Open enrollment for the Affordable Care Act (ACA), also known as Obamacare, begins Saturday, Nov. 15.
Louisiana Insurance Commissioner Jim Donelon said the enrollment period will be open until Feb. 15, 2015.
“After open enrollment ends, you must have a qualifying event such as a change in marital status or employment that affects your health insurance in order to sign up for coverage before the next enrollment period,” Donelon said.
“Health insurance can be complicated and overwhelming while at the same time, absolutely necessary – and this time of year, we want to remind folks they can call us for help understanding their options.”
During the open enrollment period, people can sign up through the online Health Insurance Marketplace or purchase individual policies sold by agents and insurers, he continued.
Donelon said subsidies are only available to those who qualify and enroll online through the Marketplace. He also advised consumers on other issues to be aware of before enrolling.
The plan with the lowest premium may not be the least expensive. Many individuals may choose to go with plans that have the lowest monthly costs, but those plans also may have higher co-pays and deductibles, which is money you pay out of pocket. A knowledgeable health insurance agent can help you determine what plan best suits your needs and budget.
Check your network. Every health insurance plan has its own network of doctors, hospitals and service providers who have signed agreements with the insurance company to provide services at a specific price. Review your plan to see if your doctor and hospital are in your network. If not, insurance may not cover the bill and you will be required to pay their bill.
The penalty for not having health insurance rises in 2015. The ACA requires individuals to have minimum essential health insurance coverage or face a financial penalty. Individuals who do not have health insurance in 2015 may be subjected to a penalty fee of two percent of their yearly household income or $325, whichever is higher. If you didn’t have coverage in 2014, you will also have to pay a penalty fee of one percent of your yearly household income or $95, whichever is higher. This is collectible when you file your 2014 federal income tax return.
Employers with greater than 50 employees are mandated to offer health insurance to employees or pay a penalty.
A new provision will go into effect Jan. 1, 2015, where those insured will pay physicians based on “value, not volume,” indicates the U.S. Department of Health and Hospitals (DHH).
“(This) provision will tie physician payments to the quality of care they provide,” DHH reports. “Physicians will see their payments modified so that those who provide higher value care will receive higher payments than those who provide lower quality care.”
Nov. 15 marks the first day those insured can review plan choices and make changes to their plans for 2015. By Dec. 15, for those who are not automatically enrolled, they must choose a plan and complete all the enrollment steps to be covered beginning in 2015.
By Dec. 31, all 2014 Marketplace coverage ends, no matter when it started.
The deadline to sign up for 2015 coverage is Feb. 15. For more information, visit www.healthcare.gov or www.hhs.gov