The Affordable Care Act kicked in this week as state health exchanges across the country opened for business Oct. 1. Americans now have until Dec. 15 to sign up for a healthcare plan that starts Jan. 1, 2014.
You can compare plans, find out if you can get help to pay for insurance and sign up for a plan through the online health exchanges. The Washington State Health Exchange already is up and running at www.wahbexchange.org/ .
But you don't have to have Internet access to apply. You can fill out a paper application, and get help from trained personal assisters or insurance agents. To get a paper application or find free help to apply in Washington, call 360-688-7700.
The Oregon Health Exchange (coveroregon.com) is open and taking paper applications, but the website will not be ready for online sign-up until later this month. To get a paper application or find free help to apply at 1-855-CoverOR (1-855-268-3767)
If you miss the Dec. 15 deadline you can still sign up through March 31. Your coverage will start soon after you sign up. After then, most people will have to wait for the new enrollment period that starts Oct. 1, 2014. The two exceptions? People who are eligible for Medicaid and businesses with fewer than 50 employees can sign up all year round.
The new law makes some of the biggest changes ever to the American economy and government. It increases the number of Americans who will have health care insurance, by the millions. And it will allow states to make changes aimed at reducing health care costs.
While the law will roll out across the country, it won't look exactly the same in every state. Fifteen states refused federal money to expand Medicaid to their poorest citizens, with several others uncommitted. And 27 states left it up to the federal government to create their health insurance marketplace.
Oregon and Washington, however, have both expanded the number of people eligible for free health care through their Medicaid programs: the Oregon Health Plan and Apple Health. And both states have created health exchanges, where you can compare plans and find out if you can get help to pay.
The rules are complicated, and what you get depends on your individual family circumstances. But thousands of trained personal assisters are ready to help you apply. And that help is free.
Cover Oregon has trained 2,200 insurance agents and 1,300 staff at partner nonprofits. In Portland, for example, the Urban League of Portland, the African American Health Coalition, NAYA, the Center for Intercultural Organizing and the Immigrant and Refugee Community Organization all have staff trained to help you. Call 1-855-CoverOR to ask for help.
Washington State also has trained community partners, such as Neighborcare, Friends of Youth and the Multicultural Health Center in Seattle. Contact King County Public Health in Seattle at 1-800-756-5437, or Clark County Public Health in Vancouver at 360-397-8000 ext. 7278, to find out who can help you.
How will the law affect you? It depends on your individual situation. Check out this cheat sheet to get you started.
I am on Medicaid through the Oregon Health Plan or Washington Apple Health.
You don't need to do anything. You already are enrolled.
Family Size | You can get free health care if your income is less than 138 percent of the federal poverty level.. |
1 | $15,800 |
2 | $21,408 |
3 | $26,951 |
4 | $32,499 |
My family is low-income. Can we get free health insurance?
For 2014, the income limit to receive free health benefits through Medicaid/OHP is 138 percent of the federal poverty level. (See chart at left)
Family Size | You are eligible for a subsidy if your income is below 400 percent of poverty |
1 | $45,960 |
2 | $62,040 |
3 | $78,120 |
4 | $94,200 |
My family is not well off, but I make too much for Medicaid or OHP
If your income is below 400 percent of the federal poverty level, (see chart at right) you are eligible for a subsidy that will lower your rates. Both the Washington and Oregon online health exchanges include calculators that tell you how much you will pay for a healthcare plan.
I am getting health insurance through an employer.
You can keep the plan you have, or you can look for a better deal through the state exchange. If your income is below 400 percent of poverty, you could be eligible for a subsidy. See chart at right.
I've been offered help to find a plan for a fee.
Help is available for no charge. You should not pay anyone to help you get health insurance. Find free help to apply: Oregon 1-855-268-3767 Washington 360-688-7700
I'm eligible for a subsidy. How do I get it?
Health insurance subsidies are paid as tax credits. They can be paid monthly – directly to your insurance carrier – or you can get your subsidy all at once as a tax credit when you do your taxes. You choose when you sign up.
I have a pre-existing health problem.
From January 2014, you can no longer be denied coverage based on a pre-existing illness.
I deal with a mental illness or a psychological problem.
All plans must include mental health coverage.
I have a problem with alcohol or drugs.
All plans must include drug and alcohol treatment.
I am an immigrant without legal papers to be in the United States. Can I use the exchange?
If you are undocumented you cannot buy insurance through the exchange. Your children may be eligible for state-funded care. You do not have to pay a penalty.
I've looked at health plans in the exchange and they all cost more than I can afford.
If a health plan would cost you more than 8 percent of your income you do not have to pay a penalty if you don't buy one. Use the calculator online to see if you would get help to pay.
I am an employer with fewer than 50 employees.
You can purchase insurance for your employees through the exchange. If you employ fewer than 25 people, whose average income is $50,000 or less, and if you pay 50 percent of their insurance premiums, you are eligible for a tax credit that can cover up to half your premium costs
What if I don't buy health insurance?
Under the law, with some exceptions, you will have to pay a penalty. In 2014 the penalty is $95 per adult and $47.50 per child up to $285 for a family or 1 percent of your income, whichever is more. The penalties rise in 2015. And, of course, if you need medical care because of an accident or illness, you will be stuck with the bill.
Health Care Events:
Seattle Public Library is hosting health exchange events, where trained personal assisters will help you compare plans, check if you can get a subsidy and sign you up.
Central Library, 1000 Fourth Ave., 206-386-4636
Oct. 7 through Dec. 14
ï‚· 3 p.m. to 7 p.m. Mondays
ï‚· 1 p.m. to 5 p.m. Tuesdays, Wednesdays and Thursdays
ï‚· 10 a.m. to 2 p.m. Saturdays
Ballard Branch, 5614 22nd Ave. N.W., 206-684-4089
Oct. 7 through Nov. 27
ï‚· 5 p.m. to 7 p.m. Mondays and Wednesdays
Broadview Branch, 12755 Greenwood Ave. N., 206-684-7519
ï‚· 1 p.m. to 5 p.m. Sunday, Nov. 3
ï‚· 1 p.m. to 5 p.m. Sunday, Dec. 1
Columbia Branch, 4721 Rainier Ave. S., 206-386-1908
ï‚· 1 p.m. to 4 p.m. Monday, Oct. 7
ï‚· 4 p.m. to 8 p.m. Wednesday, Oct. 23
ï‚· 10 a.m. to 2 p.m. Wednesday, Nov. 6
ï‚· 4 p.m. to 6 p.m. Friday, Nov. 15
ï‚· 4 p.m. to 8 p.m. Thursday, Dec. 12
Delridge Branch, 5423 Delridge Way S.W., 206-733-9125
ï‚· 11 a.m. to 3 p.m. Wednesday, Oct. 9
ï‚· 11 a.m. to 3 p.m. Wednesday, Nov. 13
ï‚· 11 a.m. to 3 p.m. Wednesday, Dec. 11
Douglass-Truth Branch, 2300 E. Yesler Way, 206-684-4704
Oct. 10 through Dec. 26
ï‚· 2 p.m. to 6 p.m. Thursdays
High Point Branch, 3411 S.W. Raymond St., 206-684-7454
Oct. 5 through Dec. 21
ï‚· 11 a.m. to 2 p.m. Saturdays
Northgate Branch, 10548 Fifth Ave. N.E., 206-386-1980
Oct. 9 through Dec. 18
ï‚· 2 p.m. to 7 p.m. Wednesdays
