Affordable Care Act: 5 FAQs on enrollment, deadlines, and subsidies
If you are confused about the Affordable Care Act or how it’s working, rest assured you’re not alone. Here, Terry Burke, vice president, individual business, Blue Cross Blue Shield of Michigan, answers five of the most-asked questions about the ACA.
Q. It’s no secret the ACA rollout got off to a bumpy start. How are things working now?
A. The processes are working much better now. The enrollments on Healthcare.gov and BCBSM.com have a very high success rate compared to a month ago. While not at an optimal state yet, the progress has allowed us to help thousands of customers each week.
Q. Much of what we see in the media indicates that many insurance plans are now more expensive with sky-high deductibles and co-pays. Is this true?
A. Consumers will see a variety of situations depending on what they need and where they are starting from. While some plans have higher deductibles, some also have lower deductibles. The ACA metal level plans offer a range of deductibles and offerings, with some price points in the range of pre-reform products in the individual market. For example, plans categorized as gold have premiums ranging from $150 to $250, and certain silver products are also competitively priced.
Q. One of the major changes after the rollout was that some people may have the option to keep their current insurance for a year. What are the details and how do I know if I’m eligible?
A. At Blue Cross, one pre-reform plan, Keep Fit, remained open in 2014. Members in Keep Fit plans had the option to stay in that plan or enroll in one of the new 2014 plans. We made this option available to all of our other members as well, although for some, a new plan was a better fit because of the essential health benefits included in these plans and the potential for a subsidy to help pay their premium. If you have questions about how a new plan could benefit you, you should contact the insurer. You have until March 31 to move to a new plan; otherwise, you cannot enroll in a new plan until the 2015 open enrollment period begins on Nov. 15, 2014.
Q. What happens if I miss the deadlines to sign up for insurance in 2014? When will I be able to apply next and will I be penalized?
A. If you miss the deadline of March 31, 2014, you could face a penalty if you do not have health insurance. The penalty is $95 or 1 percent of your income, whichever is higher. Your next opportunity to buy a plan would be during the 2015 open enrollment period from Nov. 15, 2014 to Jan. 15, 2015. The only exception would be if you had a qualifying event, such as the birth of a child, marriage or divorce, which would enable you to apply for coverage outside of an open enrollment period.
Q. What if I’m eligible for a subsidy? How will I receive it?
A. Subsidy eligibility is determined when you apply for coverage. This subsidy is shown as a reduction in your monthly premium. The balance of the premium is what you pay to your insurer every month. Any differences as the result of an increase or decrease in income will be reconciled on your tax return the following year.
Want to find out more? Call a health plan adviser at Blue Cross Blue Shield or your local Blue Cross Blue Shield contracted agent. Health plan advisers can be reached Monday through Friday from 8 a.m. to 8 p.m. by calling 855-237-3501. Consumers can also visit bcbsm.com/myblue for more information on products, and HealthcareReformBasics.com for more information on the ACA.