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Those in Alabama who need to have Obamacare health coverage will find that there are a number of different plans available currently. Of course, with the options available, it can sometimes be difficult to understand and sort through all of them. Let’s break things down so you get a better idea of the plan tiers, the benefits, the providers, and choosing your plan.
Understanding the Plan Tiers
As with other states that have the healthcare exchange, the companies offering coverage separate their plans into several different tiers. These categories are named after precious metals. It starts at the bronze level. The plans that fall into this tier will have very low monthly premiums. However, the out of pocket expenses for those plans are going to be much higher when you are paying for things such as copays and deductibles.
The silver plans pay for more of the out of pocket expenses, but they have somewhat higher monthly premiums. The gold follows suit, and at the top of the level, the platinum plans, you will find the most expensive monthly premiums. However, you will also find that they pay for 90% of your out of pocket expenses. Those who visit the doctor often would likely get the biggest benefit out of the higher tier plans.
You could also choose a catastrophic plan if you are in good health and under 30. These have low premiums and high out of pocket costs.
The Essential Benefits
One of the great things about Obamacare is that no matter what tier and plan you choose they will all include the essential benefits. The essentials 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.
While all of the plans have the essential benefits, it is important to realize that the various plans may have some additional features and benefits included. Always check to see what the plan comes with before choosing it.
Who Offers Coverage in Alabama?
Alabama has a small number of providers offering plans on the exchange. There are only three right now. Blue Cross and Blue Shield of Alabama, Humana, and United Healthcare. However, it is very important to realize that at the end of 2016, this number is going to drop to just one. Only Blue Cross and Blue Shield of Alabama will be providing plans next year, at least for now.
Making Your Choice
When you are choosing a tier level and a plan, you need to think about you and your family’s needs. If you do not typically go to the doctor very often for anything beyond what is covered with the essential benefits, you may be able to choose a plan in the bronze or silver tier. Those in Alabama who have greater medical needs would likely want to choose a platinum level plan. Even if you have a plan you are happy with, you should always look around during the open enrollment to see if there is something better out there for you.
When looking for healthcare coverage in Alabama, chances are you will be going through their exchange system unless you have coverage through your employer, or you opt for one of the out of exchange carriers in the state. As you first start to delve into the options with Obamacare in Alabama, trying to make sense of everything can feel initially confusing. It is a good idea to understand the basics of what you should expect.
What Is the Open and Special Enrollment?
The open enrollment is one of the most important things to be aware of when looking for Obamacare in Alabama. Under most circumstances, you are only allowed to enroll during this period. For 2016, the period ended on January 31, 2016. It will not open again until November, 2016. However, there are some exceptions to this rule. First, Native Americans are allowed to enroll at any time of year.
Second, you may be able to qualify for a special enrollment. This is only possible though if you have a qualifying event. Qualifying events might include moving to Alabama from another state, having a child, or getting married. If you qualify, then you will have 60 days during which you can look at the plans on the exchange and then enroll.
What Are the Plan Tiers?
As is the case in other states, the plans are all separated into different tiers named after precious metals – bronze, silver, gold, and platinum. The plans that are in the bronze level have the least expensive monthly premiums, and they have the highest out of pocket costs for things such as copays and deductibles. At the opposite end of the spectrum with the platinum plans, the price of the monthly premiums will be high. However, these plans will pay for 90% of the out of pocket costs.
Currently, there are three companies offering coverage on the exchange for Obamacare in Alabama. In 2016, you will be able to choose from Blue Cross Blue Shield of Alabama, United Healthcare, and Humana. However, at the end of this year, the only carrier that will be left in the state is Blue Cross Blue Shield of Alabama unless another company enters the state.
Paying for Coverage and Renewing?
