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How do I get healthcare under the Affordable Care Act?


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By Judy Reed

 

Rhetoric. Sound bites. Pages upon pages of rules and exemptions. A website not quite up to par. And not much useful information printed for those who need healthcare under the Affordable Care Act. So many people just want to know, how do I get healthcare? Where do I go, what do I do, and how much is it going to cost?

The Basics

Starting in 2014, every individual in the United States of America is required to have some minimum essential health insurance coverage or pay a tax penalty when you do your taxes for that year.

The deadline to acquire coverage is March 31, 2014.

There are six ways to meet the minimum essential coverage:

1. Being insured through your employer or your spouse’s employer. 

2. Being insured on your parent’s policy. Children can remain on their parent’s policy until age 26 regardless of whether they are working, in school, single or married. However, if that child has a baby of his own, that baby is not covered on the grandparent’s policy.

3. Enrollment in another government health program such as Medicare, Tricare, or a Children’s Health Insurance Program (CHIP) or Michigan’s MiChild.

4. Being eligible for coverage under Medicaid due to expansion of coverage to people with income up to 133 percent of the Federal Poverty Level.

5. Purchasing healthcare through the Exchange or Marketplace at healthcare.gov

6. Purchasing healthcare insurance from a company in the individual market.

How to find out what you are eligible for

If numbers one through three do not apply to you, you will want to see if you are eligible for subsidies to help pay for insurance. The only way to do that is by applying at healthcare.gov. You can do that one of two ways: either try to navigate it yourself, or contact a registered agent who will do the work for you at no charge.

“You will pay the same amount either way. You are paying for an agent, even if you don’t use one,” explained Gabrielle Warner, of Innovative Solutions Agency, Inc. Warner is a Chartered Benefits Consultant, and Marketplace and SHOP registered agent.

An agent will be your advocate and guide throughout the process, and can track where your application is at all times.

An agent will take you through the healthcare.gov application process to see if you are eligible for subsidies to offset health insurance premiums. You will see one of three possible results: your income is low enough that you will best benefit by expanded Medicaid, which starts in April 2014; you are eligible for subsidies; or you make too much money.

If you are eligible for subsidies, then the agent will help you choose a plan through the three insurance companies in Michigan’s exchange or marketplace. If you are not eligible for subsidies, the agent will help you to purchase insurance from a company on the individual market.

To find a registered agent to take you through the process, go to www.wmahu.org. On the left side, scroll down to “find an agent.” Put in your zip code and choose “50 mile radius” in the drop down box. Go further down the page and mark Michigan in the section titles “Certified to sell health insurance exchange marketplace coverage.” Twenty or so random agents will come up.

What if I don’t buy insurance?

In 2014, the penalty for not having insurance is $95 per person, or 1 percent of your income, whichever is greater. The penalty for children is $47.50 per child. The maximum penalty is $285 per family. Next year it increases to 2 percent or $325 per person, and in 2016 it is 2.5 percent of income or $695 per person. In 2017 and beyond it will be adjusted by the cost of living. The penalty will be due when you pay your taxes. Paying the penalty does not give you insurance; you will still need to fully fund your own healthcare, at a non-discounted rate.

There are some circumstances that may help you qualify for a hardship exemption. To see those and to get a form to apply, go to www.healthcare.gov/exemptions/

What is the transitional reinsurance program?

One thing that caught some people by surprise this month is a new fee called the transitional reinsurance program. People covered under their own employer’s insurance plan began paying the fee this month, in addition to the fee deducted for their own insurance plan. The program takes the fees and then pays it to insurers in the individual market that cover high-risk individuals. The fee will be in place from 2014 to 2016, and supposedly “levels the playing field” across the health insurance markets, and protects the high-risk insurers from huge losses.

NEXT WEEK: What businesses need to know

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Simple ways older drivers can save money on auto insurance


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(BPT) – Are your auto insurance premiums too high? Maybe they are, but not for reasons you might think. Insurance companies aren’t charging you higher premiums because you’re in an over-50 age group. You may be paying too much because you haven’t done anything to lower the cost of your premiums. Check out these money-saving tips – they could be right up your alley.

* Comparison shop. You don’t need to stay with the same insurance company forever. Prices vary from company to company. Just be sure you discuss the identical coverage with each company representative. Also, don’t go by price alone. Consider the company’s reputation, customer service and available discounts. Look online at customer reviews to get a better picture.

* Combine policies with one carrier. You may save money if you insure all your vehicles on a single policy. Your premium may also go down if you have life or homeowners’ insurance with that company, too.

* Consider asking about higher deductibles. In some cases, if you increase your deductible, you could lower your premiums. Of course, that means you’ll have to pay more money out-of-pocket if you’re in an accident.

