Despite early promises from President Obama that buying affordable insurance would soon be as simple as shopping on Amazon, the process of selecting a health-care provider is more than just a matter of picking and clicking. Plans, premiums and out-of-pocket expenses under Obamacare vary greatly from state-to-state and person-to-person, depending on factors like household size, annual income and employment. The confusion could help explain why approximately 420,000 people–about 16% of the population–are currently still uninsured in Brooklyn.
The time has come, however, to pick a provider if you haven’t already because everyone is now legally required to have health care of some kind under the Affordable Care Act–be it Medicaid, an employer health plan or insurance you’ve purchased on your own through a marketplace exchange or private company. Those without coverage, with few exceptions, will face a federal penalty equivalent to either 1% of their annual income or $95, whichever is more, when filing this year’s income tax return.
So if you still need insurance, it’s not too late to avoid an IRS fine and find a provider for 2014. To help you get started, we’ve compiled a list of basic info on two local coverage options still accepting applicants before this year’s open enrollment ends on March 31, as well as a couple of alternatives to insurance for health-care holdouts.
U.S. citizens, nationals and legal immigrants living in New York and not currently incarcerated, as well as small businesses with 50 employees or less, are eligible to enroll in New York State’s official health insurance marketplace, which was developed with $368 million in federal grant money through Obamacare. Here you can check to see if you qualify for programs like Medicaid; figure out what, if any, financial assistance you’re eligible to receive; or buy low-cost insurance by comparing various coverage plans at one time. Want someone to walk you through the process? You can get free help in person or over the phone, find a certified marketplace professional to hire, or authorize a friend, partner or lawyer to represent you in the enrollment process.
Important deadlines: March 15 is the deadline for individuals and families looking for coverage starting April 1 (the last day for individuals to show proof of insurance without being penalized), and March 31 is the deadline for small business employers or employees looking for coverage starting May 1. After March 31, open enrollment is over until January 2015.
Coverage options: Broken down by metal tiers–bronze, silver gold and platinum, with platinum being the highest monthly premium and lowest co-pay–all health-care plans offer the same essential services: doctor’s office visits, emergency services, hospital care, pre- and postnatal care, mental health and addiction treatment, prescription drugs, rehab and skill-development services and devices, lab services, prevention/wellness/long-lasting disease management, children’s dental and vision care. Some offer additional services, like adult vision and dental coverage as well.
Pricing: Use the Tax Credit and Premium Estimator to get an approximation of your plan pricing and possible tax rebates.
What you need to apply: New York State of Health estimates it takes approximately 45–60 minutes to apply either online or over the phone. Make sure you have your Social Security numbers (or document numbers for legal immigrants who need health insurance), birth dates, employer and income information for everyone in your family, policy numbers for any current health insurance and information about any health coverage available to your family.
You don’t need to be a member of the Freelancers Union, but you do have to be self-employed to enroll in its health-care system. FIC is open to independent workers living in Albany, Bronx, Clinton, Columbia, Delaware, Dutchess, Essex, Fulton, Greene, Kings, Montgomery, Nassau, New York, Orange, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Suffolk, Sullivan, Ulster, Warren, Washington, Westchester counties.
Important deadlines: Enrollment packets must be sent by March 22 to begin coverage by April 1. After March 31, open enrollment is closed until fall 2014.
Coverage Options: FIC also breaks its coverage plans down into the same four metal categories as the state marketplace with the same essential services being provided through its partnership with BlueCard PPO. In addition to the essentials, it also provides wellness services like yoga, tai chi, acupuncture and personal-health coaching at either of its Freelancers Medical locations in Brooklyn or Manhattan. Vision (provided by Davis Vision) and child dental coverage are also included.
There is a $0 co-pay for primary care, urgent care, sick visits and wellness services at Freelancers Medical’s Brooklyn and Manhattan locations. Deductibles and co-pays apply for emergency room visits, prescriptions, specialists visits and primary care visits outside of its Freelancers Medical locations and vary depending on your metal tier.
Pricing: The monthly premium for FIC Bronze plans start at $471, with an annual deductible of $6,350/individual and $12,700/family; FIC Silver plans start at $548.19, with an annual deductible of $3,500/individual or $7,000/family; FIC Gold plans start at $688.22, with an annual deductible of $700/individual or $1,400/ family; and FIC Platinum plans start at $799 (no deductible).
What you need to apply: Fill out the enrollment form and submit your first month’s premium with your mailed application.
If you don’t make the enrollment deadlines for either of the above coverage options, or simply don’t want to sign up for health insurance, you can still get affordable medical attention at an urgent care center like CityMD, which charges $125 in cash for uninsured visits and accepts walk-ins. Its board-certified physicians can cover a long list of non-life-threatening health issues faster and cheaper than a trip to the ER. Currently there is one location in Boerum Hill with six more Brooklyn centers slated to open soon.
Either option is a more feasible alternative to knocking on wood.