-have-health-coverage-in-2014/ When the uninsured need care When someone without health coverage gets urgent’often expensive’medical care but doesn't pay the bill, everyone else ends up paying the price. That's why the health care law requires all people who can afford it to take responsibility for their own health insurance by getting coverage or paying a penalty. People without health coverage will also have to pay the entire cost of all their medical care. They won't be protected from the kind of very high medical bills that can sometimes lead to bankruptcy. The fee in 2014 and beyond The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher. In 2014 the fee for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285. It's important to remember that someone who pays the fee won't get any health insurance coverage. They still will be responsible for 100% of the cost of their medical care. After open enrollment ends on March 31, 2014, they won't be able to get health coverage through the Marketplace until the next annual enrollment period, unless they have a qualifying life event. If someone can afford it but doesn't have health insurance coverage in 2014, they may have to pay a fee. They must also pay for all of their care. Minimum essential coverage To avoid the fee in 2014 you need insurance that qualifies as minimum essential coverage. If you're covered by any of the following in 2014, you're considered
  • 3. covered and don't have to pay a penalty: Any Marketplace plan, or any individual insurance plan you already have Any employer plan (including COBRA), with or without “grandfathered“ status. This includes retiree plans Medicare Medicaid The Children's Health Insurance Program (CHIP) TRICARE (for current service members and military retirees, their families, and survivors) Veterans health care programs (including the Veterans Health Care Program, VA Civilian Health and Medical Program (CHAMPVA), and Spina Bifida Health Care Benefits Program) Peace Corps Volunteer plans Other plans may also qualify. Ask your health coverage provider. Here are some health care options: http://getprotected.us Learn about getting exemptions from paying the fee.. What kinds of health insurance don't qualify as coverage? Health plans that don't meet minimum essential coverage don't qualify as coverage in 2014. If you have only these types of coverage, you may have to pay the fee. Examples include: coverage only for vision care or dental care workers' compensation coverage only for a specific disease or condition plans that offer only discounts on medical services What is the Health Insurance Marketplace? The Marketplace is a new way to find health coverage that fits your budget and meets your needs. With one application, you can see all your options and enroll. Try some of these options here: http://getprotected.us