Press Release (ePRNews.com) - Hollywood, Florida - Jul 14, 2016 - Centers for Medicare and Medicaid Services (CMS) said enrollment fell to about 11.1 million, down from the 12.7 million before the end of the 2016 Open Enrollment Period. CMS said 87% of enrolled consumers remained signed up, within the 80% to 90% retention that was expected. The administration projected that about 10 million people will remain signed up by the end of the year. Also, in the first 3 months of the year, 17,000 people lost coverage because of citizenship or immigration documentation issues, which is down 85% from last year. People are looking forward to new plans, as the Open Enrollment for health care is arriving on November 1st. Insurance companies are planned to opt out of Obamacare this next enrollment period as well, making people eager to find Obamacare coverage for 2017. Owner of ezHealthMart says “There’s 3 very important things to know before people applying for a 2017 Obamacare Health Plan, that if not done correctly may cause their plan to never go into effect or may fall off completely at some point during the year; especially because of not uploading documents correctly. ezHealthMart.com’s agent’s help people upload documents directly into the Marketplace’s system electronically. This is something navigators working for the Marketplace are still not able to do. We always have clients that walk through our doors asking why did the Marketplace not accept the original document and is there another way to send my documentation to the Marketplace.” EzHealthmart is going to cover 3 important aspects of Obamacare coverage.
The first things to know before applying for coverage is that it is almost impossible to keep coverage if documentation is not uploaded or sent to the Marketplace correctly. Uploading documentation is required in order to qualify and keep the financial assistance (tax credit or subsidy) offered by the marketplace. If consumers do not send in the requested documentation to the marketplace Subsidies can fall off. Consumers are usually given 3 months to get this information into the marketplace. If they do not submit the documentation in time, their subsidy will be cut off and they will be billed automatically by the health insurance company for the full amount after the subsidy falls off, in most cases. This could result in a consumer going from paying $20 a month to $300 or more a month.
Second is Household income and size. These are the number one things that will drive a family’s health insurance plan up when applying for ACA coverage (Obamacare). The Affordable Care Act’s benefits off of two thing mainly. The subsidy (tax credit that is paid monthly to the health insurance company on behalf of the consumer) & Cost Share Reduction (the benefit that lowers out of pocket costs like the deductible, copay, and co-insurance) depending on how close the consumer is to the Federal Poverty Level (FPL). The FPL Starts at $11,770-$47,080 for an individual in 2016. Although this may seem simple, many people enter this information wrong when completing their application on the marketplace website because it is based on the modified adjusted gross income (MAGI), not the gross income. Example: (using the FPL Chart) if a 40 year old male that is self employed and made $40,000 for the year, entered his gross income instead of his MAGI, he would have paid $264.84 for a silver plan in the state of Florida, but if the same consumer would have entered the correct MAGI amount they would only have paid $129.03 and the deductible would have been lower.
Third, After a consumer completes the application correctly, picking the right carrier in their local area is KEY. Picking the wrong carrier could result in a very small network and the consumer could struggle to find a doctor. It is mainly based on the county a consumer lives in. Example: a consumer may pick the most well known Insurance carrier, but that carrier in their area may only have clinic use available to them for their primary care physician & that clinic may be overrun with patients, while the smaller carrier could actually have 3000 primary doctors in the consumer’s area and have a much more efficient network. HMOs are more restrictive (some areas only have HMO’s available), PPOs are more lenient at a higher fee, and POS plans make a good hybrid between the two. For cost-efficiency, seek options of an HMO, rather than a POS, and if the favored doctor still isn’t covered, PPOs will offer maximum flexibility, but at a much higher cost. When choosing an HMO, people must stay in network to keep out of pocket costs down. All in all, finding a great plan that is affordable with a good network is not so simple. ezHealthMart.com offers free assistance to consumers to help them figure out what might be best for them in their area.