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Health Insurance in 2015

We are nearly to 2015 and a month into the second Open Enrollment period of the Affordable Care Act (ACA). Here are a few recaps and reminders to keep in mind going forward.

What is the ACA again?

The Affordable Care Act, also known as ObamaCare, is an individual mandate signed into law in 2010 which states that starting in 2014, you must be enrolled in a health insurance plan that meets basic minimum standards. If you aren’t, you may be required to pay a tax penalty. The law is designed to help people across a wide variety of incomes obtain insurance, and many individuals and families qualify for subsidies to help pay for monthly premiums. In Maine, 90% of people get help paying healthcare costs.

How do you enroll?

Individuals can enroll by talking to a Navigator or Certified Application Counselor, online at healthcare.gov, or over the phone. In Maine, you can also enroll via Enroll207.com.

If I’m already enrolled, do I need to do anything? Why would I need to re-enroll?

If you already bought health insurance last year, great! It’s helpful to re-enroll for several reasons. First, there may be a plan that suits your needs better or new plans on the Marketplace that were not available last year. For example, Harvard Pilgrim is now offering health insurance plans in Maine for the second open enrollment. Additionally, because your health insurance premiums are based on your income, it is important to check if your income has changed or if your family situation has changed, and update your profile appropriately. You could potentially qualify for lower costs from newer plans or have higher health needs and want to switch to a different plan level. Make sure you weigh your options and update all of your information.

What are the deadlines?

The deadline for enrolling in health insurance in 2015 is February 15, 2015. All plans purchased between now and January 15th will have coverage starting on February 1st. Plans purchased between January 15th and February 15th will begin coverage on March 1st. If you miss the enrollment deadline of February 15th, you can’t enroll again until the next Open Enrollment at the end of 2015, unless you move, get married, or have some other qualifying life change.

What happens if I don’t purchase health insurance?

You may have to pay a penalty, unless your income is very low and you qualify for an exemption. Maine did not expand Medicaid, so those who would have qualified for Medicaid coverage will not have to pay a penalty. There are other groups who are exempt from purchasing coverage, but you should check to see if you actually qualify for an exemption before deciding not to purchase insurance.

How do I find out more information?

Visit Enroll207.com, healthcare.gov, or contact Bethany at Mano en Mano at 207-370-1583. There are also other qualified assisters and navigators around the state that are trained to answer questions and help consumers understand the new system. It can seem complicated at first, but don’t let that keep you from finding an affordable plan for your family. Most Mainers qualify for assistance in paying for their health insurance premiums.


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