Health Insurance and You

Depending on your point of view, Oct. 1 will be the day when you smile and sing out  “Hallelujah!” or the day when you scowl and complain.

That’s when the Affordable Care Act truly kicks into gear. Marketplace exchanges open Oct. 1 for the purchase of health insurance, creating a path for 25 million uninsured Americans to receive comprehensive medical coverage. For those of us already covered, the question is: “How does this affect me?”

The national accounting and consulting firm PwC predicts that workers already protected by employer insurance will pay about 6.5 percent more in 2014. Regardless, here are some ways you can use the new law to your benefit:

Take advantage of the Preventive Care portion of the ACA, already in effect. No matter your age or income level, all family members now qualify for a basic physical exam at no cost to you. This includes testing for blood pressure, cholesterol, diabetes, and heart conditions, plus vaccines (including flu shots), colonoscopies, and mammograms.

Tax credits are not limited to low-income residents. Businesses with fewer than 50 full-time workers are not required to provide insurance, but small business tax breaks make employee coverage more affordable. “The tax credits for businesses are certainly an incentive,” says Dr. Kevin Valadares, program director and associate professor of health services and health administration at the University of Southern Indiana. “The small businesses that end up offering health plans will also recruit/retain the better employees as compared to those businesses that do not offer anything.” Also, if you are single and making up to $45,960 or in a family of four with taxable income of $94,200, you could be eligible for tax breaks.

Those covered by employer insurance generally are not eligible to use the new marketplace exchanges, but look closely at your options at work. They may include wellness incentives, Health Savings Accounts (HSA), or Health Reimbursement Arrangements (HRA), which could lower your costs.

If you are under 65 and not covered by comprehensive medical insurance, take a look at your new choices because cost comparisons will be easier under the new law. But remember, choosing not to have health insurance means you pay a penalty of 1 percent of your income in 2014 with the penalty increasing every year. Projections are now showing the penalty will be at 2.5 percent in 2016. Go to healthcare.gov/marketplace/individual for information about the exchanges, and the Kaiser Family Foundation site at kff.org/health-reform for a tax credit calculator.

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