As the Open Enrollment Period for enrolling in a qualified health insurance plans comes close to an end for 2016, I thought it would be a good time to review some basics on how health insurance works these days.
Open Enrollment Period
If you do not currently have a health insurance plan you have until January 31st to get signed up, or else you will most likely have to wait for 2017. If you already have a health insurance plan, the deadline to switch to a different plan was on December 15th of last year. In general, you have to be enrolled in a plan by the 15th of the previous month in order for your coverage to start on the first of the next month.
Special Enrollment Periods
You may qualify for a special enrollment period of 60 days following one of the following events. If you lose coverage, get married, have a baby, have a change in income, or move, you will qualify to be able to enroll in a plan even during non open enrollment periods. This includes children that lose coverage on their parents plan when they turn 26.
How to Enroll
In Idaho the website to search for plans, apply for a premium tax credit, and enroll in a plan is Yourhealthidaho.org. You can find a local agent to assist you on the website as well. It is important to note that using an agent does not cost you anything, so you might as well have an agent there to help you through the process. If you don’t qualify for a premium tax credit because your income is too high or low, you can still enroll in a plan through the state website.
Who Qualifies for a premium tax credit?
Anyone who doesn’t have coverage from work and has income between 100% and 400% of the federal poverty line based on their family size may qualify for the premium tax credit. Coverage from work also applies to spouses and children if coverage is offered to them. The 2015 federal poverty line for a family of 1 is $11,770 and goes up by $4,160 for each additional person in the family. 1. To find out for sure if you qualify visit Yourhealthidaho.org.
Tax Penalty for not having coverage
If you or any of your dependents do not get qualified coverage in 2016, you will most likely be faced with a very steep penalty. The penalty is $695 per adult and $347.50 per child, up to a family maximum of $2085. Or if you have a high income you pay 2.5% of your income as a penalty for not having coverage. Some families with low incomes can qualify for a no affordable coverage exemption. 2.
If you need help with your health insurance I am an agent on the Yourhealthidaho.org website and work with several Idaho health insurance companies. I am located in Idaho Falls.
By Jimmy Hancock
- ASPE. “2015 Poverty Guidelines.” US Department of Health and Human Services, 3 Sept. 2015. Web. 12 Jan. 2016. <https://aspe.hhs.gov/2015-poverty-guidelines>.
- US Centers for Medicare & Medicaid Services. “Fee For Not Being Covered.” Healthcare.gov. N.p., n.d. Web. 12 Jan. 2016.