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Guest Opinion

Deadline approaches for insurance penalty

Sedona Red Rock News of Sedona, Arizona

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As the Monday, March 31, deadline for buying health insurance gets closer, I wanted to tell you about alternative ways to purchase a health plan — especially if you have a higher income.

Many lower-income Arizonans will qualify for lower costs on their coverage, but only if they purchase it through the Health InsuranceMarketplace, at the government website.

However, if you're not eligible for lower costs, you can buy health coverage through an insurance company, an agent or broker or an online insurance seller as well as the website.

Eligibility for lower costs on health coverage is based on your income and household, size. Generally, you won't qualify if your estimated 2014 income is above $45,960 for an individual. For a family of four, the income cutoff is $94,200. If you don't qualify for lower costs based on your income, you can get coverage in one of the following ways:

Directly from an insurance company. You can contact any health insurance company and see plans available in your area. Many have websites that let you compare all plans available from that company.

With the help of an insurance agent or broker. Agents generally work for a single health insurance company. Brokers generally sell plans from a number of companies. They can help you compare plans based on features and price and complete your enrollment. You don't pay more by using an agent or broker since they're generally paid by the insurance company whose plans they sell.

From an online health insurance seller. These services offer health insurance plans from a number of insurance companies. They let you compare prices and features and then enroll with the insurance company.

Through the Health Insurance Marketplace. You can apply and enroll through the Health Insurance Marketplace website whether or not you qualify for lower costs based on your income.

No matter how you buy them, health insurance plans generally offer the same set of essential health benefits, free preventive services, coverage for preexisting conditions and other rights and protections under the Affordable Care Act.

Most plans available outside the Marketplace meet the requirement to provide adequate coverage under the ACA. This means you won't have to pay the penalty that some people must pay if they don't have coverage in 2014.

But keep in mind that not all plans you buy outside the Marketplace meet the adequacy requirement.

Most insurers must tell you if the plan you're buying qualifies as coverage under the ACA. Be sure to ask.

Even outside the Marketplace, open enrollment ends March 31.

After open enrollment ends, generally the only way you can buy a health insurance plan is if you have a qualifying life event that gives you a special enrollment period.

That's true whether you buy your health insurance through the Marketplace or other ways.

David Sayen is Medicare's regional administrator for Arizona, California, Hawaii, Nevada and the Pacific Territories.

Copyright 2014 Sedona Red Rock News, Sedona, Arizona. All Rights Reserved. This content, including derivations, may not be stored or distributed in any manner, disseminated, published, broadcast, rewritten or reproduced without express, written consent from SmallTownPapers, Inc.

Original Publication Date: February 26, 2014

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