2014 A New Year: If You are Uninsured – Get Covered!
The new Health Insurance Marketplace helps uninsured people find health coverage
The health care reform law will make health insurance more affordable for millions of Americans who do not have insurance coverage. If you qualify, the government is offering cost savings to help with certain costs.
Guaranteed benefits
Did you know that many preventive services are covered, including wellness visits, immunizations and screenings for cancer and other diseases? This means you will not pay any deductible, copay or co-insurance for many preventive services. These benefits are considered essential:
• Hospitalization
• Emergency services
• Ambulatory patient services
• Prescription drugs
• Laboratory services
• Maternity and newborn care
• Pediatric services, including oral and vision care
• Preventive and wellness services
• Mental health and substance use disorder services
• Rehabilitative and habilitative services and devices
Getting started
Before you start looking for the right plan for you, you need to figure out who needs coverage.
• Do you need coverage just for you or coverage for you and your family?
• How much coverage do you need or want?
• How do you prefer to pay for your portion of the costs?
Determine the level of coverage
The Health Insurance Marketplace plans are divided into a series of Metal Levels, depending on cost and level of benefits. Platinum covers the most, followed by Gold, then Silver, and Bronze covers the least. Depending on your age and income level, there may also be a Catastrophic Level available to you that offers the lowest level of coverage.
For example, if you choose a Bronze Level plan, you have 60% minimum coverage. That means if you get $100 worth of care, you insurance company pays for $60, and you pay for the remaining $40. In this case, you’d pay your $40 through a copay, coinsurance or deductible.
Check to make sure that you have everything you need to enroll and to receive cost savings
• To get the tax credits or cost-sharing savings, you must submit an application to the government online at www.healthcare.gov.
• The government will use your application to determine if you’re eligible for cost savings.
• Before you start, make sure you have social security numbers for yourself and everyone in your family who needs coverage.
• Also, make sure you have employer and income information (e.g. pay stubs, W-2 forms [wage and tax statements]).
• You will need health insurance policy numbers for anyone in your family who currently has coverage.
Get ready to enroll!
• To have coverage starting January 1, 2014, you need to enroll by December 23, 2014.
• The extended deadline of March 31, 2014 is the last day to get coverage for the remainder of 2014.
Most people must have health coverage in 2014 or pay a fee
If you don’t have coverage in 2014, you’ll have to pay a penalty of $95 per adult, $47.50 per child, or 1% of your income (whichever is higher). The fee increases every year. Some people may qualify for an exemption to this fee.
If you enroll by March 31, 2014, you won’t have to pay the fee for any month before your coverage began.
Highmark Blue Cross Blue Shield can help
At Highmark Blue Cross Blue Shield we are dedicated to making sure you have the health insurance that fits your needs and your budget.
• Our trained staff is available by phone at 1-877-935-5405 or at any of our Highmark Direct Stores throughout the area.
• Remember, help is available to you. If at any point you need assistance, our customer service representatives are available to answer your health care reform questions.
• If you are eligible for cost savings, you need to enroll in an individual Metal Level plan through the Health Insurance Marketplace at www.healthcare.gov.
• If you have any questions about using the Marketplace, your plan options or how you can make sure you have Highmark Blue Cross Blue Shield coverage, our customer service representatives are ready to help you at 1-877-935-5405.
We are committed to providing outstanding service
We are committed to providing outstanding services for our applicants and members. If you require special assistance, including accommodations for disabilities or limited English proficiency, please call Highmark Blue Cross Blue Shield at 1-800-876-7639 to request these free services.
Filed under: Highmark Articles