ObamaCare Open Enrollment Questions Answered

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November 15 is the first day of Open Enrollment for Obamacare (Year II: Return of the Website). You might remember last year, when Obamacare had its big roll-out and the website was such a godawful mess that all anyone could talk about for months was how terrible it was. Well, it’s back — with promises that now, the site will actually work.

Open enrollment is the time period to get insurance for the next year. And, aside from the fact that insurance is a great idea if you plan to visit a gynecologist or any sort of doctor in the next year, it’s also mandatory. So, here’s everything you need to know, courtesy of healthcare correspondent and TurboTax blog contributor Lisa Zamosky.

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When does open enrollment start and how long does it last?
"Open enrollment starts Saturday, November 15 and goes through February 15. If you want to be covered by January 1, 2015, you need to sign up by December 15 — so get to work!

"Whatever you do, don’t miss the final deadline of February 15, though. Not only are you going to get a tax penalty, but you won’t be eligible for coverage again until 2016 (though there are some extenuating circumstances, like a major life change like losing your job, getting married, having a baby, or a couple others which you can find out about on the Healthcare.gov site)."

How do I actually do the sign-up thing?
"Start by shopping at Healthcare.gov, and from there you can get to your individual state marketplaces on separate sites. We’re told the site has a great new design that makes comparison shopping easier than ever."

What if I don’t want to?
"Well, these days, the law actually requires you to have health insurance — and if you don’t, you could be on the hook for a tax penalty. You can do the math yourself, but you’re better off buying insurance, and, you know, having medical coverage than paying the penalty.

"Last year, the penalty for not having insurance was $95 (or 1% of your income, depending on your personal finance situation). But, it’ll go up this year to 2%, or you might even end up being charged $325. That’s like, two months of healthcare coverage on some plans...which is why we’d recommend just biting the bullet.

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"Also, we’d like to remind you that the out of pocket cost of insurance is pennies compared to what you’d be on the hook for in the event of a major medical emergency, so even if it feels like daunting financially, it’s way less daunting than potential mounting medical bills will be if you’re caught uninsured."

Who benefits the most from Obamacare?
"This past year, young people between the ages of 19-34 got the most benefit from the new universal healthcare program. That’s because it dropped a lot of insurance payments to lower rates, making it more affordable for young people to protect themselves. It was also great for younger people because if you make below a certain amount of money, that means you might be eligible for a subsidy — meaning you pay very little out of pocket."

How do I know if I qualify for a subsidy?
"You have to go through the market and enter your income and personal information to find out. Lots of young people — especially if they’re just starting out — qualify, and you might be eligible for financial assistance, too."

I’m under 26 and I don’t have insurance. Do I have to sign up?

"Nope, so long as you’re covered under your parents’ insurance plan. Just check with mom and dad and make sure you’re still on their policy, and you should be good to go."

What do I get when I enroll?
"One of the things Obamacare did was standardize insurance plans so that every health care plan has to have certain ‘essential benefits’: maternity care, care for newborns, birth control (which the government picks up if your private health care policy does not), mental health and substance abuse services, and primary care coverage. "

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I’m a freelancer. What should I do?
"Get over to that open enrollment site, ASAP! This is basically tailor-made for the freelance (and underemployed) economy. Even if you don’t think you can afford it, check it out because the law offers subsidies for individuals with certain income levels in need of assistance. The whole point is that the government wants you to be insured, so they’ll subsidize individuals as-needed to make that happen."

I already enrolled last year. Do I have to do anything? "You do indeed. First of all, check back and see if there’s a more competitive market rate for your particular plan (that’s the whole point — coverage and competitive pricing!). Make sure to update your personal information (had a baby? Congrats! Enter that info) and financial information, since it’s going to affect your subsidy (possibly in a way that’s great for your savings account)."

Okay, okay, I’m sold. How much is this going to actually cost me?
"Bad news: The rates across the board nationally are increasing (although pretty moderately, to be fair). Great news: There are some markets where you’ll see some plans are actually going down. Generally, there’s just a lot of variation, so check on your individual state, or visit Healthcare.gov."

What’s the actual coverage like?
"There are different levels of plans, that are priced accordingly (but all contain the base essential care coverage). There are four basic levels, and they’re named by precious metals: bronze, silver, gold, and platinum.

"Bronze covers about 60% of your medical costs on average, while silver goes up to 70%, gold to 80%, and platinum to 90%. A good rule of thumb? Generally, the more you pay every month for your insurance, the less you spend when you actually have to go to a doctor or have an emergency. The less you pay every month, the higher the amount you’re probably going to have pay out of pocket until you meet your deductible. The law requires that plans cover preventative care (coughcoughannualpapsmearcough)."

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What’s is the catastrophe plan? "So, there is a level lower than silver for people under 30. The catastrophic plan (yep, it is called that) has a super-low cost on a monthly basis but a higher deductible — meaning you’re going to shell out a ton if, say, you have to have an emergency appendectomy, but insurance kicks in after a certain amount. If you’re healthy as a horse and never go to the doctor, then this might be an okay option for you, so ask a marketplace rep about the policy (seriously, they’re there to help you, so feel free to get someone on the phone to answers all your questions and guide you."

Anything else I need to know?
"It’s good to go into this knowing your rights: Women can’t be charged more than men, for example, and until you’re 64 you can’t be penalized for age through pricing either. You can get a surcharge for smoking though, and keep in mind that rates can vary by area.

"More than anything, it’s just good to keep in mind that the whole point of insurance is to set yourself up with a safety net. You wouldn’t walk across a tightrope hundreds of feet in the air without something to catch your fall: Insurance is the same exact thing. If you’re tight financially, there’s still something that’s going to fit your budget — and, at the end of the day, it’ll cost you way left to prevent a problem than to deal with one after the damage is done."

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