Here’s a breakdown of some of the most important things to know about Affordable Care Act (ACA) enrollment.
- Initial and re-enrollment in ACA plans through state or federal exchanges began on November 15. The deadline to be enrolled for the first time or to re-enroll and change your plan in time for January 1 is December 15. You can continue to enroll through February 15 for later effective dates.
- If you’re already enrolled in an ACA plan and you don’t do anything, you’ll be automatically re-enrolled in that plan (unless it’s been discontinued).
- Individuals and families with incomes ranging from 100 to 400 percent of the poverty level may qualify for premium tax credits that reduce their monthly premium.
- If you’re re-enrolling in an ACA plan, you should check to see whether your premiums have increased and, if they have, by how much. Some states have had larger increases than others, as have some coverage tiers.
- When choosing a plan with a large deductible, consider the cost of ongoing care and medication for chronic conditions. It’s possible that the annual total cost of your premiums and out-of-pocket expenses will exceed the cost of a higher premium that allows for a copay instead of a deductible.
- If you choose not to obtain health insurance coverage in 2015, either through an agent, the federal or state exchange, or your employer, and you do not qualify for an exemption, you may face penalties. Penalties in 2015 will be the higher of either:
- 2 percent of your annual household income with a maximum equal to the average bronze plan premium
- $325 per adult ($162.50 per person under 18) with a maximum of $975 per family/household
- Penalty fees will be collected on your 2015 tax return, which you will generally file by April 15, 2016.
- Certain low-income individuals and families may not be charged a penalty for not having insurance, even if their state opted out of Medicaid expansion.
If you have questions about ACA enrollment or any of the new regulations, it’s important that you get the right answers. Many states have set up help centers to assist residents. You can also call 1-800-318-2596 to get help 24/7.