Healthcare.gov used to be one of our favorite government help sites. It was full of information about finding medical care. It was so useful for those with lower (or no!) incomes. It was easy to find government subsidized medical services that were either free or charged fees based on your income.
Now that has all changed! It’s understandable given the push to make Obamacare a success (or at least make it look like one…). And the site serves an important function since folks need all the help they can get finding healthcare!
If you are facing a fee because you did not sign up for coverage in 2014 healthcare.gov should be helpful to you. In this article you can discover how to use it in the way that is best for you. You may even be able to sign up immediately for a program you didn’t know you qualified for!
But wait, there’s more: Not all the good stuff we told you about before is gone. It is just a bit harder to find. Yes the focus is on health coverage and insurance plans for individuals, for families, and even for small businesses. And we can still help you find medical care you thought you couldn’t afford:
Discover your program today!
Health Care Coverrage,Taxes and Penalties Health Care coverage is a requirement now unless you have a special exclusion. To enforce this, the IRS requires that you show proof of your coverage on your tax returns. If you don’t have coverage you will pay a penalty — and it will increase every year! The healthcare.gov website will show you what tax forms you need depending on your coverage details. And if you didn’t have any coverage for all or part of last year it will help you determine if you need to pay a fee and if so how to calculate it and pay. You can also use the “Individual Shared Responsibility Payment Estimator” to estimate what your fee might be.
Getting Health Insurance When you get to this site it looks like it’s all about health insurance. And for the most part it is! At the top level it is divided into separate categories for Individuals & Families and for Small Businesses. Right now there is a big box about seeing if you can get 2015 health coverage if you’ve discovered you owe a fee for not getting it in 2014. You simply enter your zip code and then indicate what you would like to do first. Your choices are to see if you might be able to use the Special Enrollment Period (since Open Enrollment has already closed….); to determine whether you qualify for free or inexpensive Medicaid or CHIP plans (for children and family members); or to start an application if you already know you qualify for either of the first two options. The program will then send you to the appropriate website location (probably your state) to continue.
Health Insurance for Small Business If you choose the Small Business tab at the top of the Start page you will find the “small business Marketplace.” It is now available online. You can select the option for Employers or for Employees. If you own a business, clicking “For Employers” will take you to a page that encourages you to apply online to offer coverage to your employees. There are options to look at different plans and their prices as well as other useful tools. There’s also a phone number clearly highlighted to call with any questions.
Find Affordable Medical Treatment: Learn the Secrets! What if I still can’t afford health insurance?! Exactly. This is why we miss the old site! The tools that are highlighted include Tax Questions, Get 2014 Exemptions, Coverage to Care, and Contact Us. All those might be useful but seriously, what if you can’t afford Obamacare or some specific medical treatment even with a subsidy? Or what if you have a special situation?
We wondered the same thing. None of the major categories provided a clear way to find the answers we needed. The good news is we discovered a few important but somewhat hidden resources:
- Are you an immigrant? Disabled? A military Vet? Other? In tiny, tiny print near the very bottom of the opening page, on the left, is the “Sitemap”. Clicking Sitemap takes you to a page that lists many more detailed categories and may include what you’re looking for. On the far right is a heading called “Coverage For…”. It lists many different types of situations. So if you are unemployed, a vet, married to someone of the same sex, a retiree, in jail, disabled, an immigrant, etc., you can click that category and go to information specific to you. Note: you can also sometimes get to this list by clicking on “Get Answers” near the top of the site’s opening page. In case that page changes (which it does …), you can always go to Sitemap to find it. If you're looking for more than just health care, you can also go to benefits.gov and fill out a (fairly long) questionnaire to discover possibly amazing programs for which you might qualify.
- Want to find out fast if you qualify for a healthcare subsidy? On the far left of the Sitemap page under the heading Get Coverage, there is a category called “Getting lower costs.” Clicking it will let you see what income levels qualify for subsidies and do a quick check to see if you are eligible for special plans. That’s a good thing. But it still doesn’t answer our original question: what if you still can’t find anything you can afford? See #3:
- Need Free or Low Cost medical treatment? After much frustration, we discovered a way to find those subsidized health care centers that offer free or almost free services! The information is certainly not highlighted anywhere. But the centers still exist. We discovered how to get to them by using the search box that is near the top of the opening page, just below the major categories (and next to the “Get Answers” tab). If you enter the search term “finding lower costs” you will go to a page with several categories. Click on “How to find low-cost health care in your community” and on the next page click on “Locate a community health center near you.” Ta da! You go to a page that a lets you search by either an address or by your state or county. And you can see the results in text only or along with a map so you can determine how far away from you they are. These centers are located nationwide so you should be able to find one reasonably close to you. They provide basic checkups, care if you are ill or pregnant, vaccinations for your children, prescription drugs needed by you or your family, help if you have mental issues or addictions, and in many places even dental care. (Learn more about Free Dental Care here!)
Do try to get a coverage plan if you can! The many tools on this site will help you get there. If you simply cannot manage it, check out a healthcare center near you — that’s what they’re there for!
Finding Care You Can Afford is a category that appears in many (if not all) the selections offered after you fill out the brief questionnaire under the Find Insurance Options tab at the top of the site’s opening page. It links you to a site managed by the Health Resources and Services Administration (HRSA), also part of the Department of Health and Human Services. This is an excellent site. It provides a database of local health centers and clinics which are federally funded and which provide a variety of services including prenatal care and baby’s vaccinations, general care, prescriptions, and care for some serious conditions. These facilities provide treatment whether you have insurance or not and their fee is based on your income. You can click “Find a Health Center” and enter an address or place and you will get a list of centers near you.
Misleading Information: There is no section on issues or potentially negative costs and consequences of the new law, which will likely be extensive. There is a section called “Blog” which is actually a series of enthusiastic articles about various aspects of the new law but comments and questions are not provided for. It is possible to submit feedback about specific pages but that is not published and it’s not clear what happens to those comments.
Premature Expectations: Though most of the law will not be enacted until 2014, favorable aspects are too often described as if they were available today. For example, under the “Newsroom” heading there is a section which discuses your right to appeal if your health insurer has denied you payment for a particular service. It outlines the steps you must take to dispute the decision and appeal to the insurer, or in some cases to request an independent review. Step by step instructions are helpfully included. The Catch: If your plan existed on March 23, 2010, it has been “grandfathered” and is not subject to the new rules. So unless you’re on a fairly new plan, this feature will be of no use to you.
Dental Coverage is Confusing: Dental care is considered “essential” for children so you must be offered a plan that covers dental care if you have a child. However, dental care does not get covered at no cost. There will be plans offered to you that include dental care but you will have to pay more for them. For adults, dental care is not considered essential. So you have to look for a specific plan for dental. And unfortunately the dental care plan explanations are confusing at best and frankly rather misleading. Usually when plans talk about an “annual maximum” they are talking about your out of pocket expense. But dental insurance has an annual maximum that instead refers to your maximum benefits. So instead of you owing nothing once you have reached your “maximum”, it is the insurance company that will pay no more benefits when they have paid their “maximum” amount. So beware and read the plans carefully and be sure you know exactly what you're in for if you purchase a dental insurance plan for adults.