With the Affordable Care Act going into full-swing, many questions are coming to the forefront.
Many people want to know how the Act effects them. Others want to know when they have to enroll, how to sign up and who to call. Although there are still many elements of ACA still unclear, it is coming, and there are things you should know to prepare for the changes.
The first phase of ACA started Tuesday, with the introduction of the Health Insurance Marketplace, a website with side-by-side comparisons of health insurance plans. Tuesday also marked the beginning of the open enrollment period for patrons. The closing date of the enrollment period is March 31, 2014.
ACA, which goes into effect Jan. 1, 2014, mandates everyone has a health care plan by the end of the enrollment period. Almost anyone who does not enroll in a plan by March 31, 2014 will face a tax penalty of $95 and will not be able to apply for health insurance until next year, said Wyoming Insurance Commissioner Tom Hirsig.
“If you don’t enroll by March 31, you won’t be able to enroll in a plan in 2014,” he said.
The act does not require people to enroll through the marketplace, Hirsig said, but all must have health insurance through some outlet.
To enroll through the marketplace, visit healthcare.gov. The website will ask questions regarding your age and income, among other questions. You can then look at plans that are ranked in four tiers, bronze, silver, gold and platinum, according to a release from the Platte Valley Medical Clinic. Those tiers are based on the benefits and services covered in the plan. According to the release, bronze plans will have low monthly payments, but may pay higher deductibles and copays. Platinum plans will have the highest premiums, but fewer additional costs for consumers.
ACA will provide federal subsidies to those who qualify. Those with lower incomes are expected to receive a larger subsidy, whereas someone with a larger income may receive a smaller subsidy.
“Some people are going to like it. But some people aren’t going to get anything and it is going to be very expensive for those people,” Hirsig said.
Practice Manager at Platte Valley Medical Clinic Tonya Bartholomew said there are some benefits, including insurance companies can no longer deny customers based on preexisting conditions. Bartholomew also listed the subsidy as a potential benefit.
However, not all impacts are positive.
“The way (ACA) is going to affect the Platte Valley is very significant,” Bartholomew said.
She said deductibles could go up as a result of ACA, meaning a visit to the doctor’s office could be more expensive.
“Going to the doctor’s office for a cold, or a sore throat or a broken arm, those visits are going to cost more out of pocket money, because of higher deductibles,” Bartholomew said.
Another impact ACA will have is the rise of fraud cases, Hirsig said.
“The potential for fraud is so large, that it will just boggle your mind,” he said.
Hirsig urges everyone to be cautious of potential fraud with the arrival of ACA.
He said Wyoming residents should only use healthcare.gov to enroll for a health care plan.
“That is the only federal website you can use to enroll,” he said. Any other websites claiming that you can enroll, are most likely fraudulent.
The Affordable Care Act also does not have anything to do with Medicare or Medicaid, Hirsig said.
Hirsig said he encourages all Wyoming residents to call the Wyoming Department of Insurance with questions to ensure they are not being tricked.
For more information, or to learn how to enroll, call 307-777-7401.
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