Ask Emily is a biweekly column by Emily Bazar of the CHCF Center for Health Reporting, answering questions about the Affordable Care Act. Read all her columns at sacbee.com/askemily
Calling all procrastinators: Theres still time! Granted, I warned you in previous columns that Dec. 15 was the deadline to sign up for health insurance from Covered California or the open market if you want it to kick in Jan. 1.
But things have changed. You now have until Dec. 23 to enroll for Jan. 1.
For the extreme procrastinators among you, that isnt even the final deadline. This year and this year only the open-enrollment period lasts through March 2014. Please note, however, that the later you sign up, the later your health coverage begins.
I need to buy a health plan but make too much money to qualify for tax credits from Covered California. Should I still shop for a plan from Covered California or take my chances on the private market? Whats the difference?
Ive wondered the same thing.
Lets start with this important baseline fact: Here in California, insurers are required to offer the same plans with the same benefits, on our health insurance exchange Covered California as well as on the open market. And at the same price.
Assuming that you dont qualify for tax credits, which can be applied only to plans purchased through Covered California, that means youd be paying the same, full-cost price inside or outside Covered California for the same plan.
But you may have other options.
Some insurers might sell additional plans outside Covered California, says Charles Bacchi, executive vice president of the California Association of Health Plans.
Those plans still have to meet Obamacare coverage requirements, he says, but they may offer different benefits, such as other cost-sharing arrangements (lower or higher co-pays, out-of-pocket maximums and the like). Or some may offer more doctors and hospitals to choose from (the networks for some Covered California plans are limited). Such choices may affect plan prices.
Some regions might have different options than other regions, Bacchi says.
If you need help figuring out whats available on the private market, call the health plans directly. Or you may consider seeking the advice of an insurance agent who is certified and trained by Covered California. A certified agent can help you enroll in the exchange or the open market, and you wont pay extra for the help.
To find certified agents near you, visit CoveredCA.com.
My daughter, 30, is unemployed and lives with us. She has no income but is looking for work. Should she apply for Medi-Cal or a plan from the health insurance exchange? The Covered California application asks for household income, which would disqualify her from tax credits, based on my income.
Judging from the number of questions I receive from parents such as Steve in Azusa, many adult children are back at home with mom and dad out of necessity.
As Ive mentioned before, the Affordable Care Act relies heavily on our tax data to determine program eligibility and financial assistance. Thats where Steves question comes in. As he notes, the amount of tax credits youre eligible for rests on your household income.
So, whats household income?
In the case of an adult child living at home, it can be more complicated than you think. If you claim your child as a tax dependent, your income will count toward hers, even if shes unemployed and even if shes just applying for herself.
If (Steves daughter) is claimed as a dependent, then her income is the income of that tax filing, says Covered Californias Anne Gonzales. If she is not claimed as a dependent, then its her own income.
The same is true of Medi-Cal, which is public health insurance for low-income Californians.
Starting Jan. 1, Medi-Cal will broaden its eligibility requirements, raising the income threshold and opening the program to people who were previously ineligible, such as childless adults.
Again, if you claim your adult child as a tax dependent, your income will count toward your childs income for Medi-Cal eligibility purposes, says Tony Cava of the state Department of Health Care Services.
So what options are you left with? Perhaps not the ones you were hoping for: You could pay out-of-pocket for a plan. Theres also a catastrophic-coverage plan from Covered California for people under 30 (which your daughter may be too old for).
Please check with your tax preparer.
Questions for Emily: AskEmily@usc.edu
Learn more about Emily here .
The CHCF Center for Health Reporting partners with news organizations to cover California health policy. Located at the USC Annenberg School for Communication and Journalism , it is funded by the nonpartisan California HealthCare Foundation .
Questions for Emily: AskEmily@usc.edu.