Once you fill out your application and choose your plan, you will pay for the Obamacare in Alabama just as you would when you pay a regular insurance company. Make sure you make your payments each month so you can maintain your coverage. If you are on Humana or United Healthcare, you will have to look for another plan at the next enrollment period. If you are on Blue Cross Blue Shield of Alabama, then you can stick with your current plan and it will renew automatically. However, the rates, are going up this year, so you may want to check to see if you can find something cheaper through them. Again, keep an eye out to see if there are any new carriers who will be coming to the state.
One of the sad truths is that healthcare coverage in the state is still very expensive, even with the implementation of Obamacare. Because the prices are high, it means that some people haven’t been able to get coverage, and this means they will have to pay fines to the IRS. The current price of the fines is $695 for an adult who does not have coverage and $347.50 for a child under 18 without coverage. What many who need Obamacare in Alabama are wondering is whether there is any type of financial assistance that they might be able to use. Let’s look at some of the different options to help deal with the costs of healthcare.
Some people in the state of Alabama will be able to get Medicaid, which can pay for their healthcare costs and satisfy their requirement for Obamacare. You will find out whether you qualify when you sign up through the exchange. Even though Medicaid is an option for some, there is a slight issue.
When Obamacare passed, the majority of the states saw that there could be a gap between who would qualify for Medicaid and who would be able to pay for coverage. Most of those states decided that they would expand their Medicaid coverage in an effort to shrink that gap and provide coverage to as many people as possible. Alabama did not see fit to do that. They were one of 19 states that decided not to expand their Medicaid coverage. This means that there are more people in the state who are not able to afford coverage and that fall into this gap.
Fortunately, there may be another way that you can reduce the amount that you owe on your monthly premiums for Obamacare in Alabama.
Because the federal government realized it would be a lot to ask of people to suddenly start paying medical insurance premiums each month, they created tax subsidies. The amount of subsidies you receive each month depends on your income level and the number of people in the house who will need to be on the plan. The less you make and the more people in the family, the more you will receive in subsidies.
If you have children who need to have medical care and you are low income, you can go through ALL Kids. This program is low cost and comprehensive, and is usable for children who are 19 and under. It covers checkups, immunizations, sick child doctor visits, prescriptions, vision and dental care, hospitalization, mental health, substance abuse, and more. Parents who have a log income will want to check out this program so their kids can get the coverage they need and deserve.
Even though the healthcare costs in AL are expensive still, these options for financial assistance can help you to find programs that can lower the cost a bit. You need to have coverage, and this way, you will not have to worry about paying the fines to the IRS.
Many in Alabama worried that Obamacare passing would mean big changes to their taxes. They wondered if it would mean extra payments, and what is would mean if they chose not to get coverage. While the initial fears that people had turned out to be unfounded – their taxes didn’t skyrocket – there are still a number of things that you need to be aware of when filing taxes. Fortunately, the changes are very easy to implement into the way you already do your taxes.
Before tax time arrives, you should expect a letter in the mail that will include a form regarding your coverage. Depending on the type of coverage you have, it will be one of three different forms. For those who have Obamacare in Alabama, you can expect to receive a 1095-A, the Healthcare Marketplace Statement. If you have off exchange insurance, then you will receive the 1095-B. Those who have coverage through their employers will receive the 1095-C, called the Employer Provided Health Insurance Offer and Coverage form.
For those who are waiting for the 1095-C or the 1095-B form, you do not have to wait to do your taxes. The insurance companies will already have provided the IRS with the information they need to know about your insurance. Those who have Obamacare in Alabama though will need to wait until they receive their 1095-A. When this arrives in the mail, you will take the information that it includes and put it onto Form 8962, which gets sent in with your taxes. You should keep your 1095-A for your records.
It’s really as easy as that. Though it is another form that you need to fill out, you will find that it doesn’t complicate your taxes too much. The 1095-A includes every bit of information that you need to include on your taxes. It shows that you have coverage.
Most people will not have any trouble when it comes to doing their own taxes. If you do your taxes on your own already, you only have another couple of forms to consider. For those who have complicated taxes to handle each year, the tax professional you use can take care of everything for you. It’s just as easy as it was in the past.
