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Obamacare Tennessee Plans and Networks – Tennessee residents need to have health coverage if they hope to be in line with the law put forth by the Affordable Care Act, or Obamacare Tennessee, as many call it. Fortunately, there are a number of options when it comes to plans and providers. However, the open enrollment period for 2016 is now over. It lasted from November 1, 2015 through January 31, 2016. If you don’t have coverage yet, it means you will not be able to enroll in a plan (on the exchange or off the exchange) until the enrollment opens again in November of 2016.
There are limited ways that you could get on a plan during the year. If you qualify for special enrollment, you could choose a plan. However, you would need to have a qualifying event happen in your life for this possibility. Some potential qualifiers include having a child, moving to the state, getting divorced, or getting married. In addition, Native Americans are able to enroll at any time of the year. Those who are eligible for CHIP and Medicaid can enroll all year long as well.
If you do not have coverage, then you will have to pay a fine to the IRS. The current cost of the fine for adults is $695, and the penalty for those who are under 18 is $347.50.
Understanding the Tiers – When you are eligible to enroll, you will notice that there are several different tiers available in Obamacare Tennessee, each named after a precious metal. These indicate the coverage levels. They start at bronze and then work their way up through silver, gold, and, finally, platinum. The plans that are a part of the bronze tier will have the lowest monthly premiums, but they have the highest out of pocket expenses for things such as copays and deductibles. As you work your way up through the tiers, this changes. At the top level are the platinum plans. These have the highest of the monthly premiums, but the out of pocket expenses are very low. The plans will cover 90% of your costs.
Obamacare Tennessee Providers – When you are going through the exchange for Obamacare in Tennessee, you will have four different providers from which you can choose. These include Blue Cross Blue Shield of Tennessee, Humana, Cigna, and United Healthcare. Each of the providers then has a number of different plans from which you can choose. Regardless of which plan you have, they will all contain at least the essential benefits including 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.
Of course, more expensive plans may have much more than just these essential benefits covered. When you are looking for your plan during the enrollment period, you need to make sure that you enroll in time. However, you also have to make sure that you choose a plan that is best suited to your needs and to your budget. To Get a free health insurance quote Click here.
Getting Coverage for Obamacare Tennessee – To find Obamacare in Tennessee, you will be going through their exchange, which is available at Healthcare.gov. They use the federal exchange, as many states have decided to do. It was easier and more convenient for them than making their own exchange. There have been hundreds of thousands of people who have enrolled in Obamacare in Tennessee over the past few years and if you are planning to follow suit, then you need to understand what to expect.
The Enrollment Period and Special Enrollment for Obamacare Tennessee- The first thing you have to realize is that you need to enroll during the open enrollment period. The open enrollment for 2016 started on November 1, 2015 and went through January 31, 2016. The next open enrollment will not start until November of 2016. If you didn’t enroll when it was open, you will no longer be able to. The only exception is for those who qualify for special enrollment, Native Americans, and those who qualify for Medicaid and CHIP.
Special enrollment is only available for those who have qualifying life events, as determined by the exchange. Some of the most common examples of events that would qualify for a 60-day special enrollment period are getting married, having a child, and moving to the state.
Finding the Plan and Provider – You will then need to look at the different types of plans available. The plans are separated into metal categories or tiers. They include bronze, silver, gold, and platinum. Plans at the platinum level have the highest monthly premiums, but the lowest out of pocket costs. At the opposite end are the bronze plans. They have the highest out of pocket expenses for copay and deductibles, but they have the lowest monthly premiums. Those who are under 30 and in good health could qualify for the catastrophic plans, which are very affordable. Like the bronze plans, they will have high out of pocket costs.
There are a number of companies offering plans on the exchange. You can choose from Blue Cross Blue Shield of Tennessee, Humana, Cigna, and United Healthcare.
All of the plans from the providers will include the essential benefits. These include ambulatory care, emergency services, treatment in the hospital, maternity and newborn care, addiction treatment and mental health services, rehabilitative services and devices, pediatric care, preventative services, lab services, and prescription drugs. To Get a free health insurance quote Click Here.
