Arizona health insurance
2016
Arizona Health Exchange Open EnrollmentYour Guide to the 2016
Arizona Health Exchange
OPEN ENROLLMENT, RIGHT AROUND THE CORNER
Open enrollment is almost upon as, and that’s a good time for you to
do an annual “physical” on your health insurance coverage for the next
calendar year, in this case, 2016.
It begins November 1, 2015 and runs through January 31, 2016.
It’s the most important time of the year to make your health
insurance decision, bar none.
Why is that?
It’s the only time of the year that you can switch plans, change your
existing plan without a Special Enrollment Period (SEP—and more on that
later).
It’s also the time when carriers are allowed to make rate and plan
changes, as well as changes in their networks.
For example, a carrier may replace all their Preferred Provider
Organization plans) (PPOs) with Health Maintenance Organzation plans
(HMOs) at a certain Metallic plan level (plans are placed in Platinum,
Gold, Silver and Bronze families, with Bronze having the lowest prices
and leanest benefits).
This can dramatically change the landscape of the coverage that
you’re trying to get.
• Carriers may even pull out of the market altogether and quit
offering plans.
This happened with a major national carrier in Arizona who made an
announcement in the spring of 2015 that it would be offering no
insurance coverage at all in this state).
This is when you want to double check and make sure your favorite
doctor and hospital is still participating in your insurance company’s
network.
A call to the doctor’s office to confirm will probably suffice. But
you can also access all carriers’ networks at
www.arizonaplans.com .
It is also the time, if you’re already covered, to make sure that
your subsidy is accurate. If you’re income has changed from the time
you got your original coverage, either up or down, don’t wait any longer
to let the exchange know.
If you’re income has gone down, you may be eligible for a larger tax
credit, or a Silver plan with cost sharing reduction (which will get you
lower deductible, among other things)
If your income has gone up, you want to find out if you need to lower
the subsidy amount. Otherwise you may end up owing money at the end of
the 2016 tax year.
QUESTIONS TO ASK
Start out by letting us ask you some questions.
- Do you expect your income to change dramatically in 2016?
(Perhaps there’s a promotion in the offing, or an inheritance in the
wings, or you’re taking a better paying job). Conversely, you may
foresee having your hours cut, or having to take a lower paying job.
This may drive your subsidy up for 2016.
- Any student loan interest or tuition/fees due in 2016? (These are
amounts that reduce your income for calculation of the subsidy.)
- Any self-employment income? (If there is, you may be able to
make legitimate business deductions to your estimated income and
increase your tax credit).
- Will you have the same number of people on your 2015 income tax
return as you had in 2014? Any new dependents to claim? (Or someone
you won’t be claiming for the 2016 tax year).
We can help you answer the income question at (866) 344-8061.
Our Services are Free
You want to make sure that you get it RIGHT.
Once we have your estimated 2016 income, we can plug it in and
come up with an estimated 2016 subsidy.
This will help you determine your monthly cost for the insurance
(remember, however, that it is an estimate. The Exchange makes the final
determination of the subsidy amount, if any, at the time that you apply,
but usually the estimate is extremely accurate).
GOOD TIME TO TAKE INSURANCE SELF-CHECK
The point we want to emphasize is that the end of the calendar year
is a good time and the beginning of the Open Enrollment period to take
stock on your insurance needs and options.
Enrollment and plan selection is so important that we recommend that
you get help from someone who knows the market the best:
your licensed and certified health insurance agent (us!!!).
Of course, you can enroll on your own, but income questions can be a
little tricky, and answering them wrong can keep you from getting the
tax subsidy you deserve. Or even worse, you answer incorrectly and
get overpaid by the government when it calculate your subsidy. Remember,
it can only go by the numbers that you provide, or how you answer the
application questions.
You could be overpaid for the entire year.
This means you wind up owing subsidy payments when you file your
taxes in April, 2017, for the 2016 tax year.
HOUSEHOLD INCOME IS THE KEY
Household Income Is Key
Your household income is the key to determining a subsidy, although
there are some other factors that come into play.
Household income is the estimated income of everybody who files or
is claimed on the same tax return.
Even if you’re not living under the same roof (your husband is
working at a remote site for most for the year for example), as long as
your John
Henry and his are on the same tax return, your income is counted
jointly.
And this is your modified adjustment gross income, so it doesn’t
include such deductions as real estate interest (but can include student
loans, alimony or child support ).
Uncle Sam emphasizes that this is only an estimate but it’s important
for it to be it as realistic as possible so you get the subsidy that
you’re entitled to.
A lot of questions, a lot of things to take in account.
Our advice is to go through a licensed agent who will help find out
if you’re eligible for a subsidy and get them to match that amount to
the best plan out there to meet your needs. The cost is the same to you,
so why not take advantage of our services?
EVERYBODY SHOULD SEE VALUE
We know you realize the value of having health insurance for you and
your family.
Why doesn’t everybody else do so as well?
Some people think they’re invincible, that they never go to the
doctor, so why should they be covered?
Well, emergency rooms across the country are filled with these
invincibles who are now trying to figure out how to pay their
astronomical medical bills.
You may be in perfect health today, but who knows what will happen
tomorrow? Without insurance, a major medical event could wipe you
out financially.
From a strictly monetary point of view, there’s also the issue of the
tax penalty that you’ll pay if you don’t have insurance.
It goes up this year if you’re not, or the plan that you have doesn’t
meet the minimum Affordable Care Act (Obamacare) standards.
For 2016 the penalty increases to 2.75 percent of your adjusted
gross income .
In 2015 the individual penalty was $325 per person for the year
($162.50 per child under 18), or 2 percent of your income, whichever is
greater.
EARLIEST EFFECTIVE DATE
You need to remember that Jan 1., 2016, is the earliest date you
can get coverage in effect, even if you apply on the first day of open
enrollment (November 1, 2015).
The general rule, however, is that if you apply on or before the 15th
of the month (on December 1, 2014, for example) , the earliest you can
get coverage is the first of the following month(January 1, 2016 in this
case).
If you apply after the 15th, you skip a month to the first of the
next month:
So a December 16th application would mean a February 1st effective
date.
Open enrollment is a great time to examine your health coverage on an
annual basis, to see what changes in your income, either up or down,
will do to your plan.
We’ll be glad to help you do this.
If you have a Silver plan, you want to think long and hard before
changing to Gold or Platinum plan, because Silver is the only type of
plan that has Cost Share Reduction (CSR).
CSR will lower your deductible amount and your copays if you’re
eligible for it (eligibility is determined by a complicated formula
based on income and family size; no other plans but the Silver plans can
take advantage of CSR).
If you’re enrolled and do nothing, the Exchange should auto-enroll
your plan. You shouldn’t have to requalify during open enrollment either
unless:
- *You didn’t file taxes for 2014.
- *You had a major change in income, citizenship or your residency.
- *There was an error in your account.
So that’s a quick summary of what you can do during Open Enrollment for 2016,
but you probably have questions.
That’s a lot to keep in mind, a lot of information to juggle.
We want to make it as painless for you as possible, so don’t
hesitate to call us at (866) 344-8061. We’re here to help.
You can run your Arizona Health Health Quote here
to view rates and plans side by side from the major carriers...Free.
Again, there is absolutely no
cost to you for our services. Call 866/471.8081 Today!