Those who do not have coverage will have to pay a penalty. Without Obamacare in Alabama, or equivalent coverage, you will owe the IRS $695 for adults and $347.50 for children who are under 18 and who do not have coverage. Those penalties will go right onto your taxes, so there is no way to avoid them. If you don’t pay your taxes on time, there is a chance that the IRS could no longer allow you to get subsidies that will help you pay for your monthly premiums. It is always in your best interest to take care of the taxes as soon as you have all of the forms you need. This way, you can avoid any potential trouble.
Common Mistakes on the Application Process
It is now a requirement to have healthcare coverage in the United States. For those who are not covered through their employer, this will generally mean you have to fill out an application for Obamacare. Alabama residents who do not already have coverage will have to wait until the next open enrollment period. This starts in November, 2016. The only way that you can get coverage before that time through the exchange is if you are a Native American, or if you qualify for a special enrollment period. For people who have had a qualifying life event, you will have a 60-day period where you are able to enroll. Some examples of qualifying events include having a child or getting married.
There have been a number of instances of mistakes on the applications when people are applying for Obamacare in Alabama and turning in their information. You have to be very careful when you are filling out this information so you do not make any errors that would cause the application to be denied or delayed for any reason. Let’s look at some of the most common reasons for these errors.
Not Filling Out the Entire Application and Using the Wrong Information
Always will out every piece of the application and read each section thoroughly so you know what information needs to be included. Officials have had some applications turned in with entire sections missing, which delays the process. Another issue is putting the wrong information on the application form. This is often an oversight because people are filling out the application too quickly. Always make sure that you have the names, Social Security numbers, and birthdates correct and in the right location. One of the issues that has happened in a number of states is people putting their spouse in the dependent section by mistake.
Also, remember that Obamacare will not allow you to keep your children on your insurance until they are 26 years old. This may be an option you want to consider, as it can keep the cost of insurance down for your offspring.
Your income is required for the application as well. The income, as well as the number of people you have as dependents in the household, will determine how much you will receive in subsidies. The less you earn, the more you will generally make in subsidies, which can offset the cost of your healthcare. When you fill out your application and turn it in, you will find out how much you are able to receive. Keep in mind that you need to be truthful with your income, or else the IRS will find out and they will not allow you to take subsidies in the future.
Before you turn in the application, always double-check all of the information you provided. This will reduce the risk of making a mistake and delaying you getting Obamacare in Alabama. Take your time, and you will not have any problems at all.
Enrollment for Small Business and the Small Business Tax Credit
When the Affordable Care Act passed, it caused something of a panic to set in amongst small businesses in Alabama and across the rest of the country. Many of these companies were concerned over what it would mean for their business and whether they would now legally be required to provide health insurance coverage for their employees. Some feared that they might actually go out of business if that were the case. However, there is no reason to panic if you are a small business owner in Alabama. Obamacare might not even be required for you.
Who Needs to Enroll in Coverage?
If you are a small business with fewer than 50 full time equivalent employees, then you are not legally required to have Obamacare for your workers. However, you will need to let all of the new employees you hire know about Obamacare and what they can do to sign up for it on their own accord.
One of the things to keep in mind about the aforementioned is what a full time equivalent employee actually means. One FTE is someone who is working at least an average of 30 hours a week or 130 hours a month. However, employees who are part time could equal one FTE. For example, if you have two employees each working an average of 15 hours a week, it would be considered one full time equivalent. Consider this when you are counting your FTEs.
What Are the Benefits of Enrolling?
Even though there might not be any legal requirement for you to have Obamacare in Alabama for your employees, that doesn’t mean you should give up on the idea completely. It still may be something you want to consider given the benefits it can provide. When you are able to offer insurance for your employees, it tends to increase their loyalty and devotion to your company. This can get your employees to stay on longer so you have a lower turnover rate.
