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Health Insurance Marketplace

One of our roles as a healthcare provider is to help make our community healthier by providing relevant information and education. Here are the key facts you need to know about the Affordable Care Act:

  • The Affordable Care Act requires everyone to have health insurance, as of January 1, 2014. The goal is to make coverage more accessible and affordable for people who don’t have health insurance or who have limited coverage.
  • There are new, affordable insurance options available for people without insurance.
  • All insurance plans have to cover doctor visits, hospital­izations, maternity care, emergency room care, and prescrip­tions.
  • Financial help is available so it’s easier for people to find plans that fit their budgets.
  • All insurance plans have to show the costs and what is covered in simple language with no fine print.
  • Insurance plans can’t deny people for pre-existing conditions.
  • Help is available online, by phone, and in person to help people find the plan that works best for them. Plus there’s support for every language that’s spoken in the United States.
  • You can apply starting November 1, 2015. Coverage can start January 1, 2016.
  • After January 31, 2016, you can’t buy a health insurance plan for the rest of 2016 unless you have a life change — like having a baby, getting married, or losing other health coverage — that qualifies you for a Special Enrollment Period.

See all 2016 deadlines

See 2016 plans and prices

The Health Insurance Marketplace is for people who don’t have health coverage

If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, the Marketplace can help you get covered.

  • If you have job-based insurance: You can buy a plan through the Marketplace, but you’ll pay full price unless your employer’s insurance doesn’t meet certain standards. Most job-based plans do.
  • If you have Medicare: You can’t switch to Marketplace insurance, supplement your coverage with a Marketplace plan, or buy a Marketplace dental plan. Learn about Medicare and the Marketplace.

What you pay for insurance depends on your income

Your savings depend on your estimate of your expected income for 2016, not last year’s income. Get a quick idea if your expected income is in the range to save.

Based on the income estimate you put on your application, we’ll tell you if you qualify for one of these:

A health insurance plan with savings

Most people who apply qualify for a premium tax credit that lowers their monthly insurance bill. Some also save on out-of-pocket costs like deductibles and copayments.

The plans are offered by private insurance companies with a range of prices and features. All plans cover:

  • Essential health benefits
  • Pre-existing conditions, including pregnancy
  • Preventive care

You can add dental to a health plan, but you don’t have to. You can’t buy a dental plan unless you enroll in a health plan.

Medicaid and the Children’s Health Insurance Program (CHIP)

Medicaid and CHIP provide free or low-cost coverage to millions of people and families with limited income, disabilities, and some other situations. There’s no limited enrollment period for Medicaid or the Children’s Health Insurance Program (CHIP). You can apply any time.

Many states are expanding Medicaid to cover all households below certain incomes. See if your state is expanding and if your income is in range to qualify.

Your children may qualify for CHIP even if you don’t qualify for Medicaid.

SHOP Coverage for Businesses and Non-Profit Organizations

The Small Business Health Options Program (SHOP) Marketplace is for small employers who want to provide health and dental coverage to their employees — affordably, flexibly, and conveniently.

To use the SHOP Marketplace, your business or non-profit organization must have 50 or fewer full-time equivalent employees (FTEs). (Some states may use different employee maximums for 2016.)

You can start offering SHOP coverage to your employees any time of year.

There’s also no limited enrollment period for small businesses to enroll in SHOP coverage for their employees. You can apply any time (Priligy Online).

You can apply for coverage 4 ways

You can apply for health insurance any way that works for you:

  • Online
  • By phone
  • With in-person help
  • With a paper application

If you don’t have health insurance, you may have to pay a fee

Most people must have qualifying health coverage or pay a fee with their 2016 federal taxes.

  • If you don’t have coverage in 2016, you’ll pay a penalty of either 2.5% of your income, or $695 per adult ($347.50 per child) — whichever is higher. Learn about the fee.
  • In some cases, you might qualify for an exemption from the penalty. Apply starting November 1. Get ready now.
  • See 2016 plans and prices
  • You can apply starting November 1, 2015. Coverage can start January 1, 2016.
  • After January 31, 2016, you can’t buy a health insurance plan for the rest of 2016 unless you have a life change — like having a baby, getting married, or losing other health coverage — that qualifies you for a Special Enrollment Period.
  • See all 2016 deadlines

 

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    © 2023 Southwestern Medical Center • 5602 SW Lee Blvd • Lawton, Oklahoma 73505 • 580-531-4700 • sitemap • privacy policy • terms & conditions

    • About Us
      • CEO Welcome
      • Leadership
      • Mission, Vision & Values
      • History
      • It’s A New Day
      • Ethics & Compliance Program
      • Awards & Accreditations
      • Comments & Suggestions
      • Directions & Locations
      • Phone Directory
    • Services & Technology
      • Behavorial Health Services
      • Center for Wound Healing & Hyperbarics
      • Medical Services & Technology
      • Regional Cancer Center
      • Sleep Center
      • Southwestern Neuroscience Center
      • Women’s and Children’s Services
    • For Patients & Guests
      • Admitting & Registration
      • Advance Directives
      • Bill Pay
      • Cafeteria
      • Directions & Locations
      • Email A Patient
      • Medical Records
      • Medical Staff Directory
      • No Smoking Policy
      • Privacy Policy
      • Visiting Hours
      • Web Nursery
      • Patient Medical Passport
    • For Physicians
      • Crimson Services
      • Comments & Suggestions
      • Medical Staff Directory
      • Medical Staff News
      • Patient Medical Passport
      • Practice Opportunites
    • For Employees
      • Benefits
      • Capella Connections Newsletter
      • Discount Program
      • Education
      • Employee Assistance Program
      • Ethics & Compliance Program
    • Community
      • Contact Us
      • Community Benefit Report
      • Community Calendar
      • Health Information
      • Find a Physician
      • News Room
      • Speaker’s Bureau
      • Stories of Great Care
      • Thank an Employee
      • Volunteering
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