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Frequently asked questions & Information about ACA

What is the Affordable Care Act and how does it all work?

People nationwide will be able to begin signing up November 1st for health insurance coverage under the federal Affordable Care Act (ACA) through online marketplaces called exchanges. States had the option of setting up their own exchange or allowing the federal government to do it. In North Carolina, the federal government has set up a system so individuals and small-business owners can compare the costs and coverage offered.

What is NC Enroll and how does it work?

Blue Cross and Blue Shield of North Carolina is the only carrier to submit plans for every county and every exchange across all of North Carolina. NC Enroll provides personal assistance to educate the public on plan options through group events and retail sites to enroll individuals on the plan of their choice. Plans are approved by the federal government meeting ACA guidelines to participate on the exchange. Cost and coverage details of each plan will be online November 1st.

What is the enrollment period and when does coverage begin?

Open enrollment for coverage through the exchange begins November 1, 2017 and ends December 15, 2017. Coverage through the exchange-based health plans starts January 1, 2018. Most people who forgo insurance coverage will face a tax penalty.

What is the cost of coverage?

The coverage is affordable but not free. The government will provide sliding-scale tax credits that can make premiums more affordable for individuals earning $12,060 to $48,240 and for families, $24,600 to $98,400 for a family of four. Premiums are capped at 2% up to 9.5% based on household and income.

What happens if I do not get coverage?

Consumers don't have to decide on November 1st. You have until December 15th to sign up if you want coverage by January 1st. Fines may apply to those who do not have coverage in 2017 in the amount of 2% of income or $695 per adult (and $347.50 per child) whichever is higher. Procrastinate beyond December 15th, and you'll have to wait until the next open enrollment period in November 2018, unless you have a life-changing event like job loss, divorce or the birth of a child.

Pre-Existing Condition?

The term pre-existing condition no longer applies as a barrier to health coverage for those who are eligible for ACA.

What is needed to enroll?

Provide legal identification, verification of legal residence and income for all persons in your household. Upon verification, you will then be able to accept the tax credit for which you qualify and use it to enroll in an insurance plan.

What are the differences in the plans?

There are up to four levels of coverage to choose from: bronze, silver, gold and platinum. All cover the same benefits, but platinum has the highest premiums and lowest out-of-pocket costs, while bronze has the lowest premiums and highest out-of-pocket costs.  Speak with an agent for more details.

What coverages are provided through the plans?

The coverages and benefits are the same as other Blue Cross and Blue Shield of North Carolina Plans with coverages for prescription drugs, preventative screenings as well as well as eye exams and dental checkups for children.  Speak with an agent for more details.

I have insurance through my job. How does the Affordable Care Act impact me?

You will be able to keep your current insurance. However, the parts of the Affordable Care Act that impact all insurance plans will impact your plan. Provisions such as the ban on denying coverage to children because of a pre-existing condition, allowing young adults to stay on their parent’s insurance until age 26, and elimination of annual and lifetime caps on coverage, among others, will be part of all insurance plans in the United States. Also, all plans in the United States will have to offer the minimum services established as part of the essential health benefits package. Plans will be able to offer additional services, but will have to offer the minimum. If you have healthcare and financial needs, it will be wise to compare plans to find one that meets your needs.

 

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