Obamacare, officially known as the Affordable Care Act (ACA), was signed into effect nationwide in 2010 and enforcement began in 2014. The intent of Obamacare was to increase access to healthcare through expanding Medicaid programs, protecting consumers from being discriminated against due to pre-existing health conditions, opening a regulated Marketplace to shop for cost-efficient health insurance options, and requiring all U.S. citizens to have minimum health insurance coverage.
Obamacare’s Effect on Rhode Island Health Insurance
Rhode Island has been successful in implementing the strategies of the Affordable Care Act requested from the states, including a state exchange and Medicaid expansion. From those efforts, Rhode Island has been able to decrease their uninsured rate to one of the lowest in the nation at 5.6%.
What Rhode Island Residents Should Know About Obamacare in Rhode Island
The Pros and Cons of Rhode Island Obamacare
Rhode Island Obamacare has made health insurance coverage available to thousands that could not previously afford care. The state is also successful in managing expenses related to coverage. As a result, health insurance companies are requesting a small rate increase or in some instances, a decrease. Finally, Obamacare in Rhode Island has successfully eliminated denial of care based on pre-existing conditions and has disabled Rhode Island companies from charging a higher premium based on race or gender.
There are criticisms about Obamacare in Rhode Island on the lack of options available through the exchange. With UnitedHealthcare leaving the state market at the end of 2016, that will only leave two available options to select. Fortunately, United only had a small market share so their exit will have a small impact.
Apply for Obamacare: Health Plans and How Much You Will Pay
When shopping in the Rhode Island Obamacare Marketplace, you will find four primary health plans categories to choose from: Bronze, Silver, Gold, and Platinum. The categories determine the percentage of healthcare costs that the plan will pay for over a course of a year. The remaining percentage is what you will be expected to pay. Rhode Island is the only state that has standardized what is offered at each plan level.
These percentage differences greatly impact how much you may expect to pay on care. Think about it this way: If the bronze plan pays for 60% of a benefit, then as the patient, you can expect to pay for the remaining 40%. While this plan will cost you less monthly, it leaves you financially responsible for a larger dollar amount than a platinum plan, which pays for 90% of a benefit.
Here are the different kinds of Obamacare plans as well as the average amount of healthcare services each plan pays for:
- Bronze plan - 60%
- Silver plan - 70%
- Gold plan - 80%
- Platinum plan - 90%
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How Do I Sign Up For Obamacare In Rhode Island?
You can get Rhode Island Obamacare quotes and sign up for Obamacare plans through the Rhode Island Obamacare Marketplace. This Marketplace can be accessed through the federal website, healthcare.gov, or by calling (800) 318-2596.
What Are The Obamacare Marketplace And Exchange?
The Marketplace is a central location to shop for insurance options and enroll for selected coverage. In the case of Obamacare, Rhode Island utilizes a State-Facilitated Marketplace, Health Source RI, which operates and manages the Marketplace where public health insurance plans are offered.
Do I Need To Use An Exchange?
To access public health insurance, you will need to go through the government exchange. The only exception to personally using the exchange to sign-up for Obamacare in Rhode Island is if you are able to seek help from a Rhode Island certified counselor or a private insurance agent who can discuss your options and select a plan, on your behalf, through the exchange.
How Do I Use The Obamacare Exchange In Rhode Island?
You can use the exchange in one of four ways:
- Visit healthcare.gov
- Use the telephone support assistance available by calling (888) 975-1142
- Find a local certified counselor
- Seek help from a private insurance agent
What Does It Mean To Be On-Exchange Or Off-Exchange?
On-exchange generally refers to purchasing public health insurance from the Obamacare Rhode Island Marketplace while off-exchange refers to purchasing private health insurance coverage from a private company or marketplace.
When Is The Obamacare Enrollment Deadline And What Do I Do If I Missed It?
The Obamacare open enrollment period for 2017 in Rhode Island is from November 1, 2016 until January 31, 2017. If you miss enrollment, you would need to qualify for a special enrollment period due to a qualifying life event or purchase short term individual private insurance to avoid a health insurance penalty.
What Is The Obamacare Penalty If I Don’t Buy Health Insurance?
If you do not enroll in Obamacare or another qualifying health plan (also referred to as “minimum essential coverage”) you will be subject to a tax penalty for each month you go without coverage. This fee should be paid when you file your federal tax return. In some special cases, there are exemptions to this penalty.
The Obamacare penalty for 2016 is either 1) 2.5% of your household income, with a maximum of the price of a Bronze plan sold through the Marketplace, or 2) $695 per adult and $347.50 per child under 18 years of age with a maximum of $2,085. You will pay whichever of the two options is higher.
The Obamacare penalty for 2017 is fairly similar to 2016 with the percentage fee of 2.5% remaining the same, however, the flat fee will be adjusted for inflation.
What If I Cannot Afford Obamacare?
If you cannot afford to pay for Obamacare coverage, you may be able to qualify for a government subsidy. For more information on government subsidies, visit the Health Source RI website.
What are the alternatives to Obamacare Insurance in Rhode Island?
Any health insurance coverage that meets the minimum essential coverage, as set forth in the Affordable Care Act, can be used, whether this coverage is received through an employer, private insurance company, or purchased through a private exchange.
There are several alternatives available when selecting coverage. You can select one of the available alternatives on Health Source RI, purchase one of the many options available on the private exchange, or see if you are eligible for subsidized programs through Rhode Island’s Medicaid program.