Paying for Coverage in Obamacare Tennessee – Once you have chosen a plan through the exchange, you will then fill out your application to enroll. At that point, you will start to pay your monthly premiums to the insurance company. If you have tax subsidies, they will go to the company for you each month and lower your payments. It is important to make sure you submit your payments on time each month so you do not have your coverage cancelled. If you do, you will have to wait until the next enrollment to get coverage.
Renewing Obamacare Tennessee Policies – The plans should be renewed automatically each year, so you do not have to worry about it. If the plan you are on is no longer available, the company will let you know so you can look at your other options.
It is always a good idea to check out the different plans each year, even if yours renews automatically. This way, you can get the Obamacare coverage in Tennessee that’s right for you.
Financial Assistance for Obamacare Tennessee
For many individuals and families in Tennessee, money is tight. The income they have goes toward bills and food, and sometimes it seems as though there is very little left over. With the arrival of Obamacare, it has caused Tennessee residents to wonder just how they are supposed to pay for health insurance on top of all of their other responsibilities. Some had avoided coverage for years because the prices were too high and now they know that if they don’t pay for coverage, they will still have to pay penalties.
For those who are wondering how they can pay for their coverage, there are some options for financial assistance to make paying for coverage possible.
Medicaid and CHIP – Even though Tennessee was one of the 19 states that decided they would not expand their Medicaid coverage, it is still an option for some individuals and families. Those who qualify will be able to receive their healthcare for free and they will have satisfied the requirement of Obamacare, so they no longer have to worry about fines and penalties. The Children’s Health Insurance Program is another option. This is for children and it can help families by providing coverage for the kids, which should make it easier for them to afford Obamacare plans for themselves. When you apply for Obamacare in Tennessee, you will automatically find out if you qualify for any of these coverage types.
Tax Subsidies for Obamacare Tennessee – A large number of people in the state (85% of the people who signed up this year) are going to qualify for tax subsidies. The government realized that many people were going to have trouble paying for coverage, so they introduced this option. When you sign up for Obamacare, if you make between 100% and 400% of the federal poverty level, you will qualify for tax subsidies.
You have a choice of how and when to use these subsidies. Some people choose to hold onto them until the end of the year. Then, they apply them to their taxes. It can reduce the amount of taxes they owe. If they were getting a refund, it would increase the amount of the refund. However, with many people living paycheck to paycheck in Tennessee, using the subsidies immediately makes more sense. In that scenario, they would have the subsidies applied to their monthly premiums. This would lower them to the point where the coverage is affordable for more people in the state.
The Plans in Obamacare Tennessee – When you are looking for other ways to save money, take the time to look at the various plans and providers available. You should be able to find a number of different plans in the state, and some will be more affordable than others. All of them will contain the necessary essential benefits including 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. There are many different options that can help to make it easier for you to afford the coverage you need.
Common Mistakes on the Obamacare Tennessee Application Process
Having health coverage is actually no longer a choice. If you do not have health insurance coverage through the exchange, your employer, through a private company off the Obamacare exchange, or Medicaid, then you are subject to a penalty that the IRS will collect. The fines for not having coverage are high and getting higher each year. The current fees are $695 for an adult and $347.50 for a child. In 2016, a large number of people in Tennessee applied for coverage, as did millions across the country. Many ended up making some mistakes on their application, which delayed their enrollment. You do not want to make those same mistakes. Let’s look at some of the most common mistakes on the application process.
Missing and Incorrect Information – Many times, people simply do not fill out all of the information required on the form. Whether they miss a section or they don’t think it is important, they are turning in applications that are missing some important info. When you fill out the application, it is important to look at all of the required sections and to provide accurate information. The accuracy of the information entered has been a problem as well. You should always make sure to double-check all of the information on the application including names, birthdays, and Social Security Numbers.
Make sure everyone included on the application is in the right section as well. In some instances, officials have found spouse’s names in the section for dependents. In addition, be sure to include everyone on the application that you want to have covered under a plan. Remember that the changes to the law with Obamacare now allow children who are up to 26 years old to remain on their parent’s coverage.
