Affordable Care Act Open Enrollment Starts November 15. What You Need to Know Before You Apply.

Category: Personal Insurance

Open enrollment for purchasing health insurance from the South Carolina Health Insurance Marketplace begins November 15, 2014 and runs through February 15, 2015. South Carolina has a federally-run health insurance marketplace that can be accessed through HealthCare.gov. The marketplace will feature plans from Blue Choice Health Plan, Blue Cross Blue Shield of South Carolina, Consumers Choice Health Plan, Coventry Health Care of the Carolinas, and newcomer to the marketplace, Assurant.

South Carolina residents who qualify for a federal subsidy on their health insurance premiums must use the Health Insurance Marketplace to compare plans, apply for subsidies and enroll. South Carolina residents who do not qualify for subsidies or cost-sharing assistance can purchase individual health insurance plans from the marketplace or from a private agent or broker, directly from an insurance company, or from an online health insurance seller. Those whose income is above $46,480 for an individual or $95,400 for a family will not be eligible for government subsidies.

The Affordable Care Act requires you to enroll in a health insurance plan unless you qualify for an exemption. You will be required to report whether or not you have health coverage when you file your taxes next April.

Those who purchased plans through the Health Insurance Marketplace for 2014 can automatically renew their coverage for 2015, but it is wise to understand your options. For example, your insurer may have decided to cancel your current plan and automatically enroll you in a different plan if you do nothing. In addition, if your income has changed you may need to re-apply for the appropriate subsidy. Last, it is always wise to shop around to see if any new options are available that better fit your needs.

There are five categories of plans that you can purchase for 2015:

  • Bronze: Your health plan pays 60% of covered services. You pay the remaining 40%.
  • Silver: Your health plans pays 70% of covered services. You pay the remaining 30%.
  • Gold: Your health plan pays 80% of covered services. You pay the remaining 20%.
  • Platinum: Your health plan pays 90% of covered services. You pay the remaining 10%.
  • Catastrophic: Catastrophic plans typically pay less than the cost of care and are available only to those under 30 years old or who qualify for a hardship exemption.

Each plan will have varying levels of premiums and out-of-pocket costs that you must pay. In general, the Bronze plans will have the lowest premiums and highest out-of-pocket costs, while the Platinum plans will have the highest premiums and lowest out-of-pocket costs.

There is a lot to consider when choosing a health plan. Tidwell Insurance Agency can help you evaluate premiums, out-of-pocket costs, plan types, benefit levels and provider networks to make sure you make the right selection for you and your family.

How to Apply and Enroll

You can apply for and enroll in health coverage during the open enrollment period online, by phone, with a paper application or through a designated assistance center in your community. Again, if you do not qualify for a subsidy, you can find a plan and enroll through your insurance agent or broker.

If you apply for coverage through HealthCare.gov, you will be asked to create an account and fill out an application in order to determine your eligibility for government assistance with your premiums. If you are eligible to enroll in a marketplace health plan, you can compare plans and enroll online.

If you do not have access to a computer or don’t want to use your computer to enroll, you can enroll by phone by calling 1-800-318-2596, 24-hours-a-day, 7-days-a-week. In addition, you can apply by mail after determining your eligibility online. Simply download the 2015 application and mailing instructions after completing the eligibility process. If you would like to apply with in-person help, visit https://localhelp.healthcare.gov/ to find enrollment assistance in your area.

Healthcare.gov provides a checklist of what you will need when you apply for or renew coverage from the Health Insurance Marketplace. Be sure to gather the documents you need before you begin the enrollment process.

Do you have questions about 2015 Affordable Care Act open enrollment? Need help comparing plans and selecting coverage either inside or outside of the Health Insurance Marketplace? We can help. Contact Tidwell Insurance Agency today for all you need to know about South Carolina health care open enrollment.

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