Open Enrollment for 2016 health coverage begins Nov 1

Nebraskans will have the opportunity to purchase health insurance from the government’s Marketplace (healthcare.gov) starting Sunday, November 1 when Open Enrollment begins.  This is the second year of re-enrollment in Marketplace plans under the Affordable Care Act.

Open Enrollment runs until January 31, 2016.  To receive coverage by January 1, 2016, Nebraskans must sign up by December 15, 2015.

“Nebraskans who haven’t bought insurance yet, about 176,000 of them, may not know they could qualify for a tax credit,” Matt Leonard, director, Blue Cross and Blue Shield of Nebraska said.  “The average tax credit in Nebraska last year was $257 a month. With penalties going up this year we want to help the uninsured get coverage so they won’t be surprised at tax time.”

The tax penalty for not having health insurance will double in 2016.  If you don’t get coverage, you’ll pay a penalty equaling the greater of 2.5 % of your income, or $695 per adult ($347.50 per child) with a cap of $2699 per family.

Nebraskans who purchased health insurance on the marketplace last year are encouraged to go back there to verify their information and double-check to make sure they’re getting the right amount of tax credit for 2016.

BCBSNE members who elected to keep their health insurance plans from 2013 will be able to keep their plans again for 2016. 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 1 to January 31, 2016
  •  The penalty for not having insurance doubles in 2016
  •  If you have received a tax credit, check to see if it is the right amount in 2016

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.