Time to take note of all your health options
The new year is often a time when we reflect on the past and resolve to make positive changes. Many people promise themselves that they will eat healthier, exercise more and take steps to improve their overall health.
This year is the perfect opportunity for individuals who have been without health insurance to do exactly that – to enroll in coverage that will provide a package of essential health benefits that will protect them in case of a serious illness or accident, but also will provide ongoing wellness care.
A major provision of the Affordable Care Act requires that all of the Marketplace plans must cover preventive health screenings such as pap smears, colorectal cancer screening, vaccines, mammograms and contraception. All of these are provided without co-pays, deductibles or co-insurance. In addition, health plans are no longer able to impose lifetime limits or deny coverage due to pre-existing conditions.
As Project Manager of the Marketplace Assister Program at the Foundation for Healthy Communities, I find that many people are completely unaware of the discounts for which they may be eligible.
For example, if you are an individual with an annual income of less than $45,960, you may qualify for a premium tax credit. You can apply this credit directly to the cost of your monthly insurance premium or you can elect to have a portion of it — or all of it — refunded at the end of the year on your federal taxes. In addition, if your income as an individual is less than $28,725, you may also qualify for discounted co-pays, deductibles and prescriptions on certain plans.
This means when you look at the plans on healthcare.gov, the advertised costs for benefits may be considerably less depending on your circumstances. The size of your family also matters in terms of the discounts.
One way to find out is to talk to a trained assister either in person or on the phone. An assister can walk you through the application process and help you figure out what you are eligible for in terms of discounts. Many Granite Staters have already signed up for coverage starting on Jan. 1, but you have until March 31 to get coverage in 2014 and meet the ACA’s requirements. You can enroll any time before then and you should be able to get coverage within a matter of weeks.
New Hampshire now has a state website, www.coveringnewhampshire.org, where you can locate an assister near you. The web site also has information and a calculator to find out what kind of discounts you can receive, as well as accurate, up-to-date information on how to obtain coverage.
The only exception in terms of discounts for low and moderate-income earners are those with annual incomes below 100 percent of the federal poverty level – or less than $11,490 per year for an individual and $23,550 for a family of four. These are folks who were intended by the ACA to get coverage through the expansion of Medicaid. We are still waiting to hear if our New Hampshire legislators will accept the federal funds to provide affordable coverage to this group of residents in 2014 and beyond.
Making health care decisions is serious business. It’s important to get all the facts and not rely on hearsay or sound bites. There are trained experts in every community in New Hampshire who are available to help. Getting the care you need to improve your health is a New Year’s resolution well within reach this year. Please choose to make better health a priority in 2014.
Bernadette Cameron is project manager of the Marketplace Assister Program at Foundation for Healthy Communities.