It’s getting down to the wire, the main event (Marketplaces) of the Affordable Care Act is right around the corner and Obamacare is getting ready to go into full swing. What does it mean for you, your health insurance and who you can get medical treatment from? Well, with only a few weeks left, a lot of these important questions remained unanswered.
To prepare you the best I can for the flood of information that will come out when Ohio’s Health Insurance Marketplace opens next month, I thought we should look at some of the most important things we know for sure.
A little over a year ago I put together a list of 5 Things You Need to Know About Health Care Reform in 2014 and thought now would be a good time to add five more to the list and identify the most important details you need to know about Obamacare in 2014.
1. Ohio’s Health Insurance Marketplace Opens October 1st
It’s coming if it’s ready or not. At least thats the vibe I have gotten from everyone I’ve talked to about the launch date for Ohio’s new health care marketplace.
This will be the first day you have to buy a health insurance policy that is potentially heavily subsidized by the federal government. This date is important to know because there is also an end date, March 31 for when you can buy coverage. You will want to have your coverage in place well before then, preferably before the first of the year if it makes sense for your situation.
You would qualify for the heavy subsidies if you fall into one of these roughly estimated income ranges:
- Individual - $11,615 - $46,600
- Family of 2 - $$15,730 - $62,900
- Family of 3 - $19,810 - $79,210
- Family of 4 - $23,800 - $95,500
2. Network Nonsense
While I’m not at liberty to discuss the full details of some of these changes yet, I can tell you that as of right now it looks like health insurance companies will be providing some tough love when it comes to offering you a wide selection of doctors and hospitals to receive treatment from.
You are going to want to seriously investigate the size of the company’s network you’re considering. Just because it was great in the past doesn’t mean that will be the case now.
If you are uninsured and do not qualify for a subsidy, you might want to jump on a plan now to prevent yourself from having to deal with some of these less than ideal changes in 2014.
3. Your Income Is Number One
How much money do you make?
What’s your household income?
These are going to be some of the first questions you are asked when looking to buy health insurance now.
Don’t freak out, providing the most accurate answer, is without question, the best thing you can do.
Understanding and answering this question will go a long way to helping you understand what health insurance path you should take.
If your income is low enough to qualify for a tax credit or subsidy inside of Ohio’s Health Insurance Marketplace then you’ll find it very challenging to purchase coverage anywhere else.
4. Effective Dates
Retroactive is a thing of the past.
No longer will your effective dates fall back to the date you applied. In an ACA system, your health insurance policy will always take effect on the first of the month. Now it’s just a matter of what month that is?
That is going to be based on when your application was submitted. For first three months of the “Obamacare” enrollment period, between October 1 and December 15, your policy will take effect January 1, 2014.
Every month after, if you apply for coverage later than the 15th your effective date won’t be until the first day of the following month.
Example: If you applied for health insurance on January 12, 2014 your effective date would be February 1, 2014.
If your application is processed between the sixteenth and the last day of any month after December 15, 2013 and before April 1, 2014 your effective date will be the first day of the second month following.
Example: If your application was finalized on January 23, 2014 your effective date would be March 1, 2014.
This is going to be a no exceptions rule, so if you don’t get that application in on time you could potentially be without coverage for 45 days.
5. No More Pre-Existing Conditions
I know, this was on the last list, well guess what? It’s that important you need to hear it twice.
Make no mistake about it, you could be lying in a hospital bed recovering from a triple bypass, appendectomy and complicated back surgery and they would still have to give you health insurance.
Gone are the days of getting declined for health conditions that were considered too high risk. Gone also are the days of being able to buy a plan whenever you wanted and for a cheaper unsubsidized price.
The Bottom Line
I don’t know that anyone is fully prepared for the changes that are about to happen, both good and bad.
What you’re going to want to do is make sure you obtain information on the three pillars of your health insurance policy, price, coverage and treatment. If you know and feel good about all three then chances are you have made a pretty smart health insurance decision.
What you want to avoid is getting caught up in unnecessary and possibly false information as this new law comes to life. Missing out on your chance to improve your health insurance situation is something you will regret for an entire year if you don’t get the proper information and guidance.
When I say “now’s the time” for you to take that action and get that help, I actually mean it. Don’t miss your chance to talk with someone who can quickly and easily make sense of this process for you.
Joey is the third generation to join the family business. He's the agency’s primary content creator and all around web guy. When Joey isn’t talking about insurance on the internet, or helping clients he’s probably spending time with his family. In other rare spare moments he could be found obsessing over one of the local Cleveland sports teams, struggling to stay awake late enough to play video games or trying to remember how to play the bass guitar.