Launch of nation’s Health Insurance Marketplace just around the corner; where to get help in Southern Utah

ST. GEORGEStarting Oct. 1, people across the nation will be able to start shopping for health insurance via the Health Insurance Marketplace overseen by the federal government. The law set forth in the Affordable Car Act, also called “Obamacare,” mandates the majority of Americans have health insurance in 2014 – or face a fine.

It all starts tomorrow

Open enrollment in the Marketplace starts Oct. 1, 2013, and ends March 31, 2014. Coverage for those enrolled before the end of the year begins Jan. 1, 2014. Still, where does one go to learn about the kind of insurance they need and the proper comparisons to make?

While the state has created an online exchange for small business called Avenue H, it has opted to leave the management of its marketplace for individuals to the federal government.

Family Healthcare Clinics in St. George and Cedar are preparing to help people enroll in the exchange and help find healthcare coverage, Nancy Neff, chief executive officer of Family Healthcare, said.

It’ll take people a while to figure it out,” Neff said.

Research won’t be such a bad idea as at least five different companies within Utah are offering between 70 and 80 different plans for people to choose from. Plans will be set at various levels and priced according to the type of coverage offered. The options are rated at Bronze, Sliver, Gold and Platinum.

According to the Department of Health and Human Services, in Utah, the average premium for the lowest-cost silver plan will be $239 per month, and for the lowest cost bronze plan it will be $201 per month. The average premium nationally for the second-lowest-cost silver plan will be $328 per month before tax credits, or 16 percent below projections based off of Congressional Budget Office estimates.

Utah’s Health and Human Services reports that a 27-year-old living in Utah who makes $25,000 per year will pay $95 per month for the lowest cost bronze plan, or $145 per month for the second-lowest-cost silver plan, taking into account tax credits. For a family of four in Utah with an income of $50,000 per year, the lowest-cost bronze plan will cost only $122 per month.

Consumers will be able to get more precise quotes and comparisons once the Marketplace officially launches.

Companies that will be offering health insurance througt the Marketplace in Utah include Altius, Humana, Regence, SelectHeatlh, and UnitedHealthcare.

Where to get help and info

With the different companies offering different plans, Neff again stressed research on the part of the consumers as they look through the Marketplace and compare their options. As well, she said she advises consumers to learn which doctors accept which plans.

“Its going to to be important that people do their research,” Neff said.

Family Healthcare’s outreach and enrollment specialists will be on hand to help people confused by the Marketplace, Neff said, at their various locations starting tentatively around Oct. 7.

People in the St. George and Cedar City areas will be able to call the following numbers and leave questions for the specialists once they become available a week from from now.

  • Family Healthcare in St. George – 435-879-5514
  • Family Healthcare in Cedar City – 435-867-2754

Hours when people can visit the clinic to enroll and find coverage will be posted on Family Healthcare’s website as they are set.

A spokesman for the Enterprise Valley Medical Clinic in Enterprise said there are two Healthcare Marketplace specialists currently on hand and already taking appointments for people in the area. Appointments with a healthcare specialist can be arranged by calling 435-878-2281.

Consumers with questions can also call a 24-hour, toll-free hotline: Telephone 800-318-2596. Trained customer service representatives will be on hand to answer questions – with translation services in 150 languages as needed.

Information can also be found at the following websites:

Minimum essential coverage

If you’re covered by certain plans you may already meet the minimum essential coverage requriements. According to the government’s health care website, you’re considered covered and don’t have to pay a penalty if you have any of the following plans in 2014:

  • Any Marketplace plan, or any individual insurance plan you already have
  • Any employer plan (including COBRA), with or without “grandfathered” status. This includes retiree plans
  • Medicare
  • Medicaid
  • The Children’s Health Insurance Program (CHIP)
  • TRICARE (for current service members and military retirees, their families, and survivors)
  • Veterans health care programs (including the Veterans Health Care Program, VA Civilian Health and Medical Program (CHAMPVA), and Spina Bifida Health Care Benefits Program)
  • Peace Corps Volunteer plans

Other plans may also qualify.

Penalties

Those who do not get health insurance will be fined $95 per adult  / and $47.50 per child, or 1 percent of the individual or family annual income as applicable, whichever is greater. The fines increase annually and are projected to reach $695 per adult and $347.50 per child by 2016 or 2.5 percent of income, whichever is greater; that is, families not covered by 2016 face a fine of $2,085 or 2.5 percent of the family income, whichever is greater.

Fines are in addition to health care costs. 

According to the government’s health care website:

People without health coverage will also have to pay the entire cost of all their medical care. They won’t be protected from the kind of very high medical bills that can sometimes lead to bankruptcy.

Some exemptions are available, application for exemption may be required.

Ed. Note: The Affordable Care Act has many people for and against it. It is beyond the scope and intent of this article to address the merits of either side of the debate.

Resources:

Related posts:

Email: mkessler@stgnews.com

Twitter: @MoriKessler

Copyright St. George News, SaintGeorgeUtah.com LLC, 2013, all rights reserved.

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