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With confusion and uncertainty surrounding the implementation of the Patient Protection and Affordable Care Act (popularly known as Obamacare Act), scammers are having a whale of a time duping citizens. The scam could hit you via phone call, e-mail or fake websites. Protect yourself from scammers by being on top of the OBAMACARE FACTS!
WHAT IS THE TIMELINE FOR ENROLLMENT FOR OBAMACARE?
Obamacare will be delivered through health insurance exchanges set up by the Federal Government and the States. The exchanges can be accessed by the public at the portal https://www.healthcare.gov. The exchanges will offer insurance plans run by private insurance companies. Enrollment has begun on Oct. 1 2013 and will extend until March 31, 2014. Coverage for those who enroll this year would start from Jan. 1, 2014.
CAN I SIGN UP LATER, IF I MISS THE MARCH 2014 DEADLINE?
You can sign up during the next enrollment cycle. But you will be liable for the first year Penalty as described below.
WHO IS ELIGIBLE FOR OBAMACARE?
Obamacare is for people aged 64 and under who are not covered by employer sponsored health plan, Medicaid, Medicare or other public insurance programs. So if you are aged above 64 or you already have minimum essential health insurance coverage, you need not bother about Obamacare.
If you are 64 or under and you are not covered under Medicaid, or any other minimum essential health insurance coverage, you can apply for insurance under Obamacare.
People aged 65 and above are covered by Medicare which would remain unaffected.
WHAT IF I ALREADY HAVE HEALTH INSURANCE COVERAGE?
If you already have a minimum essential health insurance coverage (through insurance cover provided by employer, Medicare, Medicaid, the Children’s Health Insurance Program, etc.), Tricare, you need NOT sign up for fresh insurance under Obamacare. (You will NOT have to pay any penalty under the Act).
However, you may evaluate the cost of insurance under Obamacare at the exchange and switch over, if the cost is lower. (Subsidy on Premium will be available only for policies taken through the exchange)
If you are aged 64 or under and have only vision or dental coverage or only workers' compensation or coverage only for specific health conditions, or a plan that offers only discounts on medical services, you HAVE to sign up for insurance under Obamacare
IS IT MANDATORY TO SIGN UP FOR OBAMACARE?
If you are 64 or under and UNINSURED, you have to sign up for insurance under Obamacare.
WHAT IS THE PENALTY FOR NOT SIGNING UP FOR OBAMACARE?
If you are under 64 and UNINSURED but have not signed up for Obamacare by March 2014, the worst penalty is $95 per person (up to a family maximum of $285) or 1 percent of family income, whichever is greater. (The penalties would increase every year)
WILL I BE FORCED TO PAY PENALTY FOR NOT SIGNING UP?
NO! In fact, you will NOT have to physically pay penalty at all to IRS. Instead, the penalty shall ONLY be offset against future tax refunds (if you have any).
IRS cannot recover the penalty from your wages or from your bank or have a lien on your property.
HOW DO I SIGN UP FOR INSURANCE UNDER THE ACT?
You have to sign up for insurance at https://www.healthcare.gov. (Select your State). If your State has already set up its Insurance Exchange Website, you will be redirected to that. If you know the insurance exchange website of your state, you can go to the website directly and sign up.
You can also meet a navigator in person at one of the many enrollment fairs and sign up there. If you are having trouble in filling in forms at the website, you can reach a navigator by calling 800-318-2596
WHO IS A NAVIGATOR?
The navigators are trained by the federal agencies to help you for free. Their job is to help the public sign up for coverage. They don't charge fees or recommend a specific plan. They won’t ask your address, SSN, Medicaid, Credit Card or Bank info over phone.
WHAT ARE THE TYPE OF INSURANCE PLANS AVAILBLE AT THE EXCHANGE?
There are 4 plans (bronze, silver, gold and platinum) and all the four provide coverage for hospitalization, prescription drugs, emergency care, ambulatory patient services, maternity & newborn care, laboratory services and pediatric care.
The amount of premium and the percentage of cost borne by the insured differs based on the plan. For example, the bronze plan offers lowest premium but the insured will have to bear larger share of costs.
So if you want to pay lowest possible premium, choose the bronze plan.
DO I GET ANY SUBSIDY ON INSURANCE COSTS?