* Take an AARP Driver Safety course. Available both online and in the classroom – in English and Spanish – this course teaches valuable defensive driving techniques and provides a refresher about the rules of the road. When you complete the course, you could qualify for a multi-year discount from your auto insurance company (check with your insurance agent for more details). Visit www.aarp.org/drive to find a course in your area.

* Consider dropping collision and/or comprehensive coverage. It may not make financial sense to pay premiums over many years to maintain collision and comprehensive coverage. If your car is worth less than 10 times the premium, purchasing the coverage may not be cost effective, according to the Insurance Information Institute (III). But don’t drop your liability coverage, which can help cover expenses for property or bodily damage you cause while driving your car.

* Take advantage of low-mileage discounts. Some carriers offer discounts to drivers who put less than a predetermined number of miles on their vehicles each year. If you’re only using your car to drive to your kids’ houses, the grocery store, the mall and the gym, this could be a money-saving opportunity.

* Ask about car-safety discounts. Some insurers give discounts for having certain safety devices in your car, such as air bags, automatic safety belts, anti-lock brakes, daytime running lights, or even an approved alarm system. In addition to lowering your premium, these features will help keep you safe on the road.

* If you’re in the market for a new car, consider purchasing a low-profile vehicle. It’s more expensive to insure a vehicle that’s expensive to repair, popular with thieves or known for not having a good safety record. To find out vehicles’ risk levels, visit the Insurance Institute for Highway Safety website.

Everyone’s trying to save money these days. By following these tips, you’ll be in the driver’s seat when it comes to auto insurance premiums.

 

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Insurance for uninsured children


A coalition of Michigan hospitals, urban school districts and Community Health Centers launched an intensified back-to-school campaign this week to enroll eligible children in the state’s low-cost and free health insurance programs known as MIChild and Healthy Kids.

The eight-week campaign is part of a year-long effort of the Enroll Michigan coalition to enroll as many of Michigan’s more than 127,000 uninsured and eligible children as is possible in MIChild or Healthy Kids. The back-to-school effort will include local enrollment teams in school buildings and hospitals in targeted geographic areas, a simplified enrollment process for children and their families, and TV, radio, transit and billboard ads.

The Enroll Michigan coalition includes the Michigan Primary Care Association (MPCA), the Michigan Health & Hospital Association (MHA) and the Middle Cities Education Association (MCEA).

“A child who gets health care in the right place at the right time is better prepared to learn and less likely to develop serious, costly medical conditions,” said MPCA Executive Director Kim Sibilsky. “The goal of the Enroll Michigan back-to-school project is to help more Michigan children get affordable coverage, obtain the care they need, and become healthier and happier students.”

More than 127,000 children are uninsured in Michigan. While most are eligible for MIChild or Healthy Kids, they have not enrolled for reasons including language barriers, lack of transportation or means of communication (telephone access) and unawareness of eligibility and/or how to enroll. Enroll Michigan has been working since March to connect the families of eligible children to MPCA Community Navigators to complete the simplified online, telephone and in-person enrollment processes.

The coalition recently launched a gift card incentive program June 1 that gives $10 gift cards to people who refer a child to coverage through Enroll Michigan. The gift card program runs through Sept. 30 or until supplies last.

MHA President, Spencer Johnson urged families with children who have no health insurance to enroll them today by calling 2-1-1, emailing enroll@mpca.net or by visiting the Enroll Michigan website, www.enrollmichigan.com.

“The process to enroll eligible children has been simplified significantly, and the quality of care and services available through MIChild and Healthy Kids are high,” Johnson said. “We urge families whose children are without health insurance to call 2-1-1 or visit the website today. Chances are good that their child will be eligible, and can be enrolled.”

“Healthy kids can consistently attend school and aren’t distracted with avoidable medical conditions that can set them back,” said Ray Telman, executive director of the MCEA. “Let’s make sure kids return to school this fall with the best school supply there is—their health.”

For more information about Enroll Michigan, please, visit www.enrollmichigan.com and go to www.facebook.com/enrollmichigan.

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Insurance agencies receive 5-star ratings


Mark Gebhardt (left) receives 5-star award from Fremont Insurance.

Joe Clark (right) receives 5-star award from Fremont Insurance.

Two area insurance agencies have received 5-star ratings from Fremont Insurance company, a Michigan-exclusive property and casualty insurance carrier.
Both Gebhardt Insurance Agency, of Cedar Springs, and Clark Insurance Agency, of Casnovia, were presented with this prestigious honor at the company’s Winter Regional Meeting held at Crystal Mountain Resort in Thompsonville, Mich.
“(These two agencies) embody the characteristics necessary to be successful in our industry – hard work, a commitment to the customer and the drive to achieve quality business results – even in a challenging economic environment,” said Fremont Insurance Company President and CEO Richard Dunning.  “We commend Gebhardt Insurance Agency and Joe Clark Insurance Agency in this outstanding achievement and we are pleased to present this tribute of our appreciation, admiration and partnership.”

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