Shop Around for Health Care Insurance

As of January 1, 2014, the law requires almost everyone who is a legal U.S. resident to have health coverage or pay a penalty. In the first year, people without minimum coverage (a plan that pays for at least 60 percent of health care services) must pay $95 or one percent of their taxable earnings (whichever is greater). This penalty goes up each year, according to my agent, Rocky Capobianco. So, why did this happen?

The government created the Health Insurance Marketplace (in the Affordable Care Act) so people would have another way to buy health coverage, to follow the health care reform law and avoid the penalty. Like health insurance plans that are not in the marketplace, all plans in the marketplace are run by health insurance companies and offer a core set of benefits, like maternity, preventive and emergency care. If you close your workers compensation case and need health care insurance than this is important. You may have to look to plans in the marketplace for health care coverage.

So if plans in the marketplace are similar to plans outside the marketplace, and anyone can buy a plan through the marketplace, then who might consider buying through the marketplace?

Low-income individuals and families

Many workers who are injured and lose their ability to keep their jobs suffer tremendous economic losses. These workers and other low-income individuals and families can get help paying for a plan when they buy through the marketplace. People who aren’t eligible for a government-sponsored program, like Medicare or Medicaid (Medi-Cal in California), or other sources of minimum essential coverage, may still qualify for financial support to lower their premium through premium assistance (a tax credit) if their income is between 100 percent and 400 percent of the federal poverty level. These include:

  • Single people who earn 100 to 400 percent of the poverty level. This means they make between $11,490 and $45,960 a year.
  • A family of four that earns 100 to 400 percent of the poverty level. This means they make between $23,550 and $94,200 a year.
  • People who earn up to 250 percent of the poverty level. This group might get an added subsidy to help pay for their health care costs with a silver level plan.

So shop around for health care insurance. Use the internet and/or contact an insurance agent who specializes in health care insurance such as Rocky Capobianco. 805-390-8528. He agreed to allow me to make this reference and quote from his article.