Apply for health insuranceThe Affordable Care Act (ACA) has made it mandatory for most Americans to have health insurance.

In addition to making health insurance mandatory, the new law also makes health insurance guaranteed issue.  This means you cannot be denied coverage for any reason — even if you have a pre-existing medical condition.

If you live in Virginia, Maryland, or the District of Columbia, Virginia Medical Plans can help you get the coverage you need — and avoid a penalty for being uninsured.

Open Enrollment for Health Insurance

During certain times of the year, anyone can buy coverage, for any reason. This time is known as open enrollment:

  • For plans effective in 2015: Nov 15, 2014 through Feb 15, 2015 (now closed)
  • For plans effective in 2016: Nov 1, 2015 through Jan 31, 2016

Buying Coverage Outside of Open Enrollment

What if you need coverage outside the dates of open enrollment?

Certain life events are considered qualifying events and trigger a special enrollment period during which you may buy a plan.

What are Qualifying Events?

Examples of qualifying events:

  • Change in marital status (marriage/divorce/death of a spouse)
  • Relocation to a new state or to an area of your current state where the plans offered are different
  • Change in family size (birth/adoption/death of a child)
  • Involuntary loss of minimum essential health coverage (change in employment status, cancellation of current coverage)
  • Certain changes in income
  • Expiration of COBRA benefits
  • A change in family structure — for example becoming a dependent or gaining a dependent through birth, adoption, or placement in foster care — which causes your current plan to no longer meet your needs.
  • An increase in your income to the federal poverty level (FPL) if you live in a state which has not expanded Medicaid. Earning at least 100% of FPL takes you out of the Medicaid coverage gap and makes you eligible for premium tax credits when buying health insurance on the exchange.
  • A court order requiring you to provide health insurance (for example during divorce proceedings).
  • Termination of your pre-Affordable Care Act plan outside open enrollment.

What Should You Do if You Have a Qualifying Event?

If you have a qualifying event, you must submit proof of the event and the date it occurred in order to purchase a new plan. Without proof, most carriers will not process your application.

You have a limited amount of time after a qualifying event to purchase new coverage, so you must act quickly.

Contact us right away so we can direct you to your best option.

If you have a qualifying event and are eligible for a subsidy (click here to find out), then you need to purchase coverage on your state’s health insurance exchange (healthcare.gov for Virginia residents, marylandhealthconnection.com for Maryland residents, dchealthlink.com for DC residents).

If you are not eligible for a subsidy, you can apply directly with the carrier of your choice:

Whether you buy coverage directly from the carrier or on your state’s exchange, a quick call to our office at 703-702-8270 will allow us to help you understand your options and choose the plan that makes the most sense for your health needs and your budget.

Short-Term Health Insurance

Without a qualifying event, you can purchase a short-term health plan outside of open enrollment. These plans provide limited coverage, so please be sure you understand what you’re buying.

Contact Virginia Medical Plans

Call us today at 703-707-8270 and we will walk you through your options.

Assurant logoAssurant Health policyholders, we have an important update for you.

Assurant has announced its exit from the health insurance market as of December 31, 2015.

How Will this Impact Me?

If you are an Assurant policyholder, you should feel no immediate impact of Assurant’s decision to stop selling health insurance.

Assurant will continue to honor all existing policies, and your plan will continue to operate as usual until its termination date*.

However, you will need to secure new coverage when your current plan ends.

What Should I Do Now?

No action is required on your part at this time. You should continue to pay your Assurant premiums and use your policy as you always have.

If you want a basic idea of your options, you may browse other policies now by clicking INSTANT QUOTE on the upper right of this page.  We will send you email reminders with updated quotes in the coming months.

When Should I Look for New Coverage?

Your policy’s termination will be a qualifying event, making you eligible for a special enrollment period which begins 60 days prior to your plan’s termination date and extends 60 days after that date.

During the special enrollment period, you may purchase a new plan of your choosing.

You may also choose to buy a 2016 plan during open enrollment — November 1, 2015 to January 31, 2016.  (Note, the deadline to purchase coverage effective January 1, 2016 is December 15, 2015.)

Either way, we recommend you begin researching your options for a new plan as early as September or October of this year. With numerous carriers offering many variations of coverage, choosing a new plan will take patience and time.

Virginia Medical Plans Can Help

At Virginia Medical Plans, we work with all the major carriers and can help you choose the plan that makes the most sense for you.

You can reach us by phone at 703-707-8270.

 

*All 2015 individual or family Affordable Care Act-compliant plans have a termination date of December 31, 2015.

Gavel and stethescope

In a 6-3 ruling in the landmark King v. Burwell case, the Supreme Court has voted to uphold subsidies for millions of Americans who purchased health insurance on the federal marketplace.

Chief Justice Roberts’ key sentence in the majority opinion sums up the foundation of the Court’s reasoning: “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.”

This is very good news for Virginia residents, since Virginia is one of 34 states which decided not to establish their own health insurance exchange, and instead use the federal marketplace.

You can read the Court’s full opinion here.

 

Income calculateIf you purchased health insurance on the exchange and collected a subsidy (in the form of a tax credit) to help pay for coverage, or benefited from other cost-sharing reductions, you were able to do so because of the income you reported when you purchased your plan.

But if you are like many Americans, the income you anticipated and reported to the exchange may differ from the income you actually earned for the year.

As discussed in an earlier post, if you earned more than you reported, you may need to repay some of the subsidy on your next tax return.

But what happens if your income was lower than you anticipated?  Specifically, what if you collected a subsidy and then discovered your income qualified you for Medicaid?

Not much.

That’s because Medicaid eligibility, tax credit amounts, cost-sharing subsidies, etc. are determined by the exchange based upon the income you reported at the time you enrolled.

If your income changes, and you become eligible for Medicaid during the course of the year, federal rules state you will not have to repay any of the tax credit or cost-sharing subsidy you may have received.

However, we always recommend you keep track of your earnings and report a change in your income to the exchange as soon as possible.

If you do report a change in income which qualifies you for Medicaid mid-year, and you live in a state that expanded Medicaid, you will be eligible to enroll in Medicaid at that time.

If you have any questions or are looking for health insurance for yourself or your family, please give us a call at 703-707-8270.