“Open enrollment”—the annual three-month period during which Americans can comparison shop and purchase healthcare coverage on the government’s Health Insurance Marketplace— is in full swing.
To help patients navigate the Health Insurance Marketplace, Harton Regional Medical Center is offering area residents free help with evaluating insurance options and enrolling on the Marketplace. Appointments may be made with certified assisters by calling 931-461-4868.
According to the U.S. Department of Health & Human Services (HHS), between 11 and 14 million consumers will purchase 2016 coverage through the Marketplace, and most will qualify for financial assistance.
According to HHS, 7 out of 10 returning customers purchase a health plan and pay less than $75 for monthly premiums, which is the monthly fee charged for coverage, while eight of 10 will pay less than $100.
Those figures are tied to estimates that 80% of individuals re-enrolling will qualify for advanced tax credits based on their projected annual income. Newcomers to the Marketplace are expected to fall in the same income brackets and receive similar help.
“If you’re eligible for a tax credit, the government will send money directly to your insurance company to help pay the premium,” said Russ Spray, HRMC CEO.
“So, for example, instead of paying the full $350 monthly cost, you might pay $50 or $75 a month.”
Penalties for not having health insurance increase significantly in 2016 and will be assessed when 2016 federal tax returns are filed.
Fines are $695 per adult, $347.50 per child, and up to $2,085 per family, or 2.5% of family income, whichever is higher.
“Individuals who don’t have insurance or who need to re-enroll have nothing to lose and everything to gain by evaluating their options,” says Spray. “You may discover you qualify for Medicaid, tax credits or another type of discount. The goal is to find a plan that best matches your specific health needs and finances.”
Some of the mandatory benefits included in all Marketplace plans include doctor visits, prescription drugs, hospital and emergency department care, lab services, pediatric care, and free preventive and wellness services. Coverage cannot be denied for individuals with a pre-existing health condition.
“If you are eligible for health insurance but do not purchase coverage, not only will you pay a penalty when filing your tax return, but you will also lose out on financial help with your healthcare expenses throughout the year,” says Spray. “Our assisters can help you shop the Marketplace to find a plan that meets your needs.”
Harton Regional Medical Center is a 135-bed facility located in Tullahoma.