Healthsource RI Guide

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Last updated: 19th October 2018. The HealthsourceRI open enrollment period opened up on Nov 1, 2016 and closed on Jan 31st, 2017. Missing the deadline without getting coverage may cause a tax penalty. If you miss the open enrollment period for HealthsourceRI you may still be able to apply and get coverage if you meet certain criterion. You can also get a health insurance policy outside of the obamacare system. To Get a free quote Click here.

Getting insurance coverage in Rhode Island is easier than ever thanks to the new site, which allows you to examine plans and choose the right amount of coverage for your needs.

Paying for HealthsourceRI – When you choose your plan, you will be able to enroll right through the marketplace. You will pay the monthly premium to the marketplace, and they will then pay the insurance company each month. However, you may have to pay for more than just the cost of the insurance. For example, you will also have to pay your deductible, which is the amount of money you will pay out of pocket before the insurance begins. In addition, you will have to pay for your coinsurance, co-payments, and any out of network or uncovered treatments.

HealthsourceRI Renewing

If you already have a plan through the marketplace, you will be up for renewal starting during the open enrollment period. During the enrollment period, you can look for other plans that are available to see if they are a better fit for your needs. If you are happy with the plan and it is meeting your needs, and your income is the same as it was the year before, you may want to keep the plan. If there are no changes in your household that would require you to need another plan, you can keep the plan and it will renew automatically. You will not have to do anything.

However, if you do want to change your plan, it’s important to start looking over the various plans that are available and make the change as early as possible during the open enrollment. This will ensure that your plan starts as soon as possible.

Those who have Blue Cross and Blue Shield of Rhode Island will need to choose a new plan and a new carrier for 2017.

What Is Special Enrollment?

If there is one constant in the world, it is ironically the fact that life is always changing. This means that the insurance plan you have today might not be a good fit for you tomorrow. You need to make sure that you have coverage that will meet your needs.

While you are generally required to choose your insurance plan only during the open enrollment period from November 1 through January 31, some circumstances can allow you to qualify for special enrollment. If you do qualify through a life event, then you will have a 60-day special enrollment period during which you can apply.

The following are some of the life qualifying events – getting divorcer or married, moving to a new area, having a baby or adopting a child, loss of coverage under a parent’s plan, loss of job based coverage, loss of other types of coverage (Medicaid, for example), gaining status as a member of an Indian tribe, and gaining citizenship or lawful presence in the United States.

In addition, there are some other circumstances that may qualify you including a change in household status or income. Those who already have a plan through the marketplace and need to make changes to it should report their life changes and income to the marketplace. If you still need to enroll in a plan, you can contact the marketplace to determine whether you qualify for a special enrollment period based on your life-qualifying event.

Coverage for Native Americans

Native Americans will not have to wait until the open enrollment period to get their insurance. They are able to choose insurance throughout the year, and they will be able to change their insurance throughout the year as well.

HealthsourceRI Plans & Networks

Residents of the state of Rhode Island will find a number of excellent options through the HealthsourceRI marketplace when it comes to getting insurance. They can find a plan based on the amount of money they are able to afford, and in some cases, they may actually be able to get assistance when it comes to paying for the program

All of the health plans are separated into categories in the marketplace. These are based on metals. There are bronze, silver, gold, and catastrophic plans available.

The bronze plan has the lowest premiums available, but the cost of using the health services is the highest. You are required to spend more on the copays, prescriptions, and other services before the insurance will begin. Silver plans have a low premium that’s a bit higher than bronze. They have slightly lower out of pocket expenses.

The gold plan has a higher premium, but a lower cost for using the medical services. Platinum is the highest tier. With this option, you will pay the most in your monthly premiums, but you will have the lowest out of pocket expenses.

The catastrophic plans are only for those who are under age 30 or for those who qualify based on their income. These plans will require you to pay all of your medical costs up to a certain amount, and then the catastrophic insurance will kick in to pay. Most of the time, you would need to pay several thousand dollars before the insurance starts.