Depending on your income (and whether or not your employer offers an insurance plan), you could receive federal subsidies to help cover part of that premium. For example, if your Annual household income is $60,000 (2 adults and 2 children) with no employer coverage, you could get up to 47% subsidy on the annual premium of ~$9300. That means, you pay only ~$4900
Low-income individuals and families whose incomes are between 100% and 400% of the federal poverty level will receive federal subsidies if they purchase insurance via an exchange. Those from 133% to 150% of the poverty level will be subsidized such that their premium costs will be 3% to 4% of income. In 2013, the subsidy would apply for incomes up to $45,960 for an individual or $94,200 for a family of four.
HOW CAN I GET AN ESTIMATE OF MY INSURANCE COSTS & SUBSIDY?
The Kaiser Foundation has built a very useful tool for you to evaluate your premium and subsidy.
WHAT IF I CAN’T AFFORD TO PAY PREMIUM EVEN FOR A BRONZE PLAN UNDER OBAMACARE
Those who can’t afford even the lowest cost insurance under the ACT because the cost of premiums exceed 8% of their household income and whose income is below the minimum threshold for filing a tax return are not required to buy health insurance. Instead they could qualify for Medicaid.
I AM COVERED BY EMPLOYER’S INSURANCE PLAN, WILL I HAVE TO SIGN UP UNDER OBAMACARE?
No you don’t have to, since you are already covered. Some businesses may revoke employer’s insurance plan and ask employees to obtain insurance individually from the Obamacare exchanges
SHOULD I PAY SIGN-UP FEES, TO GET COVERED UNDER THE ACT?
Scammers might ask you to pay sign up fees to get covered under Obamacare. There is NO sign up fees to be paid to anyone including the official “Navigators”. You will be asked to pay a fee, only by scammers who pretend to be an official “Navigator”. Refuse to pay and report the scammer at FTC Website
I GOT A CALL THREATENING ARREST IF I DO NOT SIGN UP
The scammers may inform you that if you do not sign up immediately, you will face court summons, jail, arrest, etc. All such claims are humbug! The act specifically states that there will be no criminal prosecution at all. There will only be a monitory penalty as explained above.
I WAS CALLED BY SOMEONE CLAIMING TO BE ASSOCIATED WITH THE ACT
Federal agencies do not typically call, text, or email. They will only send or seek information by mail. So if you are called, texted or emailed with offer related to the Act, it has to be from a scammer and you should ignore that.
Scammers could call you and identify themselves as “Navigators”, “Assisters”, “Counselors”, “Insurance Agents”, etc. Don’t get carried away! Don’t divulge personal information.
Scammers could call and ask for your Checking Account Number, Routing Number, Credit Card number, Social Security number, or Medicare ID. Don’t release any personal information.
Do not respond to people who call you “from Federal Government”, “Affordable Healthcare Department”, etc. Instead call or chat with representatives at
https://www.healthcare.gov/contact-us/
A scammer may tell you that you have been chosen to receive a health insurance card through the new Affordable Care Act and request personal information before mailing you the card.
A scammer may tell you that you need to enroll under Obamacare even if you are covered by Medicare. Its untrue. If you are on any kind of Medicare or Medicaid, you do not have to sign up for Obamacare
A scammer may tell you that you have to get a new Medicare or Medicaid card under Obamacare and try to steal information. Don’t allow yourself to be fooled. Insurance under Obamacare is for those who are not under Medicare or Medicaid.
Do note! No citizen will be contacted by the Federal agencies and told that “you have been chosen” to receive healthcare insurance! Instead, YOU have to apply for insurance at https://www.healthcare.gov or the respective State exchange website by yourself
AM I FILLING-IN DETAILS, AT THE RIGHT WEBSITE?
The callers may lead you to fill in information at fake health insurance exchange website by sending you a link in a text message or in an email. To mislead users, the fake websites are designed to appear like an official healthcare exchange. To avoid error, visit https://www.healthcare.gov and select your State.
If your state has its own health care exchange website, you will be redirected to that. If not, you will stay at https://www.healthcare.gov and will be able to choose an insurance plan.
WHAT ARE THE MOST SIGNIFICANT FEATURES OF COVERAGE UNDER THE ACT?
The Act bars insurance companies from denying benefits because someone has a pre-existing medical condition, including any major illness, pregnancy or a disability. If a plan purchased covers children, they will be covered under the policy until age 26. Insurers have to justify any move to raise health plan premiums by 10 percent or more.
MORE INFORMATION & ASSISTANCE
For all information and assistance on Patient Protection and Affordable Care Act, visit https://www.healthcare.gov/contact-us/ or
Call 1-800-318-2596, TTY: 1-855-889-4325
Read through all the 20 points? Good! You would now be able to call the bluff and tick off scam callers eying to defraud you with misinformation on Obamacare.
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