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What is the importance of having health insurance?

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Keep in mind...
  • Regular medical care extends a healthy life
  • Having health insurance avoid the shared responsibility penalty
  • Health insurance protects families against costs of unexpected medical care
  • Health insurance comes with prevention services at no extra costs
  • Health insurance provides wellness counseling and programs to help subscribers stay symptom-free

Health insurance is an important protection for the individual or family against the high costs of medical care. Hospitalization and surgical procedures can overwhelm a family budget or surpass an individual’s ability to pay. Comparison shopping is an excellent method for finding the best values in health insurance plans. Comparison shopping puts the customer’s needs and preferences at the center of the search.

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Individual Mandate

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The Affordable Care Act requires that every eligible person gets and keep qualified health insurance. Those that fail or refuse to do so may have to pay the penalty for each month without insurance. The mandate has exceptions, and Marketplace policies are not the sole source of compliance with the requirement for qualified insurance coverage. Original Medicare, Medicare Advantage, Medicaid, and the CHIP each meet the requirements for qualified health insurance.

The Shared Responsibility Fee

The penalty for not having insurance in 2016 is $695 per adult and $347.50 for each minor. The IRS computes the penalty as 1/12th of the total for each uncovered month. The total is the greater of 2.5 percent of annual family income or the sum of the individual adult and minor assessments. The penalty for a family limit is $2,085.00.

Better Care, Better Outcomes

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Those with regular medical care will live healthier and more productive lives than those that do not have access to quality medical care. If a covered person gets ill, they can see a doctor right away before the illness grows more complicated or severe. This is a good outcome, a disease detected and managed. Many serious and life-threatening illnesses are avoidable with quality medical care. Diabetes might be managed if detected early by changes in diet and increased exercise or activity.

Open Enrollment Period

The open enrollment period for the 2017 calendar year began on November 1, 2016, and ended on January 31, 2017. The open enrollment period is a time when every person can purchase health insurance on the federal Marketplace or a state exchange. This is an important step in getting qualified coverage.

The open enrollment period permits changes and switching of policy choices. Consumers should use comparison shopping on and off the Obamacare Marketplace.

It is important to look at all sources of insurance, and particularly those with incomes at or near 400 percent of the federal poverty level.

After Open Enrollment

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The rule is that no one can purchase a qualified health plan after the close of the open enrollment period. The exceptions include Life Events. Those that incur status changes that require a new opportunity to purchase insurance can qualify for a special enrollment period.

The special enrollment period is a 60-day period in which one can buy health insurance. The federal Marketplace and state exchanges accept the below-listed items as qualifying events for a special enrollment period.

  • Marriage
  • Divorce
  • Childbirth
  • Adopting a child
  • Loss of employer-sponsored coverage as a dependent

Universal Acceptance

The Affordable Care Act banned medical underwriting applicants for insurance. Every eligible person can buy a policy. The Affordable Care Act uses community rating to determine prices. The exceptions are the narrowly controlled price differences based on the below-listed factors.

Medicare

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Medicare offers qualified health coverage. Original Medicare and Medicare Advantage plans meet the requirements of the Affordable Care Act. Medicaid and the CHIP meet the minimal essential requirements, and these forms of coverage avoid the tax penalty. Medicare is an important source of health insurance for older Americans.

Those with Original Medicare or Medicare Advantage meet the requirements of the Affordable Care Act.

  • Medicare Part A: Hospital care, meets the requirements for qualified health insurance.
  • Medicare Part A and Part B comprise the Original Medicare. This combination exceeds the requirements of the Affordable Care Act.
  • Medicare Advantage plans meet the requirements of the Affordable Care Act. These plans have CMS approval and meet the requirements of the law.

Qualified Health Plans

The individual mandate does not require insurance; it requires qualified health insurance. The plans must meet the requirements of the Affordable Care Act and the rules that carry out its policies. They must have the minimum actuarial value of sixty percent or higher. They must offer minimum essential coverage and the ten essential health benefits.

Health Savings Accounts

The Affordable Care Act works well with other parts of the health laws and tax codes. One example is the Health Savings Account.

Paired with a High Deductible Health Plan, consumers can pay medical expenses with pre-tax dollars. They can roll the unused portions to the following year. This feature can provide a sum that pays deductible expenses while at the same time reducing taxable income.

Employer-Sponsored Plans

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Those that receive offers of coverage from an employer should take it unless it is not affordable. Affordable Marketplace insurance takes less than 8.0 percent of annual income

Affordable employer-sponsored insurance must take less than 9.5 percent of annual income. Those with offers of employer insurance cannot use the Marketplace for financial assistance features.

Many employers add accounts and funds for deductible expenses.

Insurance Promotes Physical and Financial Health

The benefits and advantages of health insurance coverage are improved health, and financial security. Compliance with the law avoids a tax penalty. The advantages of health insurance are the benefits that come with regular medical care and prevention.

With appropriate care, doctors can treat severe illnesses before the grow into dangerous conditions. Comparison shopping is the effective way to select health insurance. Comparison helps find the right policies to meet the individual or family needs and preferences.

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