Even though there are price differences, you will find that all of the insurance companies offer the same basic necessities. The difference is in the amount that you actually pay. All of the plans will cover outpatient services, emergency services, hospital treatment, maternity and newborn care, mental health services, prescription drugs, rehabilitative services and devices, lab services, preventive and wellness services, and pediatric care.

Most people in the state of Rhode Island are required to have insurance today. Failure to have coverage through an employer, Medicare, or through the state marketplace will result in a fine. Currently, the federal fine is $695 per individual and $487.50 per child, or 2.5% of your income – whichever is highest. To avoid these penalties, you need to have insurance. Of course, for many families this is easier said than done. Some just do not have the extra money that they can spend on insurance. Fortunately, there are some ways to find some financial relief. To Get a free quote Click here.

Financial Assistance

Most people in the state of Rhode Island are required to have insurance today. Failure to have coverage through an employer, Medicare, or through the state marketplace will result in a fine. Currently, the federal fine is $695 per individual and $487.50 per child, or 2.5% of your income – whichever is highest. To avoid these penalties, you need to have insurance. Of course, for many families this is easier said than done. Some just do not have the extra money that they can spend on insurance. Fortunately, there are some ways to find some financial relief.

Getting Premium Subsidies – Also called premium tax credits, these subsidies are able to help reduce the amount of money that you will need to pay for your insurance. In order to get these subsidies, you will need to be able to meet the income requirements. You have two choices of how to use the credits. You could have the credits applied immediately, so you can lower the amount that you are paying each month on your premium. If you would rather pay the full price of the premium each month over the course of the year, you can then apply the tax credits when you file your federal income tax. This would lower the amount of taxes that you have to pay, or it could mean that you would get a larger refund if you do not owe any taxes.

Cost Sharing Reductions – Another option to help you save money is to apply for cost sharing reductions or CSR. This will reduce the amount of money that you have to pay when you are filling a prescription, visiting a doctor, or going for treatment at the hospital. The CSR lowers the out of pocket expenses, so you do not have to worry as much about your finances when you need to visit the doctor.

Again, approval will depend on your income. When you utilize CSR, you will need to choose a silver plan through the marketplace.

Income Requirements for Subsidies and Cost Sharing Reduction

Keep in mind that the income requirements can change each year. Currently, if you are single, you could qualify for a premium subsidy if you meet the following income limits:

• One person in the family and your annual income is $47,080 or less
• Two people in the family and your annual income is $63,720 or less
• Three people in the family and your annual income is $80,360 or less
• Four people in the family and your annual income is $97,000 or less
• Five people in the family and your annual income is $113,640 or less
• Six people in the family and your annual income is $130,280 of less

For Cost Sharing Reductions, the limits are:

• One person in the family and your annual income is $29,425 or less
• Two people in the family and your annual income is $39,825 or less
• Three people in the family and your annual income is $50,225 or less
• Four people in the family and your annual income is $60,625 or less
• Five people in the family and your annual income is $71,025 or less
• Six people in the family and your annual income is $81,425 of less

Getting Medicare – For those individuals and families that have a very low income, there is help. Instead of going through the marketplace, you can apply for Medicare. In order to qualify, you will need to meet the income requirements based on the size of your family.

HealthsourceRI Tax Information

Residents of the state of Rhode Island may be able to receive tax credits to help them pay for the cost of their insurance. To determine if you qualify, you will need to meet several requirements. First, you employer cannot offer insurance. Also, you cannot be on Medicare. You will also need to meet the income thresholds to qualify.

The Income Limits for Premium Subsidies

For a family of one, the maximum yearly income you can have and still qualify is $46,680. For a family of two, it is $62,920. Families of three can make up to $79,160 per year, and families of four can make up to $95,400 annually. A family of five can have a household income of $111,640, and a family of six can have a maximum of $127,880.

This tax credit will reduce the amount of tax that you will owe to the IRS. If you do not owe any money to the IRS, this will allow you to get a larger refund. These credits will help to reduce the overall amount that you are paying for your health insurance. However, you can’t use the tax credits to buy any insurance; it needs to be part of the Rhode Island Health Insurance Marketplace. The tax credits will begin as soon as your insurance starts.

You will have two choices on how you want to receive the tax credits. You can take the credits now and have them help you pay for the cost of insurance each month. Alternatively, you could choose to take the credits later and apply them when you file your taxes. Then, you can subtract the tax credit from the tax that you owe. Click here to continue reading.

HealthsourceRI Cons and Pros

The Affordable Care Act brought about a number of radical changes in the healthcare industry over the past few years. A number of states have decided to create their own healthcare exchanges so their residents can find and choose an insurance plan that meets their needs. In Rhode Island, they created HealthsourceRI, a website where you will be able to apply for coverage, compare the prices of the various plans, change your plans, and more.

However, they do offer special enrollment periods for those who have gone through a “life change”. Some of the things that will be considered life changes include getting married or divorced, having a child or adopting a child, and loss of a job.

What Are the Advantages of HealthsourceRI?

Currently, you are required to have health insurance coverage in the United States. If you do not choose to get coverage, either through your employer or through the exchange, you will be charged a penalty. The penalty for an adult without coverage is $695, and the penalty for a child without coverage is $487.50, which the parents would have to pay. Alternatively, they may charge 2.5% of your income – whichever is highest. By getting coverage through HealthsourceRI, you will be able to avoid these penalties.

When you get coverage, even through the lower priced plans, you are guaranteed to have access to a number of basic healthcare requirements. These include: outpatient services, emergency services, hospital treatment, maternity and newborn care, mental health services, prescription drugs, rehabilitative services and devices, lab services, preventive and wellness services, and pediatric care. This helps to ensure a higher level of care for the majority of people in NM.

A large number of people in NM have already enrolled, including many who have never had health insurance in the past. While there are certainly a large number of advantages to the program and to getting health insurance, there have been some issues with HealthsourceRI as well.

What Are the Cons of HealthsourceRI?

While the system is working well now, when it was first implemented, some people claim they had trouble signing up and navigating the site. This caused some people to skip the first open enrollment periods. However, things seem to be running much more smoothly through the site currently, and there are fewer issues with people who need to sign up. One of the other issues that some people had with the system (and this is not exclusive to NM) is the fact that they did not like feeling forced to sign up for insurance if they did not want it, despite the fact that it is helping to make the state a healthier place.

Overall, most people are starting to see HealthsourceRI as a success despite some of the initial drawbacks. Those who need to have insurance have an easy to navigate and understand site that lets them compare the plans and the prices, and so see whether they may qualify for any financial assistance when it comes to paying for their coverage.

Help Paying for the Service

Times are tight for many people across the country, and this means that it can be difficult to pay for health insurance coverage. Fortunately, you could have some additional help through premium subsidies. They will look at your income to determine whether you will be eligible for a premium subsidy or not. If so, then it could lower the amount of money that you pay each month. In addition, it can help you to save on the out of pocket costs you may accrue for things such as visiting the doctor, going to the hospital, or paying for prescription drugs.

The amount of the subsidy you will receive will be based on your income. The higher your income the lower the subsidy, and the lower the income the higher the subsidy. At the HealthsourceRI site, they offer a subsidy calculator you can use to get a good idea of how much of a subsidy you may qualify to receive. You will need to know your annual household income (not just your income), and you will need to input the number of family members who need insurance, as well as their age.

Their site also has a plan finder you can use to get more information about the different plans they have available. You can visit the site, enter some personal information, and then look at the various options that are available to you. Those who have questions or who want to have help signing up will be able to work with a Native American Enrollment Counselor, whose services are offered free of charge. They also have a page on the site so you can search for counselors near you by entering your zip code.

The health insurance plans will cover a range of your basic care needs including outpatient services, emergency services, hospital treatment, maternity and newborn care, mental health services, prescription drugs, rehabilitative services and devices, lab services, preventive and wellness services, and pediatric care. This can ensure that you are getting all of the proper care that you and your family need.

HealthsourceRI Impact on Small Business

 

Enrollment and Tax Credit – Many small businesses in Rhode Island have been searching for high quality, affordable health plans that they can provide for their employees. HealthsourceRI has a small business marketplace that is available to businesses as well as to nonprofit organizations that have up to 50 workers.

Offering health coverage can provide quite a few benefits. It can help to attract high quality and loyal workers, which can save money on recruiting and constantly hiring, it keeps employees healthy, and in some cases, it can actually provide savings in the form of tax credits.

Enrolling for Coverage – When you are looking for a plan for your employees, you can use SHOP, or you can use the small business plan from HealthsourceRI. You can work with an agent or a broker, who can explain the plans and options to you. You could also browse the plans on your own and find the plans that will meet your budget as well as the needs of your employees. Once you find a plan that will work, you can create an account, or log into an account if you’ve had coverage during the previous year, so you can apply. If your business is denied access to the marketplace for any reason, you can always appeal the decision.

How to Renew Coverage

Those small businesses that have already signed up through the marketplace the previous year will receive a notification for renewal 75 days before the current coverage expires. At that time, they can start to look for a new plan that may offer better benefits for their employees, or they can simply choose to renew the coverage.

Small Business Tax Credits

Small business tax credits were introduced with the Affordable Care Act, and they can help small businesses to pay for coverage for their employees. However, not all businesses will qualify for the credits.

In order to qualify for the credits, you need to have a company that has fewer than 25 employees. In this state, part-time employees will count as a fraction of a full-time employee. Two half-time employees would be the same as one full-time employee. In addition, the average annual employee wages need to be less than $50,000. Keep in mind that this number will be adjusted on an annual basis to keep up with inflation, so you should always check the latest rules.

In 2016, the maximum tax credit a small business would be able to receive is 50% of the premiums that they’ve paid for their employees. For nonprofit businesses, the maximum credit is 35%. The actual amount will be based on the average wages and the number of employees you have.

A small business can claim the tax credit on Form 8941, called the Small Employer Health Insurance Premiums form. They will fill this out when they are filing their annual income tax returns. If it is a nonprofit claiming the tax credits, they will fill Form 990-T, which is the Exempt Organization Business Income Tax Return form, as well as Form 8941.

Small businesses will find a lot of value offering insurance through the small business marketplace. They can make their employees happier and healthier, and they have the potential to save money on the cost of providing the insurance.

Whats Unique about HealthsourceRI

The goal of HealthsourceRI is to improve the overall quality of health for people in the state of Rhode Island. They strive to get people covered and insured for the benefit of their health, as well as to ensure that they do not have to pay any penalties. Most who do not have insurance coverage will have to pay a penalty, which is currently $695 for adults and $487.50 for children, or 2.5% of their income (whichever is higher).

The state exchange was created in 2013 to help provide insurance coverage options for Rhode Islanders. They have a board made up of 13 members who guide the program and make any changes and updates whenever necessary.

The site offers four different ways that you can sign up for a health insurance plan. You can apply online. All of the tools you need are right on the website by clicking their “apply online” button. You can also apply by phone, get help through enrollment through an agent, broker, or enrollment counselor in your area, or you can mail in the application if you prefer.

As with other states, you do have to abide by the open enrollment period when you are signing up for or changing your insurance plan. This date is the same for all states – November 1 through January 31.

While the plans through HealthsourceRI are able to provide all of the same basic benefits as plans in other states, including outpatient services, emergency services, hospital treatment, maternity and newborn care, mental health services, prescription drugs, rehabilitative services and devices, lab services, preventive and wellness services, and pediatric care, there are some unique aspects to the system.

In addition, Native Americans are able to enroll in the system at any point in the year. They are also able to change their insurance whenever they wish. The state has a large population of Native Americans, and NM wants to make sure that everyone is covered.

The Site Makes Finding Insurance Easy

One of the biggest differences between HealthsourceRI and many other states is the quality of their website. While it did stumble in the beginning, as did many other sites, it is now very easy to use for those who need to sign up for insurance. The site has a number of resources and tools available for users to find exactly what they need. They can sort through the various health plans to find services and doctors that are close to where they live.

The state often has community events where you can sign up in person, and even receive some free help with the enrollment. In addition, they offer some financial help for people who qualify based on their income. Some in Rhode Island may also qualify for Medicaid or Medicare, so they will not have to go through the insurance exchange to find coverage.

The site also features a subsidy calculator, which is extremely easy to use. You simply need to add your zip code, your estimated income for 2016, the number of people in the household and the number of people who will need insurance. Then, the calculator will give you an estimate of how much you may be able to receive in subsidies.

While the basics of HealthsourceRI are the same as the exchanges in many other states, it is the attention to detail and the ease of use of the site that help to make it different.

HealthsourceRI Fact Sheet

Residents of Rhode Island can use the HealthsourceRI site to compare all of the different plans that are available for health coverage. They can also enroll in plans through the site, and determine whether they are eligible to receive tax credits or a cost reduction in the amount they pay for their co-payments and prescriptions.

What Is HealthsourceRI?

This state insurance marketplace is Rhode Island’s response to the Affordable Care Act. It has been in existence since 2013, and it has helped many in Rhode Island to get quality insurance coverage. Some of the people in the state who now have coverage never had health insurance before.

The Open Enrollment Period

As is the case with other states, the open enrollment period for Rhode Island is November 1 through January 31. Those who want to have insurance that begins next year need to enroll during this time. If they do not, and they are not exempt from the open enrollment, they will need to wait until the following year and they will have to pay a penalty. The current penalty will be 2.5% of their annual income, or $695 per adult and $487.50 per child, whichever is higher.

One of the exceptions to this rule is Native Americans. They are able to apply for coverage throughout the year, and they can change their insurance coverage when they need to without qualifying for life changing events.

Coverage that is bought before the 15th of the month will start on the first of the following month. Therefore, those who buy their coverage on the 10th of December would have their insurance go into effect on January 1, 2016.

Special Enrollment

In some cases, it may be possible to qualify for a 60-day special enrollment period. Some of the types of life changing events that may allow you to qualify include getting married or divorces, losing a job, and having a child or adopting a child.

Saving Money on Insurance

Many families have trouble when it comes to affording insurance. In Rhode Island, you will find a number of options that can help to reduce the cost of coverage, and in some cases pay for all of the coverage. Medicaid is for low-income individuals and families, and Medicare is a program for people who are 65 and over who need coverage. The marketplace itself has a number of different plans available for those who have different budgets. Cost sharing reduction programs are available as well. With this option, you can save money on your out of pocket expenses such as the cost of prescriptions and copayments.

In addition, many will qualify for tax credits. These will help to reduce the amount of money paid on your monthly premiums. As with the other financial help options, your eligibility is dependent on your income. The lower the income the greater the subsidies. You can choose to have the credits applied immediately so your overall monthly expenses are lower, or you can have them all applied at the end of the year, which will lower your federal taxes, or increase your return.

Keep in mind that each year, changes come to HealthsourceRI, so it is important to keep up with them. The program has been very successful thus far, and the majority of people who choose a plan through the marketplace end up renewing the following year.

Common HealthsourceRI Questions

With the new insurance requirements in full swing, many people in Rhode Island have questions about the system and about using HealthsourceRI. It’s a relatively easy system to use, and will allow users to search for and compare all of the plans available through the state’s marketplace. They can also see whether they may be eligible for tax subsidies to make paying for their insurance cheaper.

When Is the Enrollment Period?

Open enrollment period is from November 1, 2016 through January 31, 2017. You will need to apply by December 15, 2016 to have your insurance coverage start by January 1, 2017. You need to apply by January 15, 2017 to have the insurance start on February 1, 2017, and by January 31, 2017 to have the coverage begin on March 1, 2017.

Who Qualifies for Special Enrollment?

In some cases, you may have certain changes in your life that put you out of insurance, or proper insurance, during the course of the year. Many will qualify for a 60-day special enrollment period during which time they can apply for insurance through the marketplace. Events that could qualify you for this type of enrollment include having a child or adopting a child, moving, or losing a job.

What Is the Penalty for Not Having Insurance?

If you do not have insurance through your employer or through Medicaid, and you are not exempt, there are penalties for not having coverage. If you want to avoid the penalties, you will need to start shopping for a plan during the open enrollment period. The penalties are currently $695 for an adult without coverage and $487.50 for a child without insurance. Alternatively, they may choose to charge you 2.5% of your annual income. They choose whichever of the two is higher.

What Are the Metal Tiers?

When you start to look at the different plans available, you will notice that they are separated into different metal tiers – bronze, silver, gold, and platinum. These tiers will all provide the same types of services and coverage. However, their price and the amount they will cover are different. The bronze plan is the lowest tier that has the cheapest monthly premiums. However, those who choose to use this plan will find that they have higher out of pocket costs and they will have to pay more before their insurance begins to cover the expenses. On the other hand, the platinum plans have the highest of the monthly premiums, but the lowest out of pocket expenses.

When choosing a plan, you should consider how often you go to the doctor to determine which plan makes the most financial sense for you.

In addition, there is a catastrophic plan available, but this is only for certain individuals, including those who are under 30 years old.

Do Native Americans Need to Go Through the Marketplace?

While Native Americans have other health insurance options available to them, they still may find it advantageous to go through the marketplace. They have great plans that provide a wealth of services, and Native Americans are allowed to enroll any time of the year, not only during the open enrollment period.

HealthsourceRI offers help for those who want to enroll on their website and in person at enrollment events. Their site and representatives can answer all other questions that prospective customers may have.

Whats New for HealthsourceRI in 2016?

Unless you qualify for one of the special enrollments due to a life change, or you are a Native American, you will need to enroll for a healthcare plan during open enrollment. The enrollment starts on November 1, 2016 and goes through January 31, 2017. The deadline to apply for coverage that will start on January 1, 2017 is December 15, 2016. The deadline to apply for coverage that will start on February 1, 2017 is January 15, 2017. Finally, the deadline to apply for coverage that will start on March 1, 2017 is January 31, 2017. It is important that you keep these dates in mind when trying to determine the right plan for you and your family.

Enrolling Options and New Locations

Rhode Island offers a number of options for those who want to enroll. They can apply online, send in a paper application, or speak with a broker or enrollment specialist. In addition, they have the option of visiting an enrollment center or event, which are located around the state.
A number of these facilities are now open across the state. You can check on the HealthsourceRI site to find information about the center that’s closest to you if you want to choose this enrollment option.
If you currently have Blue Cross and Blue Shield of Rhode Island as your plan, you will need to change it for the upcoming year, as they will no longer be offering service.

Premium Subsidy Information for 2016

It’s important to remember that each year, the income levels for financial help and premium subsidies can change. Even if you did or did not qualify last year, it’s important to look at the current levels for 2016 to determine whether you are eligible for a subsidy. It is based on the number of people in your family as well as your annual income.

You could qualify for a premium subsidy based on the following.

• One person in the family and your annual income is $47,080 or less
• Two people in the family and your annual income is $63,720 or less
• Three people in the family and your annual income is $80,360 or less
• Four people in the family and your annual income is $97,000 or less
• Five people in the family and your annual income is $113,640 or less
• Six people in the family and your annual income is $130,280 of less

You may qualify for a premium subsidy and cost sharing reductions based on the following.

• One person in the family and your annual income is $29,425 or less
• Two people in the family and your annual income is $39,825 or less
• Three people in the family and your annual income is $50,225 or less
• Four people in the family and your annual income is $60,625 or less
• Five people in the family and your annual income is $71,025 or less
• Six people in the family and your annual income is $81,425 of less

Keep in mind that the changes that will come to the plans and the system are generally announced well ahead of time. Still, those who are getting on the exchange and choosing a plan for the first time, or those who are changing their plan, should make an effort to keep up with the changes.

To Get a free quote Click here, or call the phone number below:

 

Speak with a Live representative, call (855) 303-0841

  • Get a Free Health Quote - No Hidden Fees
  • Speak to a Real Human
  • We will answer any other Health questions
  • Learn How to Avoid the Tax Penalty

(Operators available 9am-9pm EST)