On Oct. 1, open enrollment begins for new health insurance marketplaces where uninsured South Carolinians can buy health care coverage under Obamacare.
If you already have insurance through your job, are 65 or older or covered by Medicare or Medicaid, or are on the state or children’s health plan, you should be good to go. But if you’re, say, a 28-year-old adjunct at a college who makes less than $46,000 a year without benefits, pay attention. After 2014, most people will be required to have health insurance. If you don’t have it, you’ll be penalized at least $95 when you file taxes the first year you aren’t covered, and the fine will go up after that.
In order to get health insurance, you’re going to want to check out what plans are available through the new healthcare exchanges. You can do that online. The federal government is operating these exchanges in South Carolina because anti-Obamacare Republican leaders here didn’t want to create them at the state level. You don’t have to sign up immediately, but you should probably begin taking a look at your options.
If you’re computer savvy, head on over Healthcare.gov. By Oct. 1 there should be a button to click that will direct you to local resources.
But if you’re not that great with computers, or if you just want someone you can speak with face to face about your options, there are a few ways to do that. One is to visit your local community health center. Another is seek out a Certified Applications Counselor, which you can find on Healthcare.gov. You could also contact any private licensed insurer, but make sure to ask for documentation that he or she is licensed.
You can also find someone called a “navigator” who can guide you though the complicated process.
Navigators are people who work for one of three groups in South Carolina that received a federal Navigator Grant. Their job is just how it sounds: to navigate you through the process of obtaining healthcare in the new online marketplaces.
Out of those groups, one serving the Lowcountry is the Beaufort Black Chamber of Commerce. Another group is the Columbia-based Cooperative Ministry, which is working with the SC Progressive Network. Also working as a navigator is a for-profit Maryland-based company called Deco Management, which is partnering with a South Carolina group called The Benefit Bank.
The navigators working for these groups must have completed training, taken courses and a test, and should be available for face-to-face meetings with people they’re trying to help, according to healthcare advocates.
You might run into one of these people at a function, but you can also reach out to them and set up a meeting.
Larry Holman, president of Beaufort Black Chamber, which currently employs seven navigators, says his group will actively try to find uninsured South Carolinians to help enroll by attending civic group meetings, community events, and church functions. They’ll be covering Charleston, Beaufort, Hampton, Berkeley, Barnwell, Fairfax and Allendale counties. He says they hope to set up a hotline number in the next couple weeks for people with questions to call.
Whether you look for insurance yourself online at Healthcare.gov, or whether you get help from a navigator or other service, the process won’t necessarily be quick and easy, and you’ll need to come prepared, says South Carolina healthcare economist Lynn Bailey.
“You’re not going to be able to sit down and bang this out in 25 to 35 minutes,” she says. Also, get ready to face a lot of unfamiliar information and terminology. You should bring your 2012 tax forms and current employment information. You’ll need a working e-mail address, and you’ll need to have the Social Security numbers of everyone in your household who may end up being covered.
Another tip: take your time.
Healthcare plans aren’t going to kick in until Jan. 1, so you don’t have to be first in line this week when the marketplace opens. But you need to have it done by Dec. 15 if you want to have healthcare at the first of the year. If you’re still looking after that, you’ll need to finish up by March. Also, you don’t have to sign up immediately once you’ve met with a navigator or found a plan you like online. Do some homework about it first, Bailey says, and don’t just focus on price options. If you have a current health issue and already deal with a certain provider or caregiver, try to make sure they are in the network for a plan you’re considering.
So, what kind of plans will be on the table?
You’ll be able to choose from three basic options: Bronze, Silver and Gold. Platinum plans won’t be available in South Carolina. A Bronze plan will cover 60 percent of your basic healthcare costs; Silver will cover 70 percent and Gold 80. The costs for those plans won’t be available until this week when the market opens. If you’re under 30 you can select a catastrophic plan and pay bare bones costs, but you’ll also run the risk of paying a lot more out of pocket if you end up getting get hurt or sick. If you make between $15,500 and $46,000 per year you’ll be eligible for tax credits depending on your income.
To learn more, dial up the federal call center at (800) 318-2596
Explore the map below for more info on how rates for qualified health plans vary across the state for someone aged 35.
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