Review your Obamacare health insurance coverage

Now is the time of year when you should review your healthcare coverage and consider any changes you might want to make. The periods when you can make changes to your coverage are called “open enrollment periods.” If you have insurance through the healthcare marketplace under the Affordable Care Act (ACA), open enrollment is November 1 through January 31. To have coverage starting January 1, you need to apply by December 15.

Even though open enrollment under the ACA hasn’t started yet, it is a good idea to start researching what plans are available in your area. The amount of information available can be complex and difficult to understand.

If you are covered by the ACA (often called Obamacare) you may want to change coverage if your income or financial circumstances have changed, or the premium for your current plan has gone up. ACA plans are available in what are called “metal levels” – Bronze, Silver, Gold and Platinum.

Bronze plans have the lowest premiums, but the highest deductibles, and after the deductible they cover only 60 percent of your costs. Platinum plans have the highest premiums and the lowest deductible, but after your deductible, they cover 90 percent of your costs. Silver plans cover 70 percent, Gold plans, 80 percent.

People who have an income at or below $47,250 ($64,080 for a couple) are generally eligible for a subsidy to pay for the plan they choose. The Healthcare.gov website will calculate your subsidy based on answering questions about your income and the zip code you live in.

People with very low income may be eligible for Medicaid, although in The Gayly’s area, only Arkansas expanded Medicaid coverage. That’s bad news for people in Kansas, Missouri, Oklahoma and Texas. People in those states earning less than $15,800 fall into a coverage gap – they may make too much money to qualify for Medicaid but too little to qualify for a federal subsidy.

If you are thinking that you can’t afford health insurance, there are penalties for not having it. Although there are some exemptions, in 2016 the penalty is $695, or 2.5 percent of your income. Starting in 2017, the penalty is adjusted based on inflation.

You can do this yourself online at HealthCare.gov or by phone at (800) 318-2596. If you think you need help in taking a look at your health insurance, people called “Navigators” are available, as well as many insurance brokers and agents, some of whom advertise in The Gayly.

The Gayly – September 10, 2016 @ 1:40 p.m.