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Open enrollment for federally subsidized health insurance under the Affordable Care Act, also known as Obamacare, runs Nov. 1 through Jan. 31, and state officials are offering tips aimed at helping Louisiana residents navigate the process.
During the enrollment period, individuals and families who do not receive health insurance through their employers can sign up through the online Health Insurance Marketplace at www.healthcare.gov and purchase policies sold by private agents and insurers.
Consumers can compare health insurance plans based on key factors including providers, services and price. All plans that are part of the marketplace must offer the same set of essential health benefits, including emergency services, hospitalization, prescription drugs and preventative and wellness services.
“Make sure to give yourself plenty of time to look through all of the options to be sure that you are getting the health plan you need,” Louisiana Insurance Commissioner Jim Donelon said in a news release. “Pay attention to the doctors and facilities that are part of each network. A licensed health insurance agent can help you explore your choices and also help you determine if you’re eligible to receive financial assistance paying your premium.”
Rate filings for plans show an average cost increase statewide of about 27 percent in the individual market and 6 percent to 9 percent percent in the small-group market, which Donelon said are are typical nationwide. To view rate increases by company, visit www.ldi.la.gov/healthrates. Final costs will be posted Nov. 1.
In Louisiana, 89 percent of those who enrolled through the marketplace last year received subsidies, with the average covering 80 percent of the insurance policy's cost, according to the U.S. Department of Health and Human Services. Individuals and families who are eligible for Medicaid are not eligible for subsidies.
The Louisiana Department of Insurance offers these tips:
1. You may be eligible for a subsidy to help pay for your insurance policy. Tax credits are available for families with incomes between 100 percent and 400 percent of the poverty level. To find out if you may be eligible for a subsidy or tax credit, visit www.healthcare.gov or contact an agent.
2. Check your plan’s network. Spend some time investigating which health care providers are included in your plan and considering what best meets your needs for the coming year. A plan with a narrow network will have fewer options for physicians, facilities and emergency services. To learn more, visit www.ldi.la.gov/checknetwork to watch the state agency's video, "Understanding Healthcare Networks."
3. Decide if a health spending account is right for you. There are tax advantages to contributing to a health spending account. An HSA allows you to use pretax money to cover eligible health expenses, such as premiums and deductibles and over-the-counter medications. Unlike a flexible spending account, HSA money can be rolled over from year to year. If you are purchasing a plan on the marketplace, make sure it’s HSA-eligible.
4. There are financial penalties for not having health insurance. In 2017, the penalty will be 2.5 percent of your yearly household income or a fee for each person in your household who isn’t covered by health insurance, whichever is higher. All penalties are payable on your federal income tax return.
“As the offerings, companies and premiums can change year to year, it’s a good idea to consult an expert if you have questions about selecting a plan,” Donelon said.
The state Insurance Department website, ldi.la.gov, maintains a searchable database of licensed insurance agents.
Open enrollment runs through the end of January, but to have coverage in place on Jan. 1, you must enroll in a plan by Dec. 15.
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