Monday, February 3, 2014

"Hey, Doc" Clears Up Confusion About Marketplace Insurance Deadlines

We know health reform is big and confusing. Some parts of the law started in 2010. Other parts are rolling out over the next several years. Texas physicians and the Texas Medical Association have carefully studied the law to help you understand what the changes mean to your health care. 

As the Affordable Care Act (ACA) continues to roll out, Me&My Doctor’s “Hey Doc” series will answer your frequently-asked questions, as well as some you might not have thought to ask. 

 Q. I haven’t signed up yet. Is it too late?

A. It’s not too late. If you’re looking for insurance through the marketplace, you can still sign up. As long as you enroll in a plan by March 31, you can get coverage for 2014 and avoid the penalty for going without it. That’s when open enrollment closes for 2014. After March 31, you can still get insurance outside the marketplace. Otherwise, you’ll have to wait until the next marketplace open enrollment, with few exceptions for special events like getting married or divorced, or losing a job. So far, the federal government scheduled the next marketplace open enrollment for Nov. 15.

The sooner you enroll and pay, the sooner your insurance will take effect. Check with your insurance plan to find out when your first premium payment is due.

Q. All of these deadlines seem to be changing. What dates do I need to know?

A. It’s true. A lot of the deadlines the government originally set have changed. Here’s what you need to know for now:

Jan. 1 — This is when the Affordable Care Act “individual mandate” kicked in, and this is when the clock started ticking for the penalty you could face if you go without coverage starting this year. (See “Who must enroll? What if I don’t?”) If you already have insurance, you’re in good shape. If not, you still have time to get coverage in or out of the marketplace and avoid the penalty.

And if you signed up for marketplace insurance before or since Jan. 1 but haven’t paid, check with your health plan to find out when your premium is due to make sure you are covered.

March 31 — This is the last day to sign up for insurance through the marketplace to get coverage for 2014. For most people, it’s also the last day to get coverage in time to avoid the penalty for going without insurance in 2014, whether you buy it in or out of the marketplace.

If you sign up and pay for insurance: Your coverage begins:
Feb. 1-15 March 1
Feb. 16-28 April 1
March 1-15 April 1
March 16-31 May 1
You must pay your first month’s premium before your insurance takes effect. Once again, check with your health plan to find out when your premium is due to make sure you are covered. Some — not all — insurance companies extended the January payment deadline for coverage to take effect as of Jan. 1. If you signed up for insurance for January but did not pay the premium, call your health plan and make sure you get it paid on time so you are covered.

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