Confused by health care reform? You're not alone - KMOV.com

Confused by health care reform? You're not alone

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By KMOV Web Producer By KMOV Web Producer

SEATTLE (AP) -- The Washington state health exchange is about to open its virtual doors for a second round of signing people up for insurance. The people who run the public-private partnership promise it will be easier this time around.

Here are some questions and answers that may help:

 

Q: If I signed up for insurance through the exchange during the previous open enrollment period, do I have to go through that again?

A: Maybe. If you received a letter from your health insurance company saying your plan is being replaced, you'll probably have to go online and choose a new plan. If your plan isn't changing, you have a choice. There are lots of new plans available, so you may want to shop around again. There are twice as many plans available this year. But you may also choose to just keep your existing plan and in that case, you don't have to do anything. Worth noting: If your income has changed since you signed up the first time, your eligibility for subsidies or Medicaid may have changed.

 

Q: Do I have to buy health insurance? What happens if I don't?

A: The health care law requires everyone to have some kind of insurance. If you have insurance through your employer or have already purchased insurance on your own, you're set. If not and you live in Washington state, you need to either visit Washington Healthplanfinder online or find a broker to help you sign up. If you do not buy insurance, you will have to pay a fine when you file your income taxes. Those fines start at $95 or 1 percent of 2014 household income, but go up from there. The minimum fine in 2015 will be $325 per uninsured person or 2 percent of household income.

 

Q. When can I sign up for insurance to cover me and my family in 2015?

A. You can begin the process now at http://wahealthplanfinder.org, but you can't sign up for insurance until Saturday, Nov. 15. This open enrollment period ends Feb. 15. You need to sign up and pay for insurance by Dec. 23 in order for coverage to start Jan. 1, 2015. If you pay by Feb. 15, your coverage is effective March 1, 2015.

 

Q. How much will it cost? How do I qualify for a subsidy?

A. Prices vary according to what kind of insurance you buy and how big your deductibles will be. The income threshold for a government subsidy offered on the state exchanges varies based on a number of factors, but generally tops out at incomes of $46,000 a year for an individual or $94,200 for a family of four. The way the subsidies are figured depends on the cost of a policy as a percentage of income. Since older people pay more for insurance, they can earn more money and still get a subsidy, whereas a 21-year-old couldn't make more than about $33,000 to buy individual insurance and have the government pay part of the cost.

 

Q. Do I need to go to the exchange right now if I have Apple Health, which is Washington's free insurance through Medicaid?

A. The enrollment periods are different. If you have Apple Health, you will receive a notice that it's time to renew a year after you signed up and that may or may not be during the open enrollment period for private insurance. If you didn't sign up for health insurance last year and you think you might qualify for free insurance through Apple Health, you can check your eligibility any time. Lots of people who thought they had to buy insurance last year, found out they qualified for free insurance through Medicaid, which is the program we call Apple Health in Washington state.

 

Q. If I started to sign up last year and gave up, can I pick up where I left off?

A. Probably not. The exchange purged many of the accounts for people who did not complete the enrollment process.

 

Q. Can someone help me sign up?

A. Yes, there are a number of free options for help. You can call an insurance broker or find one at wahealthplanfinder.org. Insurance companies pay them a fee so it won't cost you anything more to sign up for insurance through a broker. You can also go to an enrollment event during the first two weekends of open enrollment. These will take place at shopping malls. You can also go to a community health center or community organization and use a navigator to help you sign up. These locations are also listed at wahealthplanfinder.org.

 

Q. Can small business owners sign up for insurance for their employees through the exchange?

A. Washington state just opened its business health insurance exchange for employers with up to 50 employees in Washington. Start the process at the same place people sign up for individual health insurance. Some businesses will get a tax subsidy for using the program.

 

Q. I have health insurance through work. Can I check out the exchange to see if that insurance would be better or cheaper?

A. Any resident of Washington can sign up for insurance through the exchange. If you have insurance available at work, it probably won't save you money to buy insurance through the exchange because most employers pay part of the cost of your insurance and government subsidies aren't usually available for people who can buy good insurance through their employer. Ask an insurance broker to help you figure this out; it's complicated.

 

Q. I waited on hold for hours last year trying to fix a problem with my insurance. Is it going to be just as bad this time?

A. We won't know until Nov. 15, but the people who run the exchange say they have fixed all the computer problems, made the site easier to use and beefed up the online help. They've also hired more people to answer the phones at the help center.

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