Eight things you need to know before Monday’s deadline to enroll in health plans
Source Mercury News | Published: March 24 2014 By Tracy Seipel
The real definition of madness in March?
Waiting until now to sign up for health insurance under the new health care law.
With the March 31 deadline fast approaching for millions of Californians who still don’t have insurance (that’s midnight Monday, folks), you’re facing some painful hurry-up-and-wait scenarios: brave the mad dash of procrastinators and finally enroll or prepare to pay a hefty penalty at tax time next year.
Whatever you choose, expect to hear from experts and advocates sounding a lot like your mother over the next few days: “Don’t play Russian roulette with your health,” warned Larry Hicks, a spokesman for Covered California, the state’s health insurance exchange. Enrolling sooner than later, he said, will help you avoid “long waits and lots of frustration” closer to March 31.
You have last-minute questions, we have answers:
Q. How “hefty” are these tax penalties if I don’t enroll?
With few exceptions — like if you belong to federally recognized American Indian tribe — you’ll owe $95 or 1 percent of your household’s modified adjusted gross income, whichever is greater. So an uninsured family of four with a $120,000 annual income would owe $1,200, said Kelley Filice Jensen, a San Jose-based CPA and health insurance agent.
People who pay the $95 flat rate would also pay $47.50 per uninsured child, with a maximum family penalty of $285.
Next year, the penalty goes up to 2 percent of household income.
Q. OK, already. I’m signing up. How long will it take to do that?
A. Enrolling on the state’s insurance exchange website, often sluggish even during calmer periods, can take hours or even days, according to many frustrated accounts; getting through to a Covered California call center operator is also a challenge: The average hold time was 30 minutes a week ago.
You’ll get a couple of extra hours this weekend, when the phone lines are open from 8 a.m. to 8 p.m., just like weekdays.
If you’re having trouble getting on the Covered California website (www.coveredca.com), or connecting to a call center operator 800-300-1506, you can sign up with the help of a Certified Insurance Agent or Certified Enrollment Counselor. Insurance agents can recommend specific plans, and counselors can guide you through the enrollment process. Both are free of charge. To find one near you, go to the Covered California website and click on the yellow button that says “Find Local Help.”
Q. I hear I need to dig up a lot of documents to enroll?
A. You’ll need a copy of the first page of your most recent tax return; and, if you are a legal immigrant, your Green Card or immigration card.
Q. How do I qualify for a subsidy to lower my premiums?
A. In general, subsidies are available to individuals earning less than $45,960. The limit for a family of four is $94,200. You’ll know if you qualify for a federal government tax subsidy or Medi-Cal by clicking on the “Individuals & Families” link on the Covered California website. Scroll down to the income chart on Page 2. You can only apply for a subsidized health plan on the exchange.
Q. What’s the biggest thing to consider in choosing a plan?
A. Ask yourself if you want to choose your own doctors (a PPO), or a managed care plan that coordinates your care and doctors for you (an HMO). And if you want to keep the doctors you already have, ask them if they are accepting the new plan you’re enrolling in.
If you’ve already signed up for a plan under the new law but have discovered it doesn’t include your doctors or hospitals, you can still enroll in a different plan by March 31. For example, many Bay Area residents have recently discovered their Anthem Blue Cross of California individual Pathway PPO plans are not accepted by doctors affiliated with the Palo Alto Medical Foundation.
Q. Can I still change my plan next month?
A. The only way you can amend or adjust your health insurance coverage after March 31 is if you experience a so-called “life-changing event,” such as getting married, having a baby, adopting a child, moving to a new area that offers different health plans, getting or losing a job, filing for bankruptcy or a death in the family.
Q. Yeah, I know they say the deadline is March 31, but haven’t they extended it before?
Covered California insists there will be no grace period this time. However, if you started an application before midnight Monday, exchange officials said they will allow you to complete it as soon as possible.
Q. Now that I’ve signed up, how long until I have to pay the first bill?
You must pay your first month’s premium by April 25 in order for your insurance to kick in on May 1. If you don’t pay by that date, you will have lost the opportunity to have health insurance this year and will face the dreaded penalty after all. The next sign-up period for health insurance starts Nov. 15.
Contact Tracy Seipel at 408-920-5343. Follow her at Twitter.com/taseipel.
GET YOUR QUESTIONS ANSWERED TUESDAY
Join Bay Area News Group health care writer Tracy Seipel and health care insurance expert and CPA Kelley Filice Jensen for a live online chat at noon Tuesday at mercurynews.com, where they will answer your questions about the new health care law heading into the March 31 enrollment deadline.