In addition, coverage will help to make your employees healthier overall. This can make them more productive and it can cut down on absences. One of the other benefits is small business tax credits. If you have fewer than 25 employees and you are paying for at least 50% of their premiums (or 35% for nonprofit organizations), and the average wage is less than $50,000, then you could get tax credits, which can lower the amount you pay in taxes each year.
What Plans Are Right for Your Company?
If you decide that you are going to enroll, you will go through the Small Business Health Options Program, or SHOP. This online marketplace for Obamacare for Alabama businesses has a number of different options available when it comes to coverage. When you choose the plan, don’t simply go for the cheapest or most expensive option there. Instead, consider what your employees actually need and find a program that will work for their needs.
Just because you don’t have to offer coverage doesn’t mean it’s not a good idea. Consider the benefits before you dismiss it.
Obamacare Fact Sheet
Residents of Alabama know Obamacare is now a requirement, even though some may not be happy about it. It is important to understand the basics of how the system works and what it will mean for them. Let’s look at some of the most important facts you will want to remember whether you will be getting coverage during the next open enrollment or whether you already have coverage.
Penalties for No Coverage
You don’t have the choice of whether you are going to get healthcare or not, at least not if you don’t want to pay fines. You need to have some type of coverage, but it doesn’t mean you need to go through the exchange to get it. You could also choose plans that are off the exchange, as long as they satisfy the requirements of Obamacare. In addition, you would get coverage through an employer. If you are Native American, or have religious reasons, you do not need to have coverage either.
For those who do not fall into those categories though, if you do not have coverage, you will have to pay the aforementioned fines. The fines as they stand right now 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 coverage.
What Is the Open Enrollment?
If you are going to be using the exchange for Obamacare in Alabama, you need to make sure that you enroll during the open period. For 2016, that period is already over, so you will have to wait until it opens again in November of 2016. However, there is a chance that you could qualify for special enrollment. You will need to have gone through some type of life qualifying event though. Some examples of these events include having a child, adopting a child, getting married or divorced, and moving to the state.
In 2017, the Choices for Obamacare in Alabama Will Be Limited
One of the most important facts residents of Alabama with Obamacare need to know is that the landscape of providers will be changing drastically next year. In 2017, two of the three carriers offering plans on the exchange will be going away. You will only have access to Blue Cross Blue Shield of Alabama, so make sure you check the plans as soon as possible if this means you need to switch. In fact, you should always check the plans, even if you are already with that carrier, so you can make sure that you are using the best option.
The Essential Benefits
There are a number of different types of plans from which you can choose with Obamacare in Alabama. All of the plans, regardless of their level, will include the essential benefits. These benefits include outpatient 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.
Once you understand the facts about Obamacare, it becomes much easier to see how it will affect you.
What’s New for 2016
Whether you already have a plan for Obamacare in Alabama, or you are going to be getting one during the next open enrollment period, you will want to know all of the changes that have happened and that will be happening soon. This will allow you to get a better idea of what plan will fit your particular needs the best.
Changes to Carriers
There are some major changes coming to the carriers at the end of the year. While the state currently has three companies offering plans that are on the exchange – Blue Cross Blue Shield of Alabama, United Healthcare, and Humana – this is going to change for 2017. During the next open enrollment, there will only be one option available on the Obamacare exchange in Alabama. Both Humana and United Healthcare are going to be leaving the market.
This is going to leave just Blue Cross Blue Shield of Alabama. Currently, that company is responsible for the majority of the market share, and it looks as though they will be taking on the bulk of the customers at the end of the year during open enrollment. At that time, the customers who are currently with Humana and United Healthcare will have to choose a plan through Blue Cross Blue Shield unless another company comes into the mix during that time.
The Cost of Coverage
Something else of note is that the cost of coverage in Alabama is very high when compared with other states. In addition, there have been increases to the cost of coverage for 2016. Human has increased their premiums by an average of just below 9%. United Healthcare has seen an average rate increase of 24.5%. With Blue Cross and Blue Shield, the increase is an average of 28%.
