Photo by Hubble Ray Smith.
Nobody was rushing to Lisa Beauchamp’s desk on the first day of open enrollment for health insurance under the Affordable Care Act, the first enrollment period under President Donald Trump’s administration.
However, the health benefits advocate for North Country HealthCare said she’s got a full schedule of appointments early next week in Bullhead City.
Nothing about ACA has changed from last year, and the penalty for not having health care coverage is still in effect, Beauchamp said. Open enrollment runs through Dec. 15 for coverage effective Jan. 1.
Premiums, deductibles and tax credits are determined after an applicant’s financial information is entered into the system, said Beauchamp, a certified application counselor. That includes their current income, withholding taxes and dependents claimed on their tax returns.
“Once you get into the system and put your information in, then you know your rates,” she said.
The penalty for not having insurance is $695 for each adult, and $347.50 for each child, up to $2,085 per household, or 2.5 percent of household income.
Blue Cross Blue Shield of Arizona is the only company offering plans through the Health Insurance Marketplace, or ACA, in Mohave County.
The company website (www.azblue.com) provides information on how people can enroll and key dates for enrollment, how to select the right plan, what plans are available and how to apply for subsidies.
“With much confusion surrounding the ACA this year, educating residents is important, especially with the shortened enrollment period,” said Amber Schlaefer, public relations representative for Blue Cross.
Plans on the marketplace include comprehensive medical coverage for doctor visits and urgent care, no-cost preventive services such as wellness visits, immunizations and flu shots, and coverage for pre-existing conditions. Some people may qualify for health plans with no monthly premium.
Beauchamp of North Country Healthcare said she’s never sure about premiums and subsidy eligibility until the ACA application is actually completed.
Most people choose the silver plan, which is a cost-sharing plan.
“People can’t go without insurance, for one thing,” she said. “What’s important to them will go through the marketplace and hopefully it’s affordable for them. It depends on the person.”
Bullhead City has a lot of casino employees whose children are covered under their company plan, but not their spouse, Beauchamp noted. Those are the people coming in for help.
Some 10.4 million people were signed up for ACA in 2016, and the figure grew to 11.4 million in 2017.
The first year of ACA was a disaster with the system constantly crashing, and problems persisted in the second year, but it was working smoothly by the third year, Beauchamp said.
If there’s a problem now, individuals can log into their account with email to find out what’s covered, how much are their deductibles and what their benefits include.
Financial help is available in the form of tax credits, or subsidies, from the federal government.
A premium tax credit helps pay for all or part of your monthly bill. Keep in mind that the tax credit amount goes down as your income rises.
Cost-share reduction helps pay your share of medical bills such as copays, deductibles and coinsurance.
Qualifying incomes are $12,060 for single-person household, $16,240 for two people, $20,420 for three people, $24,600 for four people, $28,780 for five people and $32,960 for households of six or more.
State health insurance exchanges are required to offer four types of ACA plans: bronze, silver, gold and platinum. Bronze is the least comprehensive plan in terms of cost-sharing, while platinum is the most extensive.
The second-lowest priced silver plan is called the “benchmark” plan. Tax credit amounts are derived from the benchmark plan and are adjusted according to annual income.
All plans limited out-of-pocket expenses for network healthcare to $7,150 for an individual and $14,300 for families.
Go to the HealthCare.gov website to find out more about monthly premium costs and tax credit eligibility.