Open Enrollment for 2015 health coverage begins Nov 15

Nebraskans will have the opportunity to purchase health insurance from the government’s Marketplace (healthcare.gov) starting Saturday, November 15 when Open Enrollment begins.  It is the first year of re-enrollment in Marketplace plans, and the time to sign up is shorter this year.

Open Enrollment runs from November 15 to February 15, 2015.  If you want to be covered on January 1, you have to be signed up by December 15.

New this year, the tax penalty for not having health insurance is much higher.  If you don’t get coverage in 2015, you’ll pay a penalty of either 2% of your income, or $325 per adult ($162.50 per child) — whichever is higher.

“You can keep your current marketplace coverage and not do anything,” said Matt Leonard, manager, Consumer Sales. “But we are encouraging our members who purchased on the marketplace to go back there to verify their information and double-check to make sure they’re getting the right amount of tax credit for 2015.”

BCBSNE members who elected to keep their health insurance plans from 2013 will be able to keep their plans again for 2015. They will be automatically re-enrolled unless they want to make a change or explore the Marketplace.

Consumers need to know:

  • Individual health insurance enrollment November 15 to February 15, 2015
  • Sign up by December 15 to be covered by January 1
  • The penalty for not having insurance is much higher in 2015
  • If you have received a tax credit, check to see if it is the right amount in 2015

HEALTH INSURANCE TERMS


COINSURANCE

The percentage of the bill you pay after your deductible has been met.

COPAY

A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 

DEDUCTIBLE

The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.

SUBSTANCE ABUSE DISORDER SERVICES

Includes behavioral health treatment, counseling, and psychotherapy


in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)

out-of-pocket

Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.

penalty

If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.

premium

The amount you pay to your health insurance company each month. 


Preventive services

Health care services that focus on the prevention of disease and health maintenance.

rehab SERVICES

Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).

specialist

A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.