Incorrect Income – Another issue that the officials have seen is incorrect reporting of income. When you fill out the application, you need to give an accurate (as accurate as possible) account of your income. The amount that you make will determine how much money you may be eligible to receive in tax subsidies. If you report that you make more income than you actually do, it will mean you are not able to get as much in subsidies. However, if you try to take the opposite approach and under report your income as a way to get more in subsidies, you can be sure the IRS will find out.
Not Remembering the Open Enrollment Period for Obamacare Tennessee – Finally, you have to be aware of the open enrollment period. For 2016, the open enrollment was from November 1, 2015 to January 31, 2016. This means it is now closed. You will not be able to enroll for coverage until November of 2016 unless you qualify for special enrollment due to a qualifying event. Always make sure you are within the bounds of the open enrollment when choosing your plan and enrolling. You want to take your time, but you do not want to miss the enrollment or else you will be forced to pay more fines.
Obamacare Tennessee Impact On Small Business
One of the big fears that small business owners had when it came to the Affordable Care Act was what it would mean for their responsibilities to their employees. A number of business owners in Tennessee worried that it would cost too much for them to provide coverage and that they would not be able to stay afloat. However, not all small businesses need to provide Obamacare coverage. It depends on several things.
What Companies Need to Provide Coverage for Their Employees? – If your company has more than 50 full-time equivalent employees, then you will need to provide health insurance coverage options to them. However, those companies that have fewer than 50 full-time-equivalent employees will not be required to pay for coverage. Keep in mind that a “full-time equivalent” is someone who works 30 hours per week on average or 130 hours total a month. However, two part-time workers could add up to one full time equivalent. For example, if you have two part-time workers who each work an average of 15 hours a week, they would count as one full-time equivalent employee.
Those companies who do not have more than 50 employees are under no obligation to provide coverage to their employees. However, whenever they bring aboard a new employee, they are required to let them know about Obamacare in Tennessee and how it works, so they can get coverage on their own. You can find the information you need to pass on to your employees through the US Department of Labor.
Consider Enrolling in Obamacare Tennessee- Even though your business might not be required to provide Obamacare coverage to your employees, that doesn’t mean it is a bad idea to consider. You can find some great benefits when you provide coverage to your staff. They will be more likely to want to stay with your company since they have coverage. In addition, it helps to keep them healthy and happy, which can make them more productive while cutting down on absences.
For small businesses to be able to go through SHOP, the Small Business Health Options Program, they will need to have fewer than 25 full-time equivalent employees, pay at least half of their premiums (35% for nonprofits), and they need to have an average annual wage of less than $50,000. You will find out if you qualify when you apply. If you do, then you will be able to look at the various plans and prices for the coverage. Try to find a plan that will meet most of the needs of your employees.
When you get coverage, you might also qualify for tax credits. This can help to lower the amount that your company has to pay for taxes each year, and is yet another benefit that comes from offering coverage to employees.
If you have been thinking about offering coverage to your employees, it might be time to look at the options that are available during the open enrollment period.
Obamacare Tennessee Fact Sheet
Those who live in Tennessee are well aware that Obamacare is now the law of the land. They understand that the law has overhauled the insurance companies and that it requires people to have coverage. However, they might not understand exactly what all of that entails and how it will affect them. It is important to get a better grasp of what Obamacare will mean to you and your family.
You Need Health Insurance – Health insurance coverage has gone from simply being a good idea to being a requirement. You no longer have a choice of whether you want to have coverage or not unless you are exempt. Some examples for being exempt include religious reasons and being a Native American. If you aren’t exempt, and you don’t have Medicaid or coverage from your employer, then you need to have Obamacare coverage in Tennessee.
Those who do not get coverage will not face jail time. However, they will have to pay a penalty to the IRS. The current penalty is $695 for adults without coverage or 2.5% of their income (they choose whichever is higher) and $347.50 for children with no coverage.
You Must Enroll During Open Enrollment – You can’t simply choose to enroll whenever you like throughout the year. You are required to do so only during the open enrollment. The 2016, open enrollment was from November 1, 2015 to January 31, 2016. It will not open again until November 1, 2017. If you don’t have the proper coverage, it means you will have to pay the aforementioned penalties.