The subsidies are higher in Alabama this year, and that has helped to make it a little easier for some to afford the healthcare plans. However, with the rate at which the price of the coverage is going up, it is still difficult for many people to afford getting health insurance. One possible way to help with this would be for more companies to start offering plans in the state to help increase the competition, but it is currently unknown whether there will be any additional carriers after 2016.
What does this mean for you? It means you will want to shop around amongst the plans that are available rather than simply going through auto renewal. If you find that the plans on the exchange for Obamacare in Alabama are too high, you might want to look at some of the off exchange plans, as long as they conform with all of the Obamacare rules.
Even though the rates have gone up, the number of people enrolled is up from 2015 by 14%. This is mainly due to the fact that people do not want to have to pay the penalty for not having insurance coverage. It’s important that you continue to watch for changes to the exchange in Alabama to see if new companies offering Obamacare become available at the end of the year. It could mean a lot of savings if they do.
Cons and Pros of AL Obamacare
In many parts of the country, Obamacare wasn’t popular when it was first introduced, and it is still not welcome for some. While there are certainly differing opinions on the Affordable Care Act, residents of Alabama know that it is required for them to have some type of healthcare insurance that satisfies the requirements of the Act. Truth be told, there are both good and bad elements to the system, and it is important to look at it from a neutral point of view rather than to take political sides in the matter. Let’s look at the pros and cons of Alabama Obamacare so you can have a better understanding of what the other side might think about it.
The Cons of Alabama Obamacare
What was the biggest gripe that people tended to have with Obamacare when it was introduced? Most people know that health insurance is a good idea and that it is there to protect their health as well as their finances. However, people hated that it was no longer just a good idea. It is mandatory, and it they do not have coverage, they are going to have to pay fines.
It feels as though they are forced into healthcare, and even though they won’t go to jail if they do not have insurance, they will pay a penalty. These penalties are quite high – $695 per person, or 2.5% of their income, whichever is higher. For children, the penalty is $347.50.
People are not thrilled about the open enrollment either. You can’t simply sign up for coverage whenever you want, unless you qualify for Medicaid or you are a Native American. Most people need to wait to sign up during the open enrollment window. It’s already closed for 2016 and doesn’t open up again until November, 2016 for coverage in 2017.
The Pros of Obamacare in Alabama
Even though there are some cons, there are certainly quite a few benefits to it as well. One of the biggest benefits is that the insurance companies are not able to deny someone coverage any longer just because they have a preexisting condition. They are still able to get healthcare, and they do not have to pay any more for it just because of the condition. In addition, the company can’t drop you or charge more if you develop a condition after you already have a plan.
Parents can keep their kids on their insurance plan until the kids are 26 years old. Also the tax subsidies can help to make it easier for people to pay for their monthly premiums. Depending on your income and the number of people in the family, you can qualify for subsidies that you can apply for your monthly premiums to lower them, or you can apply them to your taxes at the end of the year if you prefer.
Many feel that the pros outweigh the cons. Regardless of how you feel though, having coverage is now the law.
Have you judged Obamacare without having all of the facts? Many people are upset that they are required to have healthcare coverage and naturally feel that there is nothing good about the program. It is a good idea to take your feelings out of the equation and just look at the facts. This way, you can see what Obamacare in Alabama means and get a better idea of how it will affect you. The following are some of the most commonly asked questions about Obamacare.
Do I Need Obamacare in Alabama?
You need to have insurance coverage in most cases, but that does not mean you have to choose a plan on the exchange for Obamacare in Alabama. You could choose an off exchange plan if you prefer, or you might have coverage through your employer. These would satisfy the requirements of Obamacare. Native Americans and those who have religious reasons for not having insurance are not required to get any coverage.
If you do not fall into those categories though, you will need to have coverage unless you want to pay a fin. The fines are currently $695 for an adult without coverage (or 2.5% of their income, whichever is higher) and for children, the cost of the fine is $347.50.
