Individual Health Insurance - W.E. Davis Insurance

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Do you need Health Insurance coverage?

Many places want you to shop your own health insurance without any real guidance. Be careful, there is a lot to consider when purchasing healthcare coverage. We have access to online databases and can better assist you through the process. Give us a call today for assistance.

Here are five options for those still without insurance:

1. Take advantage of the grace period

This special break was created for anyone who began enrolling in an insurance marketplace by Monday’s deadline but didn’t finish. That includes people stymied by website outages or overwhelmed phone lines, missing information on applications, and other problems or confusion.

Those who started an application on by March 31 should log on and finish it as soon as possible.

People applying online will have until April 15 to finish, administration spokesman Aaron Albright said yesterday. Paper applications will be accepted until Monday.

Consumers will have to attest that they had tried to enroll by March 31.

For most people, going through a marketplace opens the door to lower costs. Those who use the grace period will get coverage starting on May 1 and won’t owe a fine.

2. Use a special enrollment period

The government also is offering extensions for problems that might have prevented people from signing up through a marketplace: natural disasters, domestic abuse, serious illness, mistakes by application counselors, or errors by insurance companies.

To seek a “special enrollment period,” contact the federal call center at 1-800-318-2596 or your state marketplace and explain what went wrong. If the extension is approved, that brings another 60 days to enroll.

Also, at any time during the year, certain life events — such as changing jobs, getting married or divorced, or becoming a parent — open a 60-day window to sign up for marketplace coverage.

3. Sign up for Medicaid

Those who qualify still can enroll in Medicaid — there’s no deadline. Eligibility is based on income and varies from state to state. The main beneficiaries of the change are adults earning up to about $16,100 per year, with no children living at home.

4. Buy insurance outside the marketplaces

Buyers can always go directly to an insurance company, but it might be expensive. Plans bought outside the marketplaces don’t come with government subsidies that hold down the cost for people with low or midlevel incomes. But they do include the law’s consumer protections.

Even after the deadline, buying a plan that meets the law’s essential coverage standard reduces the penalty owed, which is based on the months without coverage.

5. Get ready for next time

Open enrollment for 2015 is scheduled to begin on Nov. 15 and run just three months. That’s another chance to get covered or switch into a plan with subsidies.

Something to think about: The uninsured penalty next year rises to 2 percent of income or $325 per adult and $162.50 per child.

Changes to Medicaid Coverage FAQs: Extending Medicaid to more Low-Income Ohioans

Who is newly eligible for Medicaid coverage?
  • Beginning January 1, 2014, an additional group of residents - also referred to as Group 8 - will become eligible for Medicaid coverage Ohio.
  • Group 8: This group includes adults between the ages of 19 to 64, who are between 0 – 138%* FPL and are not eligible under another category of Medicaid. NEW: Parents 91-138% are now eligible as Group 8 adults.
  • arents: Parents living with their minor children between 0 – 90% of the Federal Poverty level are currently eligible for Medicaid coverage.
How can I apply for Medicaid?
  • To see if you are eligible for Medicaid benefits, you should complete an application online at Benefits.Ohio.Gov.
  • If you cannot complete an application online you can go to your local JFS office and complete an application with a case worker or call the Ohio Medicaid Consumer Hotline at (800) 324-8680.
I think I am in the newly covered Medicaid population, when do I sign up?
  • Beginning on December 9, newly eligible adults will be able to submit applications through Benefits.Ohio.Gov for coverage starting on January 1, 2014. Please Note: If you are a part of an existing Medicaid category and need coverage now, click here to apply now.
What does 138%* FPL look like for an individual or household?
What if I learn I do not qualify for Medicaid?
  • If you do not qualify for Medicaid, you may qualify for help paying for insurance on the federal Health Insurance Marketplace.
  • For more information on the federal Health Insurance Marketplace visit or call the federal hotline at (800) 318-2596.
For additional help please visit your local county JFS or call the Medicaid Consumer Hotline at 1 (800) 324-8680.
*138% includes individuals who are at 133% FPL with a 5% disregard during eligibility calculations.
Will residents in the newly covered population be considered participants in the Medicaid program?
  • Yes, residents who are part of the extension population will be full participants in the Medicaid program.
  • Residents in the newly eligible population are included in the MAGI Medicaid group so the rules that apply to the MAGI program categories also apply to the new population (income and household calculation rules).
  • Click here to review the MAGI Medicaid FAQs
When will the newly eligible group begin enrolling for Medicaid benefits and if found eligible when will their Medicaid benefit coverage begin?
  • Enrollment for the newly covered population starts on December 9, 2013 and Medicaid benefit coverage starts no earlier than January 1, 2014.
  • Note: Although benefit coverage starts on January 1, 2014, if residents are found eligible during December 2013 they may not receive their card until the end of January.
Are residents who are currently eligible for Medicaid now going to be covered under the newly covered population?
  • Most residents who are currently eligible for Medicaid are not going to be covered under the newly covered population.
  • Certain individuals who are currently eligible on the basis of blindness or disability will be eligible to be covered under a MAGI coverage group
If a resident currently has Medicaid coverage, do they have to change their Managed Care plan?
No, residents who are currently covered by Medicaid will not have changes to their plans, unless they fall under the following categories:
  • Receive a Medicaid spenddown
  • A part of the Medicaid buy in for workers with disabilities (MBIWD)
  • If a resident is under age 65, currently pay a spenddown or MBIWD premium, and are NOT covered by Medicare, you may be eligible for coverage without a spenddown or premium. Contact your case worker to find out.
How will Medicaid benefits for the newly covered population be different from the benefits available to current Medicaid recipients?
  • The newly eligible group will have essentially the same Medicaid benefit coverage with the same Managed Care plans as current Medicaid recipients. Review the details of Medicaid benefit coverage here.
Will all residents who are part of the newly covered population be enrolled in Medicaid Managed Care Plans?
  • es, all residents who are newly eligible for Medicaid will receive Medicaid benefits through a Managed Care provider.
Residents who are excluded from Medicaid Managed Care plans include:
  • Medicaid eligible Individuals on home and community based waivers
  • Medicaid eligible Individuals who are institutionalized
  • Individuals eligible for both Medicaid and Medicare
  • Individuals eligible for Medicaid who have a spenddown
  • BCMH (Bureau for Children with Medical Handicaps) children diagnosed with cancer, cystic fibrosis, or hemophilia
  • For more information on Managed Care plans click here.
Will residents who are part of the newly covered population be able to select and change Managed Care Plans like current Medicaid recipients?
  • Yes, residents who are part of the newly eligible population will be able to choose, or change, their managed care plans just like current Medicaid recipients.
Will residents in the newly covered population be subject to co-pays?
  • Individuals on Medicaid may be subject to minimal co-pays for select services. For more information on Medicaid services can be found here.
Does the newly covered population have any asset limits that can prevent someone from qualifying?
  • There are no asset tests or asset restrictions for the newly eligible population because the newly covered population falls within the MAGI eligibility rules.
  • Click here to review the MAGI Medicaid FAQs
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