Obama Care 2017  -  A Brief Overview



Open Enrollment Starts Nov 1, 2016

Updating Your Premium Discount Tax Credit

All Plans Cover Essential Benefits 

Biggest Difference - The Doctors, Hospitals " In Network"
 
All Insurance  Plans Renew January 1 of 2017

Compare and Save

Increased Tax Penalty for 2017

Important Dates

  • Open Enrollment for new plans and renewals start November 1, 2016 
  • Apply by December 15, 2016  for January 1, 2017. 
  • Last day of Open Enrollment is January 31, 2017.  

All Plans Cover Essential Benefits

The ACA sets the rules for what your insurance plan must cover. These " Essential Benefits " are the same with ALL plans. Coverage includes primary and specialist doctors, hospitalization, skilled nursing and rehabilitation, RX prescriptions, out patient diagnostic and surgery; 100 % payment for defined Preventative Care - annual physicals; mammograms, pap and women's health and expanded preventative for children.  What will vary from plan to plan are the copays - what you pay for a doctor visit or Rx drug - and  deductibles - what you must pay first before what the insurance payments for covered benefits like prescriptions, out patient or hospitalization begins. 

Think of insurance as a Car  - they all have 4 wheels, an engine, seats and a roof. And all will get you down the road.  The difference is between a Porsche and a Rambler. 
Biggest Difference between Plans and Insurance Companies -  " Networks " of Doctors, Hospitals and Medical Providers

The insurance companies negotiate what they pay doctors for covered medical services.  Those physicians who agree to work with that particular insurance companies' reimbursement rate are " In - Network " .  Other doctors may be considered " Out of Network " where  you would pay a higher copay. Or even not covered at all -   you would pay the entire bill ( except in a life threatening emergency ) 

As all the insurance plan cover those " Essential Benefits " -  checking to see if your particular doctors you see are " In Network " is now a VERY important comparison between insurance companies.  

  • Tax Penalty Increasing   

If you choose not to take coverage, what will the penalty tax cost you?  For 2017, $ 695.00 per adult and $347.50 per child (up to $2,085.00 per family) OR 2.5% of family income, whichever is greater.

Compare  with  2016 tax year,  these were  $ 325.00 per adult and $ 162.50  per child (up to $ 975.00 per family) OR 2.0% of family income, whichever is greater.

So a big increase  -  Having compliant coverage allows you to avoid this.

Updating Your Premium Discount Tax Credit 

When you signed up on Healthcare.gov, you had the option to check a box " Allow the Marketplace to review your tax return."    If you did so,  The Health Insurance Marketplace will (in most cases) update your tax credit; using your 2015 tax return, any changes in number of dependents, the 2015 baseline Silver plan and income guidelines. 

If you believe your income will change in 2017 as compared to 2015 -  you should log on to Healthcare.gov and update this -  starting November 1, 2016.  

As an agent certified to work on The Marketplace and having helped some 800 plus folks - we have the experience and training to guide you thru the process. And our New software will make this much easier for 2017. 

ALL Insurance  Plans Renew 
January 1 of 2017

Rates are going UP.  This applies to all the plans and all the insurance companies.

Think about  ---  

  • How you use medical services ?
  • How much will you pay before the insurance pays ? 
  • Are my doctors " in network " ?
  • COMPARE and SAVE 

Health Insurance is More than Just a Website 

Now that Healthcare.gov is working well, it is relatively easy to log on, create an account and buy insurance– just like any other website selling everything from widgets to wingnuts.
 
But knowing the insurance plans - what they cover, which doctors to use and how they will help you when you actually need health care – can be a challenge.  Copays, deductibles, preventative, Rx coverage, HMO’s, PPO’s, in-network, out of network, out of pocket, tiered, local, limited, unlimited, facility fees, etc, etc. So many details, so little time !!!   
 
As an independent agent with over fifteen years experience and certified by the Insurance Marketplace – I can help you determine the insurance coverage to best meet your needs, values and budget.  I know the insurance plans and how the premium discounts thru Healthcare.gov actually work. AND – you pay NO  additional premium or fees for my services.
 
Be sure you are buying effective insurance  - Not a box of nuts
Jeremy Sheridan
828.606.7994

Agent for Home, Auto, Life and Health Insurance