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!
Update December 2018
Listen up everyone because this is important: The CDC reports that the percentage of children not getting vaccinations is going up. This is not good. The facts are in — vaccinations DO NOT cause autism!! There is absolutely no reason to avoid these shots. And not doing so endangers both your kids and others. Even if you have no health insurance, if you are under-insured, or if you can’t afford vaccinations, your children can still receive these shots.Please please please contact your state’s health department to find out about the Vaccines for Children Program. If is funded by the U.S. Government and is free to those who don’t have insurance or cannot afford these shots. You are even eligible if you are an American Indian or an Alaska Nativel Please: do it now!
News Alert October 2018
Open enrollment is coming right up. From the first of November through December 15 you can apply for a new health care plan. The healthcare.gov site is there to help, with easy to access topics like how to get ready to apply if it’s your first time, how you can keep or change your current plan, what to do if you’re still without a plan for 2018, how you can get help from an agent or broker, and how to update your plan if you have had a significant income or life change. The healthcare.gov site is also a useful place to find ongoing tips and information in their blog. The most recent issue (Oct. 11) is about how you can find out what Marketplace health plans cover.
Update April 2018
Are you a vet? You're in luck! Seriously – if you haven't found the new website that replaces va.gov, where have you been? Go now to our latest article about the streamlined, so much easier to use vets.gov!
Update March 2018: Did you miss the Open Enrollment period for 2018? It does come and go pretty fast and so you may have a lot of company. And you might be able to still acquire some coverage or change your current plan, depending on your situation. The website make it pretty easy to get the information you need. On the landing page for the site, just click the green box that says “See if I can enroll” or the one that says “See if I can change” — whichever one matches your situation. After that they’ll ask for your zip code plus ask some questions to see if you are eligible for a special enrollment time that extends through the end of this year. They’ll also check to see if you qualify for programs like CHIP or Medicaid, which may apply to you if you’re considered low income or you have disabilities. If it looks like any of those apply to you then you can go ahead and apply online.
Update October 2017
healthcare.gov reminds you now that the Open Enrollment period for 2018 will start on November 1 and close December 15. If you missed that period this year be sure to put it on your calendar for next year. It has closed for this year (2017) but you may still be able to sign up for CHIP, Medicaid, or a program through the Marketplace. If you visit healthcare.gov right on the opening page you can input your state and your email address and get updates mailed to you about what your options are for this year (2017). You can also click the question “Still need ’17 plan?” and it will show you how to see if you can still enroll for this year. You can even start to fill our a 2017 Marketplace application and fin our if might qualify for a special enrollment period.
Update June 2017 Does it concern you that your Medicare Card shows your Social Security Number for all to see? It should! This is a serious security issue since that number makes it easier for bad actors who steal your identity and more. Fortunately steps are being taken to change that. The SSN’s will be removed and new cards issued. The new cards will use unique numbers that are assigned randomly, called a Medicare Beneficiary Identifier. The new cards are expected to be sent out starting in April of 2018 with a goal of replacing all cards by April of 2019.
Update February 2017 The future of health care plans is certainly uncertain at this time with the change in the presidency and with the weakening stability of the existing version of “Obamacare.” Humana has announced that they will withdraw at the end of this year. And far fewer have signed up for plans, threatening its financial solvency. However — if you were automatically re-enrolled in a plan for 2017 you should still log in and update your information regarding your income and any changes in your household so that you get the correct amount of savings.
News October 2016 If healthcare is driving you crazy you have a lot of company — though that may not make you feel any better. A new health care year is coming up and you do need to be able to show you’re covered in order to avoid penalties. Right now (late Oct. 2016) on healthcare.gov you can get a preview of plans and prices for 2017 (enrollment starts on November 1). You just need to provide what you expect your 2017 income to be and some details about your household (family). When you submit this information you’ll see what’s available to you for the upcoming year. Of course to get precise information you’ll eventually have to enter more complete information, but this will give you an idea of what to expect.
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.
healthcare.gov is one government site which has been optimized for mobile devices. That’s a good thing — if what you are interested in is health insurance (as opposed to finding actual health care…). You can quickly click to see if you can enroll or change your enrollment, find documents you may need to prove you have insurance, get exemptions, or update your information due to an income or life change.
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.