As Oct.1 signaled the official opening of the Silver State Health Insurance Exchange, it was a major milestone on the road to complying with the Affordable Health Care Act, which requires individuals to purchase health insurance in 2014.
As individuals across the country begin the process to comply with new health care laws, there are some facts to be sure of before proceeding.
“The first thing to keep in mind is that everyone with a few exceptions, will be required to carry insurance in 2014,” Nevada Division of Insurance Public Information Officer Jake Sunderland said. “If you currently have insurance through your employer, or a government program like Medicare or Medicaid, you don’t have to do anything. If you currently purchase insurance on your own as an individual, you may see some of your options change when it is time to renew. If you don’t have insurance at all, you will need to shop for and purchase insurance.”
In order to have coverage begin Jan. 1, individuals must enroll by Dec. 15. You can enroll for coverage in 2014 until March 31 of next year. For those people looking to buy health insurance for the first time, or on their own, Sunderland said the NDOI recommends using an insurance agent or Exchange Enrollment Facilitators to help provide education and outreach. The facilitators don’t receive a commission but also don’t give advice on purchasing.
The NDOI can also be a big resource in helping individuals and families help find the right plans for them, Sunderland said. But while there are resources to help individuals buy the right insurance plan, using help can be the best way to ensure getting the right plan.
“The Nevada Division of Insurance has a wealth of information available to help Nevadans understand the healthcare reform law and health insurance,” Sunderland said. “We also recommend that you utilize a licensed insurance agent or certified Exchange Enrollment Facilitator,” Sunderland said. “An insurance agent can help you look at your options on or off the Exchange and pick the best plan for your personal situation.”
But whether you decide to research on your own or with the help of an agent or facilitator, there are some questions to ask to help figure out what health plan is right for you.
“There are so many variables,” Sunderland said. “The most important thing is to make sure you pick a plan that is best for you and your family. This means taking a close look at your needs when it comes to health care. What prescriptions do you need? Do you have children? Do you expect to go to the doctor a lot? Or do you really just need emergency coverage?
“It’s important to answer these questions firs and then review the insurance plan information such as provider network, formulary and the cost sharing and monthly premiums to see what matches your needs at a price that makes sense for you family.”
Those who don’t have health insurance coverage face penalties, which is up to $95 per adult and $47.50 per child or 1 percent of family income, whichever is greater, in the first year. The penalty increases each year there after.
There are potential subsidies and cost sharing reductions available for individuals and families making 400 percent of the federal poverty level or less. The Silver State Health Insurance Exchange can tell applicants whether they qualify.
To view the Silver State Health Insurance Exchange, please visit www.exchange.nv.gov.