Who Offers Coverage?
In Alabama, Obamacare plans are offered on the exchange from just three carriers in 2016 – United Healthcare, Human, and Blue Cross Blue Shield of Alabama. The latter provides plans for the greatest market share. It is important to note that next year, only Blue Cross Blue Shield of Alabama will remain, and all of the plans will go through them unless another carrier emerges.
What Are Essential Benefits?
The plan that you choose, regardless of provider and tier level, will include at least the essential benefits are required by Obamacare. These essential benefits are ambulatory patient services, treatments in the hospital, emergency services, pediatric care, lab services, maternity and newborn care, mental health services and addiction treatment, prescription drugs, rehab services and devices, and preventative services.
What About Preexisting Conditions?
Many people worry that if they have a preexisting condition, there is no way that they can get coverage, and if they do find a company that will cover them, it will cost a fortune. With the passing of Obamacare, that’s no longer the case. The companies are not allowed to deny you coverage just because you have a preexisting condition, and they can’t charge you more for the plans. In addition, they will not be able to increase your rates simply because you develop a condition while on the plan.
Why Are There Different Tiers?
The different tiers – bronze, silver, gold, and platinum – make it easier to understand the different levels of care those plans in the tier provide. The bronze plans have low monthly premiums and high out of pocket costs. As you go through each of the successive precious metals, the cost of the premiums grows while the cost of out of pocket expenses diminishes. Therefore, someone who is seriously ill would likely want to choose a platinum level plan.
Now that you know the answers to some of the most commonly asked questions, you will have a better idea of what Obamacare in Alabama will mean for you.
Unique Aspects of Obamacare in Alabama
You know that you need to have healthcare coverage now that the Affordable Care Act has passed. Obamacare in Alabama works very similarly to the plans in the other parts of the country, although there are some notable differences, as mentioned below. If you do not have coverage currently, you will have to wait for the open enrollment for Obamacare in Alabama to open again, which is in November of 2017. The only way you can get coverage on the exchange between now and then would be if you are a Native American, or if you have a qualifying life event. A qualifying event could be something such as having a child, getting divorced, or if you have just moved to Alabama. Obamacare’s special enrollment will then give you 60 days to search for a plan and to enroll.
As with the other states, if you do not have some form of healthcare coverage, whether on the exchange, off the exchange, or through an employer, you are subject to a fine. The current find is $695 for an adult without coverage and $347.50 for children without coverage.
No Medicaid Expansion
When Obamacare was announced, there was a fear that it would create a gap where there would be people who were unable to get coverage through Medicaid because they made too much money, and who would still not be able to afford the healthcare plans through Obamacare. Many states chose to expand their Medicaid coverage to close this gap. Unfortunately, Alabama was not one of those states. This means that it may be more difficult for some people to qualify for Medicaid coverage. Many in the state who are in need of Obamacare will find that they are able to get tax subsidies, created by the federal government, to help them offset the cost of their insurance.
Alabama healthcare is expensive. In fact, it has the third most expensive plans for individual healthcare in the nation when factoring in all of the costs, according to research conducted by GoBankingRates. Alabama is one of only five states that does not do any review of the proposed rate changes, which is likely why it is so costly
Providers in the State
Alabama has only three carriers that offer plans on the healthcare exchange, although there are companies in the state that offer plans off exchange that meet the requirements of Obamacare. The available carriers on the exchange include Humana, Blue Cross Blue Shield of Alabama, and United Healthcare. They offer plans across the spectrum from bronze to silver, gold, and platinum. All of the plans offered include the essential benefits – 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.
It is important to keep in mind that even though all of the plans will offer the above benefits, some plans will have additional features and services. Always look into what the plans offer to be sure you are getting what you and your family need.
While there are some similarities between Alabama and many other states, it is very important that you take the time to learn the differences as well so you know what to expect.