What happens Jan. 1, 2014? Two big things:
1) Everyone can buy health insurance. Insurance companies can no longer screen out people with health risks.
2) Everyone who doesn’t already have insurance needs to buy it, except for a few groups, including those who have incomes below the poverty level. (To check poverty levels, see this page.)
This means those who get health coverage at work, or through Medicare or some other government program, don’t have to do anything. They just need to sign up for next year’s coverage the same way they always do. Three-fourths of Floridians are not affected.
Uninsured Floridians can shop at a federally-run online Marketplace beginning Oct. 1 for coverage that begins Jan. 1. Open enrollment lasts through March 31, 2014.
Information about enrollment is at www.healthcare.gov or by calling a toll-free number, (800) 318-2596.
Note to Medicare beneficiaries: Your enrollment period for 2014 coverage in a prescription drug plan or Medicare Advantage plan is Oct. 15 through Dec. 7. Go to www.cms.gov or call 1-800-Medicare. To talk to a volunteer advisor, call Florida SHINE (Serving Health Insurance Needs of Elders) at 1-800-963-5337.
FAQ:
I don’t want to buy insurance. Do I have to?
No, if you’re willing to pay the penalty: $95 or 1% of your income. So if your income is $20,000, your penalty is $200. The penalty increases every year. Of course, going without insurance leaves you open to bankruptcy if you become seriously ill or injured.
Note: Those who have incomes under the poverty level do not have to buy health insurance.
I want to shop for a health policy. What are my choices?
In Florida, we don’t know yet. The list of plans and prices will have to be released by Oct. 1, the first shopping day on the federal online Marketplace at www.healthcare.gov.
Will I qualify for a subsidy?
It depends on your income and family size. HHS says most of the uninsured who shop on the Marketplace will qualify for financial help. That can be a discount on the premium price or help in paying out-of-pocket expenses. Use this income calculator to see whether you qualify: http://kff.org/interactive/subsidy-calculator/
Does my boss have to provide me with health insurance?
No. If you work for a big company with more than 50 full-time employees, your employer may have to cover you in 2015 or pay a hefty penalty. But not in 2014; this part of the law was deferred for a year. (Note: The law defines full-time as 30 hours a week or more.)
If you’re in a small company, with fewer than 50 full-timers, the employer does not have to provide health coverage, even in the future. But small employers who want to shop for a plan have two choices in Florida:
1) Use the federal online SHOP – Small Business Health Options Program – Marketplace at www.healthcare.gov/small-businesses/. Tax credits are available for companies with fewer than 25 employees.
2) A state-sponsored alternative exchange called Florida Health Choices offers a few plans; tax credits are not available. Site: Myfloridachoices.org.
See also:
- Kaiser Health News' Insurance Marketplace 101: Answering Consumer Questions.
- Also from Kaiser Health News: FAQ: How is Employer-Sponsored Health Insurance Changing?
