Missed “Obamacare” 2015 Open Enrollment?

Health Benefits Center Says You Have More Choices Than You Think!

HOLLYWOOD, Fla.--()--With the Affordable Care Act/Obamacare Feb. 15 open enrollment deadline past and the next enrollment period six months away, you still have plenty of health insurance choices, says Steve Dorfman, CEO of Health Benefits Center, a nationwide insurance brokerage based in Hollywood, Fla.

“There is still a vast number of underserved people out there”

“There is still a vast number of underserved people out there,” Dorfman says. “Some have divorced, moved, lost jobs, gained or lost significant income. These are justifiably called ‘life-changing events,’ and they can still enroll under ACA. That’s not all. More than 10,000 Baby Boomers turn 65 every day, and it’s time for anyone approaching that age to consider Medicare supplemental plans. In other words, there are lots of options.”

If there is any doubt, start by visiting the Affordable Care Act (ACA) website at www.healthcare.gov. For any tax questions, go to www.irs.gov/Affordable-Care-Act.

Don’t forget, your existing policy automatically renews unless you indicate otherwise during the enrollment period. In the meantime, here are some answers to common questions.

I have no health insurance. How do I get it?

If you are waiting for the 2016 Obamacare/ Affordable Care Act (ACA) open enrollment period Nov. 15-Jan. 31 and lack insurance now, you have four choices:

  • You can qualify for Obamacare only if you have a “qualifying event,” such as loss of a job and health coverage, marriage, having a baby, or getting divorce.
  • You can find a short-term “bridge” policy. This could be your best option, as it is far cheaper than conventional policies -- often even with the penalty -- and provides discounts with participating providers. While benefits are more limited and often do not cover many pre-existing conditions and tests, it pays to shop around for the right policy. In Florida, mandated coverage in a short-term policy includes routine child health care, mammograms and Pap smears, osteoporosis, and cleft lip and palate.
  • You can find a job with employer-provided healthcare coverage that spares you the penalty.
  • You can go without insurance and pay out of pocket. This is, of course, risky, but cheapest -- if you are lucky.

Temporary insurance often is the soundest option, particularly for recent college graduates, retirees under 65 waiting to qualify for Medicare and workers between jobs or waiting to qualify for employer-sponsored coverage. And, these temporary policies take effect more quickly and with less red tape than policies through the exchanges.

All Obamacare policies offer additional free coverage with no-copays for such preventive treatments as annual exams, vaccinations and colonoscopies -- 15 services for men, 22 for women and 26 for children. Some of these preventive health mandates apply to Medicare patients as well.

If I have a short-term plan, do I face a penalty?

Yes, and that penalty increased in 2015. You face a higher penalty this year, of 2 percent of your income or $325 per adult and $162.50 per child – whichever is more. That’s more than triple the penalty for 2014, of 1 percent of your income or $95. Translation, if you are an individual or family of four making $50,000 a year, your penalty is $1,000. If you are making $100,000, your penalty is $2,000. Still, the short-term plan with the penalty could still cost less than an ACA/Obamacare plan, and you would at least have insurance.

What life-changing events can get ACA/Obamacare insurance outside the enrollment period?

Those events can include:

  • Getting married
  • Having a baby
  • Adopting a child or placing a child for adoption or foster care
  • Losing other health coverage (e.g., at your job)
  • Moving to a new residence away from your part of the state
  • Gaining citizenship or lawful presence in the U.S.
  • Gaining or continuing status as a member of an Indian tribe or an Alaska Native shareholder.
  • Leaving incarceration
  • For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions

Are supplemental insurance policies worthwhile?

They can certainly help, particularly as a supplement to short-term policies. Accident Insurance helps you handle the medical and out-of-pocket costs that add up after an accidental injury, including emergency treatment, hospital stays and medical exams, and other expenses you may face, such as transportation and lodging needs. Supplemental cash-benefit or lump-sum policies can cover cancer, critical care, dental and hospital confinement.

What about high-deductible policies?

High-deductible health plans (HDHPs) come with lower premiums and higher deductibles. They are required if you want to establish a health savings account. As of 2015, the minimum out-of-pocket is $1,300 single, and $2,600 family, and the maximum out-of-pocket is $6,450 single and $12,900 family. Unused money in health savings accounts rolls over from one year to the next and can even be used in retirement.

What happens when I turn 65?

If you are already enrolled in the ACA Marketplace, you can keep your coverage under the Marketplace until you turn 65 and Medicare kicks in. About six months before you turn 65, go to the medicare.gov website and start exploring your options. Medicare does not cover everything, and it is vital to explore and compare supplemental Medicare Part B policies. These may cost you $100 or $200 a month, but they will cost far less that your current policy or that under Obamacare.

Do I lose my tax privacy if I sign up under ACA and qualify for a subsidy?

There is some privacy loss, for the Healthcare Insurance Exchange must verify your income through your W2s and/or tax forms. Many people are still getting letters seeking “more information” to verify income. For 2015, you may need to submit a pay stub to determine if your income matches the projected income you stated. You may call the Healthcare marketplace directly at 1-800-318-2596. Do NOT ignore the letter. In responding the marketplace, please include your enrollment number or Social Security number on all correspondence. If you are covered a federal as opposed to a state plan, please send it, with your enrollment or Social Security number, to:

Health Insurance Marketplace
Department of Health and Human Services
465 Industrial Blvd.
London, KY 40750-0001

When in doubt, call a trusted insurance broker, who can tailor a plan to your budget and your needs.

Steven Dorfman is Chief Executive Officer of Health Benefits Center in Hollywood, Florida, a brokerage with nearly 100 agents serving all 50 states, at 800-492-1834 and hbcinsure.com.


Wragg & Casas Strategic Communications
Mark Sell/Jeanmarie Ferrara, 305-372-1234, Cell: 305-206-5397
msell@wraggcasas.com / jferrara@wraggcasas.com


Release Summary

Missed the deadline for "Obamacare" open enrollment? Steve Dorfman of Health Benefits Center of Florida says you have more choices than you might think.

Health Benefits Center