Changes to the Insurance System – Obamacare has brought with it a number of changes to the health insurance system in the United States and many feel these changes are for the better. One of the biggest changes is the fact that an insurance company is no longer allowed to deny someone coverage just because they have a preexisting condition. In addition, they are not allowed to charge those people more because of their condition. They are unable to cancel the policies of these individuals as well, unless they are committing fraud.
Another change is that parents are allowed to keep their children on their coverage until they are 26 years old now. This provides the young adults with more of a cushion while they are in college and starting to make their way through the world.
Plans and Tiers in Obamacare Tennessee- There are currently four providers on the exchange in Tennessee offering Obamacare plans. These include Blue Cross Blue Shield of Tennessee, Humana, Cigna, and United Healthcare. They have a number of different plans that are separated into bronze, silver, gold, and platinum tiers. The bronze tiers have high out of pocket expenses and low monthly premiums. The platinum plans have high monthly premiums and low out of pocket costs.
When you are choosing a plan, it is important to learn as much about Obamacare, as well as the individual plan, as possible. This ensures you know exactly what your plan will cover.
Obamacare Tennessee Tax Information
People have been very concerned about what Obamacare will mean for their individual taxes. They aren’t only concerned that they might have to pay more taxes to pay for the system, but they wonder just how the addition of Obamacare will affect how they will pay those taxes. Residents of Tennessee will find that even though there are some changes, they are not overly complicated, and most people will not have any trouble figuring out how to do their taxes.
However, it is important to remember that you need to have some type of coverage if you do not want the IRS to impose penalties on your taxes. The current fines are $695 for adults and $347.50 for children who are under 18 and who do not have coverage. If you do not have coverage, you can expect these penalties on your taxes.
The Forms for Your Taxes – The forms that you will receive will depend on how you get your health coverage in Tennessee. Obamacare recipients will receive a 1095-A, which is the Healthcare Insurance Marketplace Statement. This form will provide you with the information you need to complete your taxes and it should arrive in the mail well before your taxes are due.
If you have coverage through a company that is not on the exchange, then you will receive a 1095-B form. This is called the Health Coverage form. Your insurance company will send this to you before the taxes are due. It proves to the IRS that you have coverage that is deemed acceptable by Obamacare. Those who have health insurance coverage through their employer will receive the 1095-C, called the Employer Provided Health Insurance Offer and Coverage form.
Each of the forms will give you the information you need about your coverage and how it affects your taxes. It also works as proof of coverage, so you should keep it in your files in case there are any issues with the IRS not getting the proper information and trying to charge you a penalty.
If you are waiting for the 1095-A, you actually do need to wait until you receive it before you can submit your taxes. It has information you need. Those who are getting either of the other two forms do not have to wait before they file their taxes.
Doing your taxes with the 1095-A does include a couple extra steps and you do need to wait until the form arrives. However, it is generally considered to be easy for most people to add the information to their taxes. For those who have complicated taxes, though, there is always the chance that it could be confusing. For those individuals, it might be a good idea to speak with a tax professional, which will ensure you fill them out correctly.
File on Time – Always make sure you file your taxes and be sure to file them on time. If you don’t, then the IRS may not allow you to have tax subsidies, which you likely need to help pay for your Obamacare in Tennessee.
What’s New for Obamacare Tennessee in 2016?
In the 2016 open enrollment period for Obamacare in Tennessee, 268,876 people enrolled. This was an increase over the previous year by about 16% and around 48% of the people enrolling in 2016 were brand new to the exchange. This increased number has been promising and it shows that the program is working in the state. Many of the people who enrolled – 85% of them – were able to receive subsidies that help them to lower the amount they are paying for their coverage.
The Enrollment Period Is Over for Obamacare Tennessee – The open enrollment for 2016 lasted from November 1, 2015 to January 31, 2016. It will not open again until November of 2017. The only way that you will be able to enroll in a plan, whether it is on the exchange or off the exchange, is if you have a qualifying event. Examples of qualifying events include having a child, moving to the state, and getting married. Native Americans are allowed to enroll at any time of the year, and they do not have to have any qualifying event to do so. In addition, those who are eligible for Medicaid and CHIP can enroll in those plans throughout the year.
