A lot of changes will take place in the American health insurance landscape in the coming weeks and years. Individuals and small business owners need to remember only three dates: October 1 2013, January 1,2014, and March 31, 2014. Here, find out what those dates represent. Also, learn about the other changes you can expect to see as the Affordable Care Act is finally put into place.
October 1, 2013: Open enrollment for insurance in the Health Insurance Marketplace begins. (The Marketplace is also called the Exchange.) Uninsured individuals can begin to explore their options for health insurance through the Exchange. Small business owners can also apply for health insurance for their employees through the Exchange.
Based on the information in your application, insurance providers can offer you competitive rates and plans for your health insurance needs. All of these plans meet minimum health insurance standards and provide required benefits.
January 1, 2014: New health insurance policies are active. If you wait and purchase health insurance late in the open enrollment period, you will delay your start date for coverage.
March 31, 2014: Open enrollment closes. After this date, you will not be able to shop for and purchase health insurance through the Marketplace until the next open enrollment period, or unless you qualify for a special enrollment period (see below).
Other benefits that begin in 2014
You cannot be denied health insurance coverage because of a pre-existing condition or disease. However, one exception exists: Individual insurance plans can still deny coverage for a pre-existing condition. In other words, if you already have individually purchased insurance, your insurance company is grandfathered in and can refuse to pay for a procedure or treatment related to a condition you had before you purchased insurance. At any time, you can use the Exchange to purchase insurance that does not exclude your condition.
Similarly, gender can no longer be a factor in health insurance expenses. Health insurance companies will not be able to discriminate against individuals, deny them coverage, or charge them more because of their gender.
Also, companies will no longer be able to limit the amount of coverage they provide in a year. If you have a larger health insurance need in 2014, your insurance company cannot deny payment because of a limit or cap they’ve placed on you or your insurance policy.
The penalty for not buying insurance
The Affordable Care Act is the law. You are required to have health insurance beginning in 2014. If you do not, you must pay a penalty.
The penalty in 2014 is 1 percent of your yearly income, or $95 per person for the year, whichever is higher. In 2014 the fee for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285. The fee increases every year.
The penalty for not insuring yourself or your children continues to increase this year. The penalty for an uninsured adult is $325. The penalty for an uninsured child is $162.50. The penalty for a family will be $975 or 2 percent of the family income, whichever is greater.
The penalty for an uninsured adult is $695. The penalty for an uninsured child is $347.50. The penalty for a family will be $2,085 or 2.5 percent of the family income, whichever is greater.
What happens after open enrollment closes?
If you experience a life change (including births, deaths, and marriage) outside of open enrollment, you qualify for a special enrollment period during which you can change your insurance coverage.