What is Health Care Reform?
How has health care reform changed things?
Most people are required to have health insurance as part of the ACA’s individual mandate. You can purchase a health plan during the annual open enrollment period established by the law. You may be eligible to purchase health insurance outside of the open enrollment period if you have a qualifying event, such as having a baby, getting married, or moving to a new county. Additionally, a subsidy is available to help pay the cost of a health plan for those that qualify.
We can help you compare, buy and enroll in a plan that fits your budget and your needs. You can buy a Florida Blue health plan starting October 1, 2015. If you qualify for a premium tax credit, also called a ‘subsidy’, starting November 1, 2015 you can enroll in a Florida Blue subsidy-eligible plan. The last day you can enroll in a health plan for 2016 coverage is January 31, unless you qualify for a special enrollment.
What is health insurance?
Health insurance pays part of the medical cost when you need it. You pay every month for the peace of mind knowing if you need unexpected medical care then you aren’t responsible for paying the whole cost of the bill. But, you may have to pay a deductible. After the deductible is met, health insurance pays for most of the cost for medical care, such as doctor or hospital visits, prescription drugs, tests, maternity care and other health services you may need.
Health care plans also have wellness (or preventive) services to help keep you healthy at no additional cost. This includes visits such as annual checkups, mammograms and vaccines.
Likely Costs for Essential Health Benefits
Are there different kinds of plans to choose from?
If you get your insurance directly from Florida Blue or as an employer of a small business, rather than through a large employer or a government program, it will fall into one of four metal levels. These categories are based on gold and platinum plans paying for more of your medical care than bronze or silver plans. Your choice determines your monthly premium and how much of the bill you pay for services such as hospital visits or prescriptions. It also affects your total out-of-pocket costs – the total amount you spend in a year if you need care.
We offer plans that are approved by the Federal Government that include comprehensive coverage and health care support for every stage of your life. We are here to help you choose a plan that is right for your lifestyle and situation. We can walk you through buying a Florida Blue plan on the Marketplace and qualifying for financial assistance, or help you buy a plan directly through Florida Blue.
All plans offer the same essential health benefits, but the out-of-pocket cost and monthly premium differs with each plan.
What doctors can I see?
Your plan offers a network of local doctors in the community and throughout Florida. Certain plans allow you to see doctors offered by Blue plans in other states as well. It is important to enroll in a health plan that includes your doctor(s) or you will pay more to see doctors that are not in the network. To find whether a plan includes your doctor, use our searchable provider directory or talk to a Florida Blue agent.
Other reasons your subsidy may change
Each year the amount you qualify for can change. The amount of your subsidy is based on the combination of several things: your most recent household income available to the Marketplace, the cost of plans available to you in your area and the government’s Federal Poverty Level (FPL) income tables.
The Marketplace uses your verified household income from the most recent of:
- your most recent 2015 Marketplace application
- your 2014 tax return information, or
- your 2014 Marketplace application