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Last updated on Thursday, December 11, 2014
(INDIANAPOLIS) - Open enrollment for Individual Major Medical Health Insurance both on and off of the federal Marketplace began November 15, 2014, and will end on February 15, 2015.
To have coverage begin on January 1, 2015, you must choose a plan by December 15.
The Indiana Department of Insurance provides answers to some frequently asked questions to keep Hoosiers seeking individual health insurance coverage for 2015 in the know.
What Should You Know If This Is Your First Time to Enroll?
There are four ways you can apply for coverage:
No matter which way you choose to enroll, you will need to fill out a single Marketplace application to find out if you qualify for a health plan with premium tax credits and other savings based on your income, or free or low-cost coverage through Medicaid and the Children's Health Insurance Program (CHIP).
What Should You Know About Automatic Renewals?
By now, providers have mailed out renewal notices to those who had plans in 2014. If you had a plan and you do nothing, you will automatically be renewed for 2015 if your plan is still available. However, even if you had a plan on the Marketplace last year, you should shop around this year as there are many more plans being offered for 2015. By shopping around on the Marketplace, you may actually save money by not letting your plan be automatically renewed. If you received tax subsidies in 2014 for your Marketplace plan, the tax subsidies were based on what is known as the benchmark plan.
In 2014, there were only four providers offering 278 individual On Exchange Marketplace plans in Indiana. For 2015, there are eight providers offering 975 plans. This means that the second lowest silver plan (or the benchmark plan) from 2014 that was offered in your county may NOT be the second lowest silver plan available in your area in 2015, and the subsidy amount could be lowered. To learn more, visit http://www.in.gov/healthcarereform/2596.htm. Then, click on the map to see the affects of auto-renewal in Indiana counties.
What Should You Know If Your Policy Was Discontinued?
Hoosiers who were notified by their insurance company that their "transitional" or "grandfathered" policy is being terminated should shop around and review all plan offerings in their area. In March 2014, the Department of Insurance released Bulletin 205 informing insurance companies on their options to renew transitional policies. Some companies chose to non-renew their transitional plans and those individuals should have received a notice letter already. Additional information may be found at http://www.in.gov/idoi/files/Bulletin_205.pdf .
Will You Be Eligible for Premium Tax Credits When You (Re)Enroll?
If your household income falls between 100 percent and 400 percent of the federal poverty level, you may be eligible for premium tax credits through the federal Marketplace. However, if your household income is higher, you still enroll in the federal Marketplace. You also can contact an insurance agent who sells individual policies outside of the federal Marketplace.
Individuals who fall below 100 percent of the federal poverty level who do not qualify for Medicaid can purchase through the Marketplace with no tax credit.
Will Premium Tax Credits Reduce the Cost of Your Healthcare?
No, premium tax credits do not reduce the overall cost of health insurance. However, premium tax credits reduce the amount of money that you have to pay towards your premium - the remainder of the premium is paid to the insurance company by the federal government. Premium tax credits are determined based on your household income and the number of members in your household.
How Will You Get Your Premium Tax Credit?
To obtain a premium tax credit, you must file a tax return with the IRS for 2014. You also will need to fill out an application on healthcare.gov and provide information about your household members and your estimated income for 2015. The federal Marketplace will then estimate the amount of premium tax credit that you can claim on your tax return.
What Is the Deadline to Make Sure You Have Coverage?
Hoosiers seeking coverage need to make sure they have selected a plan no later than December 15, 2014. Your insurance company will mail you a letter indicating when the premium is due.
Where Can You Find Help with Open Enrollment?
The Indiana Department of Insurance suggests that you contact a certified Indiana Navigator or licensed insurance agent for assistance. You can find a Navigator in your area by visiting in.gov/idoi/2823.htm or locate a certified insurance agent in your area by visiting in.gov/idoi/2611.htm and clicking on Find an Agent/Agency.
For information on Healthcare Reform and more answers to frequently asked questions, visit Indiana's Healthcare Reform website at www.in.gov/healthcarereform/index.htm.
The Indiana Department of Insurance (IDOI) protects Indiana's insurance consumers by monitoring and regulating the financial strengths and market conduct activities of insurance companies and agents. The IDOI monitors insurance companies and agents for compliance with state laws to protect consumers and to offer them the best array of insurance products available. The IDOI also assists Hoosiers with insurance questions and provides guidance in understanding how insurance policies work.
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