Affordable Care Act
By Louisa McQueeney
The Affordable Care Act (ACA) signed into law by President Obama in 2010, guarantees that consumers are not denied insurance due to a pre-existing health condition and ensures that consumers receive a comprehensive set of benefits, including free preventive care when they buy a health insurance policy. It also includes consumer protections like no annual or lifetime dollar amount of coverage and includes all 10 essential health benefits.
Open Enrollment for 2016 has closed but you may still be eligible to apply for insurance through the Health Insurance Marketplace. There are many types of qualifying events that trigger a Special Enrollment Period (SEP) for people who need to obtain or change health insurance coverage. A change in immigration status, employment, family status (marriage, divorce, having a baby, or when you move to a new area), all qualify for a special enrollment period.
Florida has not expanded the Medicaid program and consumers making less than 100% of the federal poverty line will likely not qualify for Medicaid or premium tax credit subsidies. However, they should apply to get a hardship exemption. Navigators have information available for local health services that may be low cost or free. If a consumer’s income changes they will qualify for a special enrollment period and can sign of for health coverage.
Gaps in coverage of more than two months may cause taxpayers to be charged a shared responsibility payment or penalty when you file your tax return next year. The maximum penalty for 2016 is the greater of 2.5 percent of your annual income or $695 per adult and $347.50 per child. The penalty is prorated by month, so it pays to get covered when a change occurs. If someone discovers they do not have any offer of health insurance coverage that is affordable, they should still sign up on HealthCare.gov to apply for an exemption from paying the penalty for not having health insurance.
Florida Community Health Action Information Network, better known as Florida CHAIN, has certified navigators available in your area to guide you through the application and enrollment processes (see our AD in this edition of Conexión). Navigators are trained and certified by the U.S. Department of Health and Human Services and they are registered by the Florida Department of Financial Services. There is no charge for navigator services and the navigators will help you determine your eligibility for premium tax credit subsidies, provide impartial plan comparisons, and assist with your enrollment. The navigators adhere to strict federal and state privacy standards and must offer impartial information that focuses on your best interests, not the interests of insurance companies. You can schedule an appointment with Florida CHAIN navigators by calling 877-813-9115 or online at www.CoveringFlorida.org
