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Be Sure You’re Covered! Navigating Health Insurance Marketplaces

It’s that time of year again. Health insurance marketplaces are open for enrollment November 15, 2014 – February 15, 2015. These marketplaces give uninsured individuals and families the opportunity to sign up for health coverage.

We know that going through the process of enrollment can be intimidating, but it’s important. Yes, health insurance provides coverage for upcoming planned and unplanned medical care. But this year, the penalty for not having health insurance is going up. If you remain uninsured for 2015, you will face a tax penalty of up to 2% of your gross household income or $325 per adult and $162.50 per child (you’ll pay whichever amount is higher).

With the holidays around the corner, it’s a good idea to prepare for enrollment now. Consider the following:

Gather Materials to Apply

To apply for health insurance on the marketplaces, you’ll need some information handy. Remember to have these items for each member of your household (when applicable).

1. Mailing address 2. Social Security number 3. Employer and income info – You can use paystubs or W2 4. Estimated 2015 income 5. Insurance info for current coverage – This includes your policy numbers 6. A completed Employer Covered Tool -This only for those eligible for employer-sponsored insurance, that are planning on enrolling in marketplace coverage. 7. Any notices from your current marketplace coverage and your plan ID

Check Your Eligibility for Savings

Some individuals and families might be eligible for savings. These savings are based on household size and income. You can check your income bracket for the following opportunities to save:

  1. Premium tax credits – (This will reduce the monthly premium you pay for coverage)

  2. Medicaid

  3. CHIP (Children’s Health Insurance Program)

Compare Health Plans

The marketplaces offer a variety of health plans for individuals and families to choose from. Health coverage is a big decision and a sizeable financial investment, so consider your options carefully. Look at the following while you make your decision:

  1. Plan category.You can choose from Bronze, Silver, Gold, Platinum & Catastrophic. Each plan offers a different level of coverage and a different price point. Consider your family’s medical needs and your budget when looking at plan categories.

  2. Premium.This is the amount you’ll be charged monthly for your coverage.

  3. Out-of-pocket costs. This will include your deductible, copayments and coinsurance. Selecting a plan with a lower monthly premium might mean you have considerably more out-of-pocket expenses. Look for the right balance. Read more about out-of-pocket costs and the correlation between premiums and deductibles.

  4. Provider network. Some plans offer broad provider networks (with more choices of in-network providers) while some are narrow (there is a limited number of in-network providers). Read more about network size.


Have a Question About the Health Insurance Marketplaces?

We’re here to help! Please comment below with your questions about open enrollment and the marketplaces.

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