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Individual medical insurance checkup

Posted October 08, 2014 in Advice Column

Mark your calendar: The 2015 open enrollment period for individual medical insurance begins Nov. 15, 2014, and runs through Feb. 15, 2015. During this period, you can purchase individual medical coverage or make changes to existing coverage for 2015. No underwriting is required.

•    What if I miss the deadline? Typically, individual medical coverage can only be purchased during the open enrollment period. If you don’t select coverage during this period, you may not have another opportunity until the 2016 open enrollment.

•    Are there any exceptions? Some life events may qualify you for a special enrollment period. These include, but are not limited to getting married or divorced, having a baby, moving to a new state or being dropped from a parent’s insurance plan. Learn more about getting coverage after Feb. 15.

•    Why is individual medical coverage important? Individual medical coverage provides essential benefits that are required by the Affordable Care Act. Most Americans are required to obtain health insurance with essential coverage or pay a tax penalty. For 2015, the penalty is 2 percent of your income or $325 per adult and $162.50 per child, whichever amount is more. Even after you pay the fee, you still won’t be insured.

•    When will my new coverage take effect? In general, when you purchase a new policy between the first and 15th days of the month, your coverage will begin at the start of the following month. Enroll between the 16th and the last day of the month, and your coverage will begin a month later. For example, if you enroll Dec. 20, your policy will take effect Feb. 1.

• What is a subsidy and do I qualify? A health insurance subsidy lowers the amount you spend on your monthly premium through advanced tax credits. Under the Affordable Care Act, Americans making less than 400 percent of the federal poverty level may qualify for a health insurance subsidy during open enrollment.

•    Do I need additional coverage? Whether you get your individual medical insurance through the Marketplace or your employer, consider supplemental health insurance. Supplemental insurance can help offset out-of-pocket expenses such as deductibles, co-pays and co-insurance. It also can help pay for non-medical expenses incurred as a result of a hospital stay, emergency room visit or outpatient surgery, including but not limited to transportation, lodging and child care. Contact your State Farm® agent for additional information about individual medical and supplemental health insurance.





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