4 most common questions people ask about insurance enrollment

Carol Allen (right) of Public Health - Seattle & King County with one very happy woman who enrolled during an event at Third Place Commons.

Carol Allen (right) of Public Health – Seattle & King County with one very happy woman who enrolled during an event at Third Place Commons.

Here are four of the most common questions presented to outreach staff at Public Health-Seattle & King County. Our staff has been setting up shop at places such as libraries, health centers, social service agencies, colleges, and schools.

  1. What sort of coverage am I eligible for? (Is it a Medicaid plan, or one of the Exchange plans?)
  2. How much will it cost me?
  3. Can I continue going to my same doctor?
  4. If I don’t enroll, will I get penalized?

The answers, of course, depend on the individual.  That’s why signing up is such a personal thing.

So, everyone should just go to the Healthplanfinder website and see for themselves.

But, if you want a preview, here’s the basic outline:

For Question-1, the expanded Medicaid covers adults up to 138% of the official “federal poverty level,” which is $15,856 a year for an individual, or $32,499 if you’re in a family of four.

Question-2 is one of the main reasons everyone should check out the Washington Healthplanfinder website. You can find out quickly where your income puts you in terms of the sliding scale of insurance costs. If you qualify for Medicaid, it’ll be free. Otherwise, many people qualify for a low-cost health plan, if they earn less than $45,960 as an individual or less than $94,200 for a family of four. The monthly payment goes up as your income goes up.

Much depends on your choice

The cost will also depend on which plan you choose — and King County residents can choose from 31 medical plans. The website will help you figure out which one best fits your needs.

As for doctor choice, that also depends on which of the 31 plans you choose. The Healthplanfinder lets you search for specific providers to see which plans allow you to keep a specific doctor, clinic, or hospital.

If you don’t have health insurance, starting next year, you’ll have to pay a fine of $95 per adult on your IRS tax return — or 1% of your income, whichever is greater. (It gets complicated, and there are some exceptions, as explained by the Kaiser Family Foundation. The minimum penalty increases in 2015, to $325, and then to $695 or 2.5 percent of household income in 2016. For families, the minimum penalty will be $2,085 or up to 2.5 percent of household income.)

When people need help enrolling in the new health insurance plans, they can call the toll-free help line (855-923-4633), or come to an “in-person” assistance event.

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