The Available Providers – This year, one of the providers that was offering Obamacare in Tennessee is no longer available. Community Health Alliance stopped operations because the regulators felt that there was too great of a chance that it could fail in 2016, which would have caused more problems in the market if it happened in the middle of the year. They ceased operations and gave the people who were currently on plans with them plenty of time to find other plans from different providers during the open enrollment. A number of co-ops closed as well.
Still, there are four providers who are on the exchange and who are offering plans. These include Blue Cross Blue Shield of Tennessee, Humana, Cigna, and United Healthcare. In addition, there are four off market providers that have plans that will satisfy your requirements for Obamacare in Tennessee. They include Tennessee Rural Health, United Healthcare Life Insurance Company, Aetna, and Freedom Life Insurance Company of America.
Each of the plans from these providers include the essential benefits – 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.
Rates Are Climbing in Obamacare Tennessee – One of the things that many who are on Obamacare in Tennessee are unhappy about in 2016 is the increase in rates. Blue Cross Blue Shield of Tennessee is seeing the largest of the rate increases. The average rate increase is 36.2%. Since this provider accounts for 72% of the market share in the state for individuals, this means that many people are going to be paying more for their coverage this year.
Humana is also seeing an increase. Their increase is a more modest 5.8%. Cigna will see a 0.4% increase, and United Healthcare will not see any increases this year.
These are the major changes and increases that residents of Tennessee should be aware of concerning Obamacare in 2016.
Cons and Pros of Obamacare Tennessee
You no longer have a choice of whether you are going to get health insurance or not, unless you want to pay a hefty penalty. With the arrival of the Affordable Care Act several years ago, it has brought out opponents and proponents in droves and there are still people arguing about the flaws and merits of the system. Regardless of personal feelings, it is important to realize that it is now the law, and that means you need to have coverage. Before praising or condemning the system too much, it is a good idea to look at the cons and the pros that Obamacare has for residents of Tennessee.
Cons of Obamacare Tennessee – One of the biggest issues that people have when it comes to Obamacare is not the overhaul of the powers of insurance companies, but rather the fact that the new law takes choice out of the equation for citizens. Even though it is a good idea to have insurance coverage, people dislike being told that they have to buy coverage or face a fine. They wish they had the ability to forego coverage and not have to pay a fine. The current fines are quite high. Adults who do not have coverage will be paying a fine of $695 per year, or 2.5% of their income, whichever is higher. The penalty for those who are under 18 is $347.50.
Another one of the issues that some people have with the system is the limited enrollment period. If they could enroll at any time of the year, they would likely have less of a problem with it. However, as the system is set up now, residents of Tennessee in need of Obamacare, as well as in other states, have to enroll during the open enrollment period. If they miss the open enrollment, which is generally from November to January, they are unable to enroll in a program and will have to pay a fine unless they are able to qualify for special enrollment.
Pros of Obamacare Tennessee – Of course, even though there are these cons to Obamacare, that certainly doesn’t mean it is all bad. In fact, there are a number of great things that Obamacare has helped to bring about in the health insurance field. One of the biggest benefits is that insurance providers are no longer able to deny coverage to someone who has a preexisting condition. In addition, they can’t increase the premiums for someone just because they have a condition.
Another one of the benefits helps residents of Tennessee to pay for their coverage. Tax subsidies will help with the costs, and many individuals and families will qualify for them. The amount of subsidies you will receive will depend on your level of income as well as the number of people in your family.
Regardless of what you think about Obamacare, you will have to get coverage of some sort if you plan to comply with the law. Take the time to find a good plan during the open enrollment to get the coverage you need.
Obamacare Tennessee FAQ
If you are a resident of Tennessee and you don’t have Obamacare coverage yet, it might be due to the fact that you want to learn more about the system. You probably have a few questions that you would like answered before you sign up during the next open enrollment. Let’s look at some of the most common questions that people have when it comes to Obamacare so you can have a better idea of what you should expect.
