You may know that every American is required to have health insurance by law. But what exactly does that entail? How do you go about finding the right policy and how much it will cost?
Whether you’re a full-time nanny, a part-time senior caregiver or an occasional babysitter, it’s important for caregivers to understand what the law requires you to do, and how to go about finding and signing up for the right health insurance policy. It’s also important to remember that health insurance is for you: Having the right protection in place in case of emergency can save you a whole host of problems, both financially and in terms of your well-being.
Here are answers to seven common questions caregivers have about health insurance:
1. Am I eligible for health insurance?
“Anyone who needs health insurance is eligible under the Affordable Care Act,” says Nick Moriello, president of Highmark Blue Cross Blue Shield Delaware. “That is one of the positive pieces of the law.” Before the Affordable Care Act, you could be denied coverage for a pre-existing condition. But now, you are free to shop for the policy that best fits your personal and financial needs.
2. Do I have to purchase a health insurance policy?
Everyone is required to have health insurance of some kind under the law. If you’re covered under a spouse’s plan or are under 26 and covered by your parents’ insurance, you don’t need to apply for more insurance. In previous years, you could be fined for not having coverage, but this is no longer the case. Even without a monetary penalty, it’s still a good idea to have health insurance so an injury or illness doesn’t significantly impact you financially.
3. When do I sign up for health insurance?
Open enrollment begins November 1st for plans taking effect next year. The cutoff date for enrollment is December 15. You should enroll before the deadline approaches to avoid any potential headaches in trying to obtain a policy. If you’re already enrolled in a policy, it will expire at the end of the year. When open enrollment begins, it’s important to renew your policy to make sure you’re covered. Take the time to compare your current coverage to a few new policies and see if there’s a better fit for you.
4. What If I don’t sign up in time?
If you miss the open enrollment period, you can’t purchase coverage until next year’s open enrollment. The only exception is if you incur a “life changing event,” such as the birth of a child, getting married or beginning a new job. You’ll then have a 60-day period to be able to purchase a policy.
5. How do I purchase health care coverage?
Begin by comparing plans. Check online markets like Stride Health or the federal marketplace. You can choose from different levels (often called “metallics”) of cost and care services provided. All plans have universal coverage for wellness visits, emergency care and maternity care. Make sure you are shopping for a plan that lets you see the doctors you want, go to your preferred hospitals, get the deductibles that fit your budget and also covers your prescription drug needs.
6. How much will my health insurance policy cost?
The different so-called “metallic” levels are named for the types of coverage offered, with the most basic coverage listed as bronze level. Catastrophic insurance is also available for individuals under 30 years of age. You should figure out what you can afford for coverage, but prices are regulated by the Department of Insurance. That means the same plan, even if it’s offered in three different places, is always going to be the same.
7. Are there ways to lower the cost of my policy?
If your income is no more than 400% above the federal poverty level (which currently calculates to under $156,000 for a family of four or under $75,300 for an individual), you may qualify for government subsidies to help pay for part of your insurance. State exchanges and some online markets can administer those subsidies. On HealthCare.gov, you can find out if you qualify for subsidies or get exact plan prices and savings by filling out a Marketplace application.
“It’s important to remember that your wages must be documented in order to qualify for a subsidy,” says Tom Breedlove, Sr. Director of Care HomePay. “That means your employer has to be paying you on the books.”
Your Next Steps: