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Obamacare Louisiana Plans and Networks – Everyone knows that having health coverage is now the law, and for many in Louisiana, this means getting Obamacare through the exchange. When you first start to look at all of the options and possibilities, it can be confusing. There are so many plans and carriers, not to mention the tiers that you have to try to make sense of when exploring the exchange. Let’s look at what each of these things really means so you have a better idea of what you should look for and choose when you are getting health coverage.
What Are the Tiers?
One of the first things you will notice when you start to go through the different plans is that they are all separated into different tiers. This is to give you some basic shorthand regarding how they work and what they offer. Each of the tiers is named after a precious metal.
At the bottom of the list is bronze, and all of the plans that fall into this category tend to have low monthly premiums. They have high out of pocket costs though. As you progress through the rest of the plan, the price of the monthly premium goes up, but the out of pocket costs drop significantly. The platinum plans, for example, will pay for 90% of the out of pocket costs, which is substantial for those who have chronic illnesses or who visit the doctor a lot.
When you are choosing your plans, consider how often you will be using it to find the tier that makes the most sense for you.
Who Are the Carriers in the State?
Once you have an idea of the tier that is likely right for you, you can start to look at the plans available through the various carriers in the state. For Obamacare Louisiana currently has five carriers on the exchange. You can choose from Blue Cross Blue Shield of Louisiana, HMO Louisiana, Humana United Healthcare, and Vantage Health Plan. When you are choosing one of the plans through the carriers, consider what features it offers and how much it costs to see if it is right for you or not.
All Plans Have the Essential Benefits
One of the nice things about the implementation of Obamacare is the fact that all of the plans regardless of the tier they are in will provide you with the essential benefits. This list of benefits is the same for all of the plans, so you don’t have to worry. The benefits include ambulatory care, emergency services, treatment in the hospital, maternity and newborn care, addiction treatment and mental health services, prescription drugs, rehabilitative services and devices, pediatric care, preventative services and lab services.
Enrolling – Once you have a plan in mind, you can buy it through the exchange. You simply have to make sure you are enrolling, or switching plans, during the open enrollment. This is generally from November to January each year. If it is not during the open enrollment, you will need to have a qualifying event, such as moving to the state, to enroll. However, those who qualify for Medicaid, as well as Native Americans, can enroll at any time of the year.
Obamacare Louisiana Getting Coverage
Residents of Louisiana know they need health coverage, and they may be looking into getting Obamacare currently. It’s important to understand exactly what this entails and when you can get the coverage you need. You do not need to go through the Obamacare exchange for coverage. For example, you might have coverage through your employer that satisfies the Obamacare requirements. Other Louisiana residents will want to go through the exchange though, but they need to do so at the right time.
Open Enrollment and Special Enrollment
One of the first and most important things to remember when getting coverage for Obamacare in Louisiana is the open enrollment period. This generally starts in November and goes through the end of January. This is the only time that you will be able to get coverage in the state through the exchange, unless you meet one of the following three conditions.
First, those who are Native American are able to enroll at any point of the year. Those who qualify for Medicaid are able to get coverage at any time of the year as well. Finally, if you have a qualifying event, such as having a child or getting married, you can qualify for special enrollment. This will provide you with 60 days, from the start of that event, where you can look for coverage in the state.
Going Through the Exchange
Many people will be going through the exchange for their plans. Louisiana uses the federal exchange, as the state did not want to create its own exchange. All of the various plans from the carriers – Blue Cross Blue Shield of Louisiana, HMO Louisiana, Humana United Healthcare, and Vantage Health Plan – are on the site. They separate the various plans into different tiers named after precious metals. Those that are in the bronze tier have low monthly premiums and high out of pocket costs. Those in the platinum tier have high monthly premiums, but the plan pays for 90% of the out of pocket costs.
What’s the Right Plan?
When you are choosing a plan for you and your family, you need to think about how often you use the doctor and the types of services you use. Those who are relatively healthy and who do not plan to visit the doctor often could use a bronze or silver plan in most cases. Those who have health issues may want to consider getting a gold or platinum plan so they can keep their out of pocket expenses for things such as copays and deductibles down.
Paying and Renewing – Once you choose your plan, you will pay for it just as you would any other insurance, by making monthly premium payments. Make sure those payments are on time so you do not have to worry about having your plan cancelled. Most of the renewals will happen automatically as well, so you don’t have to worry. If there is a change with the plan, they will notify you. However, even though the renewal might be automatic, it can still be a good idea to check for any other plans that might be better during the open enrollment period.
Obamacare Louisiana Financial Assistance
One of the problems that many people had when it came to Obamacare Louisiana was the cost. Many feared that they would not be able to afford the cost of healthcare, and they surely didn’t want to spend money on the fines that have been implemented. Right now, the fine for an adult who does not have coverage is $695, or 2.5% of their income, whichever is higher. For children who do not have coverage, the fines for their parents will be $347.50.
Fortunately, there are some financial assistance options that can help those who may have trouble paying for their health coverage.
The first thing that you may want to consider is Medicaid. However, it should be known that Louisiana was one of the states that chose not to expand their Medicaid coverage. This means that there is a “gap” where those who make too much money to qualify for Medicaid still do not make enough money to comfortably afford getting health coverage.
However, it may still be an option for those who have children and who have a low income, or are elderly or disabled. When you sign up for Obamacare in Louisiana, you will find out immediately whether you qualify for coverage through Medicaid or not. If not, there still is a way that you can save money on the cost of coverage.
The government knows that it can be difficult for many people who are having trouble making ends meet get to the point where they can afford coverage. To help with this, they’ve introduced tax subsidies. Again, you will find out how much you qualify for in subsidies when you choose to sign up for Obamacare. They determine how much you will receive based on the number of people who are living in the household, as well as your income.
When you receive your subsidies, you can choose how you will use them. Many people choose to have them applied immediately, which will help to reduce the amount of money they have to spend on their monthly premiums. Others choose to apply the tax subsidies at the end of the year. This way, they will owe less in taxes, or they could get back a larger refund.
CHIP – Louisiana also has the Children’s Health Insurance Program, or CHIP. This will provide health coverage for children who are up to 19 years old. This program is no-cost, and it will pay for things such as doctor’s visits, hospital care, shots, prescription drugs, and other services. To qualify, the child has to be uninsured and the household income needs to be below a certain limit.
It’s true that health care coverage can still be quite expensive and difficult for some people to afford. However, as you can see, there are some financial assistance options that you can consider. In addition, always make sure to look at the price of the plans available and choose those that are in your budget so you can make your payments each month.
Obamacare Louisiana Tax Information
One of the concerns that many in Louisiana had when they first learned that Obamacare would become the law of the land was what would happen with their taxes. Not only were they concerned that their income taxes would go up, they were also wondering what implications the new law would have when they filled out their taxes each year. Fortunately, the changes to the way that you do your taxes are minimal. However, there are some differences that are important to note. Mostly, it means you will be getting another form in the mail for the taxes, and you may have to fill out another form to turn in to the IRS. It depends on how you get your coverage though.
Understanding the Forms
Before it is time for the taxes to become due, you will receive a form in the mail. This has information you need to keep for your records, and it might have information needed for your taxes. Those who have Obamacare in Louisiana will receive the 1095-A form. This form is also known as the Healthcare Marketplace Statement. If you have coverage through a private company, you will receive the 1095-B, and if you have coverage through your employer, you will have the 1095-C come in the mail.
Those who are getting the 1095-B and the 1095-C will not have to wait for those forms to arrive before they fill out their taxes. The information the IRS needs will have already been sent to them, either by the private insurance company or by the employer, as the case may be. However, if you are going to be getting the Healthcare Marketplace Statement, you will have to wait until it arrives to fill out your taxes.
In that case, you will need to fill out Form 8962 using the information that came with the 1095-A. Keep the 1095-A for your records, and then turn 8962 in with your taxes. While this does add an additional step for those who have coverage through the exchange, it doesn’t really take that much longer to take care of the taxes each year.
Make Sure You File the Taxes – It is important that you actually fill out your taxes each year. If you don’t fill them out and turn them in, the IRS will fine you, and you might not be able to receive tax subsidies the following year. If you don’t let them know that you have coverage, they will fine you. The current fines are $695 for adults without coverage (or 2.5% of their income, whichever is higher), and $347.50 for children without coverage.
While the taxes are still easy to handle for most people, this could be different if you already have complicated taxes. If you do not want to go through the trouble of filling everything out and turning in the forms on your own, you might benefit from speaking with a tax professional. They can take care of everything for you and make sure it gets turned in on time.
Common Mistakes on the Obamacare Louisiana Application Process
While the application for Obamacare in Louisiana is relatively simple, there are some elements that can be confusing, and this has caused there to be a number of issues with improperly filled out applications. Naturally, this means that the applications could be delayed or even denied. If that happens, and you don’t take care of it in time, it could mean that you won’t have the coverage you need, and that could end up in a fine. Since you don’t want to have to pay the fine for not having coverage and you do not want to have to wait until the next open enrollment period, it is important that you fill out the application correctly.
Not Filling Out the Application Correctly or Entirely
One of the biggest issues with the application process is that people simply aren’t filling out all of the sections. They are missing one or two spots here or there and that is causing the applications to be delayed or denied. In addition, some applications for Obamacare in Louisiana have information added to the wrong places. For example, people have put their spouse in the dependents section where their children should go. Also keep in mind that you can now keep your kids on your insurance up until they are 26 years old.
Another portion of the application that some people fill out wrong is the income. Always be as accurate as possible with your income levels, as this plays a very important role in the application. When you apply for Obamacare in Louisiana, your income, as well as the number of people in the house, dictate how much you can get in tax subsidies. If you over report your income, you will not get as much. However, you do not want to underreport either. If the IRS believes that you were not honest about your income in an attempt to get more in tax subsidies, they will not allow you to have subsidies in the years that follow.
Missing the Deadline
One of the biggest problems of Obamacare is the fact that they have a deadline each year. People are not allowed to enroll whenever they would like, except under certain conditions. Native Americans, as well as those who qualify for Medicaid, can qualify. In addition, those who have a qualifying life event could get a 60-day special enrollment period. However, most people do not have that option. Instead, if they miss the deadline, they will have to wait until the following November to apply. If that happens, you will likely have to pay the fee for not having coverage. To avoid that, always make sure you pay attention to the application deadlines.
Once you know the main issues for filling out Obamacare applications in Louisiana, you can avoid them so you can get through the system quickly and easily. Go slow on the application when you are filling it out, and double-check everything before you turn it in to the government.
Enrollment and Tax Credit for the Small Business
Business owners in Louisiana worried that the implementation of the Affordable Care Act would cause problems for them. They felt that it meant they would now be required to provide health insurance for their employees. This would be a financial nightmare for many companies, as they would not be capable of affording it. It turns out this is not necessarily the case. The requirement is only for large companies that have more than 50 employees. The small businesses that were worrying do not have to worry, but they should know more about the small business requirement and how it works, as well as the small business tax credit.
Who Needs to Enroll?
If your business has 50 or fewer fulltime equivalent employees, you do not have to provide insurance coverage. It is important to understand what a fulltime equivalent employee is though. The FTE works an average of 30 hours a week or 130 hours per month. Two part-time employees could therefore count as one FTE. For example, if you have two employees who each average 15 hours per week it would count as one FTE. You need to think about this when you are calculating whether you need to provide insurance or not.
Is It a Good Idea for Your Business to Enroll?
While you might not be required by law to offer coverage to your employees, it is still something you might want to consider doing, as it offers some nice benefits. Employees tend to want coverage, and this can give them more of an incentive to stay at your company, which can mean a lower turnover rate. In addition, having Obamacare for Louisiana employees means that they will be healthier and more productive. It generally means fewer absences as well.
Many employers will also be able to enjoy tax credits as well, which can reduce the amount you will owe in taxes. However, you have to qualify for this.
Qualifying for SHOP and Tax Credits
If you have 25 or fewer employees, you will be able to go through the Small Business Health Options Program, or SHOP to find to find the healthcare plans for your business. In addition, you will need to pay for at least 50% of their premiums, or 35% if you are a nonprofit. The average wage for your employees needs to be $50,000 or less annually.
There are a number of different plans available for Louisiana Obamacare through SHOP. When you are choosing plans for your employees, you will want to make sure that you choose a plan that is actually going to help them. If not, they aren’t going to want to sign up for it. Think about their needs and try to find a plan that will fit those needs, as well as your budget. Remember that you can use tax credits to help reduce your overall cost.
With all of the benefits that can come from offering health coverage in Louisiana, Obamacare might not be a bad idea at all.
Cons and Pros of Obamacare Louisiana
Over the past few years, there have been people on both sides of the Obamacare fence in Louisiana. Some people believe that the system is unfair and oppressive, while others feel that the change to the healthcare system was long overdue and that the changes it has made were essential. While it’s easy to jump onto one side or the other after being swayed by what people say, the best thing to do is actually look at the pros and cons so you can make up your own mind about the system and see how it will affect you.
The Cons of Obamacare Louisiana – One of the first reasons that so many people in Louisiana have been apprehensive about Obamacare is the fact that it has become law. They do not like the idea that they are going to be required to have health coverage. They might know that having coverage is a good idea, but when it is mandated by the government, and when you have to pay a fine if you do not have coverage, it doesn’t sit well with them. The current fine for not having coverage is $695 for an adult, and $347.50 for children. They will add this to your taxes if you do not have some type of coverage that satisfies the Obamacare requirement.
Another one of the issues with Obamacare has been the limited time for enrolling. People are only allowed to enroll during the open period, which is generally from November to the end of January. If you haven’t received coverage at this point, you will have to wait until it opens again in November.
The Pros of Obamacare Louisiana – Even though there are certainly quite a few things that people dislike when it comes to Obamacare in Louisiana, there are plenty of benefits as well. For example, the insurance companies are no longer allowed to deny someone from getting health insurance just because they have a preexisting condition. This means that more people are able to get the coverage they need. Another one of the advantages of Obamacare is that parents are now able to keep their children on their insurance up until they are 26 years old.
The system has also tried to make health coverage more affordable for people, and the addition of tax subsidies has helped with this quite a bit. The subsidies can be used at the end of the year with your taxes to reduce the amount that you owe, or increase your return, or they can be used immediately. Many find that having the subsidies applied immediately is the best option. When you do this, it will reduce the amount you have to pay for the monthly premiums.
While there are certainly good and bad elements to Obamacare, Louisiana residents should try to focus on the good aspects. It’s now the law and everyone needs to have coverage if they do not want to pay any fines to the IRS.
Obamacare Louisiana Fact Sheet
Residents who are living in Louisiana may understand that having health coverage is now a requirement of the law, but they may not understand exactly how all of that works and what they need to do to make sure they are within the bounds of the law. It is important to have a good working understanding of at least the basics of Obamacare in Louisiana so you know what to expect.
You Can Go Without Healthcare
You will not go to jail if you don’t have health coverage, contrary to what some people might want you to believe. However, if you do not have healthcare, you are technically in violation of the law, and that means you will receive a fine. The current fines, which could be going up, are already very high. They are $695 for an adult that does not have coverage (or 2.5% of their income – whichever is highest), and $347.50 for children who do not have health coverage.
Coverage Doesn’t Have to Be Through the Exchange
You don’t have to choose a plan that comes through the Obamacare exchange for your coverage. You simply need to have a plan that satisfies the requirement of Obamacare and that contains all of the essential benefits. You could get coverage through a private company, or you could have coverage through an employer if you choose. As long as they satisfy the Obamacare requirements, you are covered and you will not have to pay a fine.
You Get the Essential Benefits
When you have health coverage, you are entitled to all of the essential benefits regardless of the type or level of plan you choose. The essential benefits include ambulatory care, emergency services, hospitalization, maternity and newborn care, mental health services and addiction treatment, rehabilitative devices and services, prescription drugs, lab services, preventative services, and pediatric services.
Another one of the things that many people still don’t realize about Obamacare Louisiana is the fact that you can only enroll at certain times of the year in most cases. Native Americans are allowed to sign up for a plan at any point throughout the year. Those who are able to qualify for Medicaid can sign up throughout the year as well. People who qualify for special enrollment can get a 60-day period during which they can sign up. To qualify for this, you need to have had some type of qualifying event in your life, such as having a child or getting married.
For everyone else, you have to enroll during open enrollment. This is generally from the beginning of November to the end of January. However, you should always check the dates each year to be sure you are enrolling on time.
Armed with some of the basic facts about Obamacare, you should be in a better position when it comes time to choose your plan. Keep in mind that even if you already have a plan, you should take time during each open enrollment to see if there might be something better out there for you.
Unique Aspects of Obamacare Louisiana
While Obamacare in Louisiana is much like it is in most other states around the country, there are some unique aspects that are important to know. It’s important for residents to understand exactly what they can expect with the system and how it will work for them. Let’s look at some of the most important elements of Obamacare in the state.
The Federal Exchange and Open Enrollment – The state does not have their own exchange. Instead, they opted to use the federal exchange, and that is where residents will find and choose their plans. They can choose plans available from the carriers mentioned below. The state uses the same open enrollment period as other states. It starts in November and runs through the end of January. The open enrollment is the only time to enroll in a plan or to change a plan, so always be aware of the dates.
The Carriers in Louisiana – When you are looking for plans, you will have a number of carriers from which you can choose. In 2016, there are five carriers available, which is one less from last year. The CO-OP has closed its doors, so residents of Louisiana who need to have Obamacare will need to go through one of the five remaining companies – Blue Cross Blue Shield of Louisiana, HMO Louisiana, Humana United Healthcare, and Vantage Health Plan.
These companies offer a wide range of plans that fall into the metal tier categories that you will find in other states – bronze, silver, gold, and platinum. While the exact features of the plans from the carriers can vary, all of them are required to include the essential benefits as mandated by Obamacare. These benefits include outpatient care, emergency services, treatment in the hospital, maternity and newborn care, addiction treatment and mental health services, prescription drugs, rehabilitative services and devices, pediatric care, preventative services and lab services.
Medicaid Expansion Coming Soon – For the first several years of the Affordable Care Act, the state decided that they would not expand Medicaid, even though it meant that there would be a number of people who would not qualify for the service, and who would still not be able to afford regular health coverage. The governor at the time, Bobby Jindal, was very opposed to having Obamacare in Louisiana and was vehement that they would not expand Medicaid. However, times are changing. The new governor, John Bel Edwards, said that he wanted to expand Medicaid so more people in the state would be able to get coverage.
One of the first things he did in office was to sign an executive order to expand Medicaid. The estimates are that by July of 2016, the Medicaid expansion will be complete, and around 300,000 people will now be able to qualify for coverage under the plan.
While there are certainly a number of aspects to Obamacare in Louisiana that are the same as in other states, it is important to know the differences and to know how they apply to you.
What’s New for Obamacare Louisiana in 2016?
2016 has been a relatively successful year for Obamacare in Louisiana, with 214,148 people enrolled in the program, including the renewals and the new enrollees. There was about a 15% increase in enrollees in 2016. While there are a number of things that remain the same in 2016 as they were in 2015, there are some differences that are certainly worth noting.
At the end of 2015, the Louisiana Health Cooperative decided that it would no longer be available in 2016.Though the CO-OP was in financial trouble, they promised their customers – 16,000 of them – that they would be able to pay for claims and take care of the other obligations through the end of the year. This was welcome news, but it did mean that all of those patients needed to find a new carrier during the 2016 open enrollment period. If they didn’t enroll in a new plan and with a new carrier at that time, they would not have continuous coverage.
The Remaining Carriers
For 2016, there were only five carriers remaining in the state. All of those remaining carriers requested an increase in the cost of their premiums, which were approved. This means that the cost of health coverage in the state has gone up for 2016, and it’s still too early to tell if there will be even more rate hikes in 2017.
The remaining carriers include Blue Cross Blue Shield of Louisiana, HMO Louisiana, Humana United Healthcare, and Vantage Health Plan. The rates for Blue Cross Blue Shield of Louisiana have average rate increases between 14.575 and 19.68%. HMO Louisiana has an average increase of around 12%, and Humana has an increase that’s lower than the others at only 4.26%. United Healthcare’s premium rates went up by around 9% on average, and Vantage Health Plan had a 6.81% increase.
When Bobby Jindal was the governor of Louisiana, he opposed Obamacare as well as the expansion of Medicaid. However, things are starting to change, and it looks as though Louisiana is going to expand Medicaid in the near future – they are currently aiming for around July, 2016, and this is good news for those who have languished in the gap that not expanding had created. It means that more people should now be able to qualify for Medicaid, so more people in the state have health coverage.
Subsidies Remain – Subsidies help people to afford their healthcare premiums each month, and for a time, there was worry that they would go away. The Supreme Court ruled that the subsidies were legal in every state, and this means that they will remain for the foreseeable future.
As you can see, there have been some substantial changes to Obamacare Louisiana for 2016. Take note of the changes and determine whether they will affect you or not. Whether you are going to be getting coverage for the first time at the end of this year, or you are already on a plan, make sure you pay attention to the open enrollment period to find the plan that’s right for you.
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