Is Coverage Really Necessary? – In the past, having health insurance was a good idea, but it wasn’t required. Today, that’s different. Since the Affordable Care Act went into effect, it means that you need to have coverage that satisfies the Obamacare requirement. If you have Medicaid, CHIP, or coverage through your employer, then you do not need to go through the exchange for coverage. In addition, if you are specially exempt because you are a Native American or because of religious reasons, you will not have to get coverage. The majority of the people in the state will need coverage though.
What Happens If You Don’t Have Coverage? – One of the misconceptions that people had about Obamacare is the belief that if you don’t have insurance you will have to go to jail. That’s not the case. However, the IRS will impose penalties on you. The current penalties are quite high. They are $695 for adults (or 2.5% of their income) and $347.50 for children without coverage.
What Providers Are Available for Obamacare Tennessee? – In the state of Tennessee, Obamacare plans on the exchange are offered by just four different providers – Blue Cross Blue Shield of Tennessee, Humana, Cigna, and United Healthcare. Even though there are only four carriers in the state on the exchange, there are also providers who are off the exchange, but who still provide coverage that satisfies the Obamacare requirements. These other four companies are Tennessee Rural Health, United Healthcare Life Insurance Company, Aetna, and Freedom Life Insurance Company of America.
What Are the Essential Benefits? – No matter which provider and plan you choose, you will find that they are all going to offer at least the 10 essential benefits. The essential 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. Many of the plans will offer more than just these services, so it is always important to see exactly what your plan will feature.
Does Your Preexisting Condition Mean You Can’t Get Coverage? – One of the biggest problems with the health insurance system before these changes with Obamacare occurred was that many insurance companies would deny coverage, raise rates, and cancel coverage on people who had a preexisting condition or who developed a condition. The new law makes it so this is no longer possible. You can get the coverage you need.
These are some of the most commonly asked questions regarding Obamacare today. Make sure you have answers to all of your questions before you choose a plan.
Unique Aspects of Obamacare Tennessee
When the Affordable Care Act passed several years ago, it meant that everyone, in all states in the country, would be required to have health coverage. You will need to have a plan that is approved by Obamacare to provide you with the coverage needed to satisfy the law. This could be one of the programs available through the exchange, but it doesn’t have to be. Those who qualify for Medicaid, as well as those who have coverage through their employer or through another company that provides adequate care, would satisfy the law’s requirements.
No Expanded Medicare – There are 32 states in the country that decided to expand their Medicaid coverage, which would allow for more people to get onto Medicaid who might not be able to afford the cost of healthcare. 19 states chose not to expand Medicaid, and, unfortunately, Tennessee is one of those states. This means it is more difficult for many individuals and families to get help paying for their health coverage.
Limited Number of Providers – Each state has certain carriers that offer plans for their residents. In Tennessee, there are currently only four options when it comes to providers. This is smaller than it is in many states around the country. Residents in Tennessee who need Obamacare can check out the plans that are available from Blue Cross Blue Shield of Tennessee, Humana, Cigna, and United Healthcare. One company that had offered coverage last year is no longer available in Tennessee. Community Health Alliance shut down.
Regardless of the provider or plan that you choose, you are able to receive the essential benefits at a minimum. The essential 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.
Keep in mind that even though all of the plans contain these benefits, they may have a number of other features and offerings. When you are choosing your provider and plan for Obamacare in Tennessee, you will want to know everything that your plan does and does not include, so you can choose the one that makes the most sense for your needs.
In addition to the companies offering coverage through the exchange in Tennessee, there are four additional carriers that offer plans outside of the exchange. They include Tennessee Rural Health, United Healthcare Life Insurance Company, Aetna, and Freedom Life Insurance Company of America.
You Will Still Have Subsidies – One of the nice things about the Obamacare system is that many individuals and families will qualify for tax subsidies. There was concern that these subsidies might go away this year, but the Supreme Court ruled that the subsidies are legal in all states, including Tennessee. If this had not been approved, then Tennessee carriers would have had to resubmit their rates. There are many similarities in Obamacare in Tennessee and in other states. However, it is important for residents to understand the differences when it comes time to look for their plans.
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