Obamacare and Pre-Existing Condition Coverage

Starting January 1st of 2014, all qualified health plans must begin to cover pre-existing conditions with no waiting periods for 10 core essential health benefits.  These benefits include hospitalization, ambulatory patient services, emergency services, laboratory services, rehabilitation, mental health services, preventive care and wellness, maternity and newborn care, prescription drugs and ambulatory services such as doctor's office visits.  Each plan will have different coverage levels depending on the benefit structure of a given policy.  For more information on health care reform in North Carolina, visit Obamacare NC.

What Will Happen to Your Current Individual Policy When Obamacare Begins?

If you are one of those who currently have a health insurance policy that has been in force and unchanged since March 23rd of 2010, you have a grandfathered policy and for 2014 your policy will remain largely the same as it is today.  However, if you have a policy effective or that has been changed since March 23rd, 2010, then you have a non-grandfathered policy that must conform to the Affordable Care Act (ACA), more commonly known as Obamacare.  Starting January 1st, 2014 your policy will either automatically become ACA compliant or you will be rolled onto an ACA compliant plan.  During the open enrollment season you will be given the option of changing plans to another carrier, or switching to a higher or lower benefit plan.  During open enrollment you will also be given the option to see if you qualify for a health insurance subsidy through the NC Health Insurance Marketplace.  If you have a plan already, you should contact your agent to help you through this process or if you are applying for a new plan, the agent or carrier of your choice will be able to help you see if you qualify.  If you currently have a plan in force I recommend making these changes prior to December 15th, 2013.  The best time to get these changes made will be late October or early November, because during that period I expect to see a lull in new enrollments and it will be easiest at that point to get in touch with an agent.

Visit our website for more information about open enrollment and Obamacare in NC.

How to Get a Subsidy to Pay for Your Health Insurance Through Obamacare

Qualifying and accepting your health insurance subsidy should be fairly simple provided you meet the income guidelines.  Those between 100% and 400% of the Federal Poverty Level will qualify for a subsidy on a sliding scale.  When open enrollment begins on October 1st, to apply for a subsidy, there is no need to provide documentation as long as your income is within 10% of your 2012 Modified Adjusted Gross Income.  When you contact an agent to get health insurance quotes, you'll tell the agent your estimated income.  Then, when you decide on a plan you'll be linked to the NC Health Insurance Marketplace where your income will be verified with the IRS by your tax ID number.  Once your income is verified you will decide how much of the subsidy to accept.  If you accept to much, then you will owe it back to the government when you file your 2014 taxes.  If you accept to little, then you can accept the balance of your subsidy also when you file taxes.  For this reason it is advised to accurately estimate your current income so that you don't accept to much subsidy.  If your income is less than 90% of your 2012 income and you want to accept your full subsidy, then Equifax will be used to verify your income.  If that is not adequate, then you may have to provide pay stubs or other proof of your current income.

For more information on Obamacare and to receive important updates, visit the following link: Obamacare NC