Here's what the poor & uninsured need to know about health insurance


Chris WaltersBlog author Chris WaltersChris Walters writes for Policygenius, a digital insurance brokerage trying to make sense of insurance for consumers. He previously wrote for The Consumerist.

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Although the March 31st deadline to buy personal health insurance and avoid a tax penalty is only a few weeks away, a couple of new reports show that the two groups that stand to benefit the most—the poor and the uninsured—are barely participating.

  1. A full 90% of people who are uninsured haven't bought insurance on the marketplace.

  2. 80% of people who say they can't afford insurance are actually eligible for subsidies, but two-thirds of them don't know this.

  3. The poorer you are, the less likely you are to have even heard about the marketplaces.

The incredibly low participation rates from the poor and uninsured are even more surprising considering the onslaught of media coverage and promotional campaigns that have been running for months now. Despite everything, there's clearly still a large information gap.So maybe it's time to take a more personal approach. If you know people in your family or circle of friends who still haven't shopped for health insurance on one of the marketplaces, either because they're worried about the cost or because they have no idea how it all works, feel free to use the information below to help clear things up.It matters because after March 31st most Americans won't be able to buy a policy through the health insurance marketplace again until November 14th, and that means they could possibly face a tax penalty (a small one, but still) when filing their 2014 taxes next year.

Excuse #1: "I haven't bought health insurance because I can't afford it"

For some this is sadly true even with the new cheaper plans, but at least those people are unlikely to face a tax penalty next year for not buying a policy.For everyone else who says this—including all those people identified in the McKinsey survey who are eligible for health insurance subsidies but don't know it—now is a good time to spend the 2 to 3 minutes it takes to find out your subsidy status. (Yes, it happens that fast.)If you can go online, here's a chart that shows qualifying income ranges for the health insurance subsidy.If your income falls within the eligibility range, then you have your choice of two free interactive tools to help you find out exactly how much money you can get.Option A (more streamlined):Kaiser Family Foundation's Subsidy Calculator (English)Option B (more educational, better for absolute newbies):Subsidy Calculator Tool (English)If you need an offline tool, Consumers Union (the organization that publishes Consumer Reports) offers free downloadable brochures in English and Spanish for every state. They're very clear and explain how the subsidy works and how to determine your eligibility. (Be sure to choose the version in the first column, because it's the one that includes a phone number you can call for further help.)Any subsidy you qualify for is applied directly to the monthly premium of the plan you purchase. For example, if you qualify for a $100/month subsidy and buy a plan that's normally $200/month, you'll only have to pay $100/month ($200 minus the $100 subsidy).

Excuse #2: "I don't know what information I'll have to provide"

When you shop on the marketplace, you'll need to provide enough personal information to prove your identity. If for some reason the marketplace can't confirm you're who you say you are, you might be asked to provide other types of proof.In addition to personal information you'll be asked to give your estimated income for 2014, and any subsidy you receive will be based on that number. Next year when you file your 2014 taxes, the amount on your tax return will be compared to what you submitted to the marketplace to make sure they match. If you should have received a larger subsidy, you'll get that difference paid to you in a refund. If you should have received a smaller subsidy, you'll have to pay back the difference.If you want to know more about the verification process, Consumer Reports has a brief but detailed overview.If you want to know what the actual shopping experience is like, we published a detailed account titled "What no one tells you about shopping the ACA health insurance exchanges".

Excuse #3: "I can't access the website"

Not everyone can go online and spend the hour or two it can take from start to finish, but fortunately you can do it all over the phone. Here's a list of every state's marketplace help line. You can also find your state's phone number printed on the brochures we mentioned above, so if you're planning on explaining all of this to someone offline, be sure to print that out to bring with you.

So what do you do next?

If you're looking to take the next step and get covered we've put together a handy checklist detailing how to go about shopping on the exchanges.(This article first appeared on Huffington post)

*Sources1, 2: "Individual market enrollment: Updated view", McKinsey & Company, March 2014.3: "Health Reform Monitoring Survey", Urban Institute Health Policy Center, March 2014.

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Blog author Chris Walters

Chris Walters writes for Policygenius, a digital insurance brokerage trying to make sense of insurance for consumers. He previously wrote for The Consumerist.

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