In case you hadn’t heard, Google need not be your doctor anymore, you hypochondriacs. You can see a real doctor, get tests taken, turn your head and cough or get your feet up in them stirrups if you sign up for health insurance provided by the Affordable Care Act, also known as Obamacare, by March 31. The thing is, shopping for insurance might be intimidating, so here’s all you need to know about getting covered before the deadline.
For starters, there’s this: Does your job pay your insurance or do you otherwise already have it? Congratulations, you’re fine and you can ignore all of this! Here, watch some classic music videos.
STARTING OUT
For the rest of you, let’s begin with where you can buy your insurance. You can shop online for it at New York state’s health care exchange (you can also call the health exchange’s help line at 855-355-5777 if you want to do things over the phone). The exchange is where you’ll fill out information like your income from the past year, marital status, household size and then shop for a plan. Not sure what kind of plan you should choose? As we went over when the exchanges first opened, every plan falls in to one of five basic tiers: Catastrophic, Bronze, Silver, Gold and Platinum. All of the plans you choose have to cover the following the medical services: doctor’s visits, emergency room care, hospital care, pregnancy and newborn care, mental health and addiction, prescription drugs, rehab, lab services, preventative care and pediatric vision and dental. After that, it’s a matter of how much you want to pay for coverage.
According to Healthcare.gov, your choice of plans run from covering about 60% of your healthcare costs with Bronze plans, all the way to 90% with Platinum ones. Catastrophic plans are only eligible to people under 30 years old or if you qualify for a hardship exemption, and while those plans are cheap, they come with ridiculously high deductibles. Beyond that, Bronze and Silver plans will cost you the least when it comes to paying your premiums, but they also have higher out of pocket costs and deductibles. Picking a plan is a matter of personal choice. Take into account how healthy you are, and keep in mind that relatively healthy people stick with high deductibles and low premiums, since the odds are that (hopefully) you won’t have to make huge use of your health care.
Here’s a few other things to keep in mind when shopping for a plan:
- If you’re already seeing a doctor, make sure your doctor is in the plans you’re scoping.
- Consider how much can you afford on health insurance (although subsidies might make this easier on your wallet and less of a consideration).
- Does the plan cover your medication? Not all of the plans cover the same meds.
- Do you need dental and eye care? Every plan is not required to carry those services but there are plans that have them.
THE COSTS OF STAYING HEALTHY
How much will you end up paying? It’s hard for us to say. You can see a breakdown of all the plans and what they cost before logging in to the exchange by visiting Health Sherpa, which also helpfully has a subsidy calculator for you. Yes, that’s right, since the government is mandating you get covered, you can get subsidies to help carry the costs if you make less than $45,900 per year. The subsidy is based on an estimate of how much income you declare on your 2014 tax return. For people with steady jobs, that should be relatively easy. Freelancers will have to estimate, but here’s a tip: if you overestimate slightly and pay more immediately, only to find out you declared less income than you thought you would, your subsidy will increase. But it also works going the other way, and will decrease if you estimated too little income. For everyone making more than $45,900, which is 400% of the poverty level for an individual ($94,200 for a family of four), the government deems you sitting pretty and you’re not eligible for subsidies.
But take note that if you make less than $15,862 you’ll be eligible for Expanded Medicaid because New York is a Medicaid expansion state. Expanded Medicaid is regular Medicaid, just now more accessible for more people because the eligibility requirements have been lessened, which means you can be less poor now and still qualify for it. There is no deadline to obtain Medicaid, but you still need to log into the Marketplace to obtain it. If you already have Medicaid you don’t need to obtain a Marketplace plan, you’re already covered.
What if you decide you don’t feel like getting insurance, or you just straight up forget? You’ll disappoint Adam Scott, for starters. You also don’t get away scot-free. If you make at least $10,150 when filing as an individual or and $20,300 when filing as a married couple, you get penalized when you file your 2014 tax returns. That penalty will be either $95 or 1 percent of your gross income, whichever comes out to more.
THERE’S HELP THOUGH
If all this makes you want to hyperventilate (don’t- you don’t have health insurance yet!) you can enlist the help of a real live person called a Navigator or In-Person Assistant (IPA). This person knows the semi-complicatedness of the marketplace and one can be found throughout Brooklyn. (Find one nearest you so you can call them and make an appointment.) Here’s a list of all the locations for the IPA’s thanks to the Brooklyn Chamber of Commerce and the Brooklyn Public Library and whether they accept walk ins or work by appointment only.
You can also take a last-minute Brooklyn Brainery course, “Obamacare and Me in NYC,” today at 4pm for just five bucks, like I did recently. What I found out there might save your life. Or your teeth, your liver, your knee from that climbing injury, or your lungs from exacerbating your asthma after that parkour session. You get the picture.
Remember, if you miss the deadline you may end up not being insured for the rest of 2014 and will have to wait till the next enrollment period which is November 15, 2014 to February 15, 2015 to be insured for the rest of 2015.
Health insurance! It’ll come in handy if you’re ever hit by a car whilst on your bike.
THE BIG BOOK OF TURN YOUR HEAD AND COUGH (GLOSSARY)
Premiums- What you pay monthly, sometimes quarterly, or yearly for health insurance.
Deductibles- How much out of pocket you have to foot before your insurance kicks in.
Health Savings Account- the health equivalent of Transit Checks this is money taken out of your account pre taxes. Best used for those health related activities health insurance may not pay for like your Chinese cupping obsession or yoga and reiki.