Photo by Cristiano Betta, from Flickr’s The Commons.
The clock is ticking folks — and no, we don’t mean the countdown to Christmas. Those people who are not insured or had their current health insurance canceled and don’t want to go with the default plan recommended by their insurance company have until Dec. 23 to enroll in a new plan, if they want it to start Jan. 1.
Luckily for those in Washington, the website used to enroll in government-subsidized insurance plans and Medicaid is working, at least most of the time. And the government exchange site isn’t the only option for buying insurance — there’s also an individual market outside of the exchange.
But even if the websites work, the truth is that buying health insurance can be overwhelming and confusing. So we’ve distilled the process down to five steps to help get you through it.
1. Figure out if you are eligible for a tax subsidy.
Depending on your income and household size, you could be eligible for a tax subsidy under the Affordable Care Act. To figure this out, go to Washington Healthplanfinder, the state’s insurance exchange, or use a calculator on a site like the Kaiser Family Foundation. The subsidies are available to those earning up to four times the federal poverty line. For an individual, that’s roughly $45,000 a year.
And be careful about what you’re using as your income. The subsidies are based on your Modified Adjusted Gross Income (MAGI), which includes wages, tips, taxable income, ordinary dividends, unemployment benefits, alimony, etc. minus a variety of deductions such as student loan interest, health savings account deductions, some self-employed expenses and other items. (Check out this great fact sheet from University of California Berkeley for more information on MAGI.)
If you are eligible for a subsidy, you should buy your insurance from the exchange because your premiums will be lower. Also, catastrophic plans are available only through the exchange, though they’re limited to people under age 30 and those with certain financial exemptions. And plans on the exchange are likely to be cheaper because they often include coverage for fewer doctors and hospitals.
If you’re not getting a subsidy and want more doctors included in your plan, you might as well buy it outside of the exchange where there are more options.
2. Find a good insurance broker.