Resolution: Double-check health coverage

If you're starting 2015 with new health insurance,  congratulations.  We just learned that about 110,000 North Carolinians used the federal marketplace to buy new policies that take effect Jan. 1.  Almost 140,000 others who already had coverage through the Affordable Care Act went to by Dec. 15 to either renew that plan or select a new one for 2015.

For those who procrastinated,  there are six more weeks to sign up and/or compare options.  The numbers suggest that tens of thousands in this state simply let their 2014 policies renew.  That may bring a bigger bill in January,  but it's not too late to switch.  You can still shop around and make a new choice that will be effective in February or March.

"We know from past experience that people don't like shopping for insurance and inertia takes over,"  said Adam Linker,  health policy analyst for the N.C. Justice Center.

Linker notes that unlike last year,  when choices were final,  this year's rules allow changes up to Feb. 15 even if you already made a 2015 selection.  He suggests using the next six weeks to call your doctors and check with your preferred hospitals to make sure they're in the network for your plan.  Even if you checked when you were buying,  there can be hiccups and last-minute changes.  It's better to discover them while you still have options than when you're sick and stuck.

Carolinas HealthCare offers insurance aid

Carolinas HealthCare System is still offering financial aid to help some low-income patients pay insurance premiums for 2015.

As I reported recently, the system has launched a new program to help people whose income falls between 100 percent and 250 percent of the poverty level buy health insurance on the Affordable Care Act marketplace without facing high deductibles.  Dec. 15 was the deadline for getting covered by Jan. 1, but the program continues until open enrollment ends Feb. 15.

"We have helped close to 400 people get insurance at no charge to the insured,"  Pardon Dexter,  one of the private insurance consultants working with CHS on sign-ups,  said last week.  "The government subsidy usually covers about 50 percent to 80 percent of the cost and the Carolinas Healthcare Foundation is picking up the rest. In many situations,  the gross premium is $600 per month;  the government subsidy is around $400 and then the foundation pays the remaining $200."

When the marketplace debuted in 2014,  many low-income families opted for lower-priced policies with higher deductibles and other out-of-pocket costs.  As Dexter noted,  if you're making around $20,000 a year,  paying $200 a month is still  "like Mount Everest."  But the prospect of paying hundreds or even thousands of dollars out of pocket means those families either skip medical care or run up debt they can't pay.  And that means neither the patients nor CHS doctors and hospitals reap the intended benefit of the ACA.

"This is a great community service that the foundation is providing and I can tell you without a doubt that most of the people we are helping would not be able to afford their coverage if they did not get financial assistance from both the federal government and the CHS Foundation,"  Dexter said.

The income range for foundation aid depends on household size. It ranges from $11,760 to $29,175 for an individual,  and from $23,850 to $59,625 for a family of four  (check info for other households here).  People earning up to 400 percent of the poverty level can still get federal subsidies,  even though the foundation won't kick in.

The CHS Registration Center at Morehead Street and Kings Drive takes walk-ins from 8 a.m.  to 5 p.m.  Mondays,  Wednesdays and Fridays and from 10 a.m.  to 7 p.m.  Tuesdays and Thursdays.  For information about premium assistance or to make an appointment, call 704-446-6150. 

Read more here:

Reader needs more time for tough choice

The deadline to make decisions about Jan. 1 coverage on the Affordable Care Act exchange is almost here.  A Gaston County reader wants to know if he can take more time,  even if it means he misses the Dec. 15 date and has to make a second switch early in 2015.

"I have been trying to compare plans and am running out of time,"  he wrote Thursday.

The answer is yes.  No decision by Dec. 15 means an existing policy automatically renews,  but enrollment on the exchange remains open through Feb. 15.  Customers can start the year with their auto-renew policies and switch in February  (if they make a new choice by Jan. 15)  or March.

This reader,  who asked not to be named,  illustrates why it's so complex.  He had a pre-Obamacare policy with Blue Cross and Blue Shield of North Carolina that he liked,  and he kept it as a grandfathered plan in 2014.

In October he got a notice that his monthly payment would rise from $745 to $1,360,  an 83 percent hike.  It turned out he was among 42,000 North Carolinians who got erroneous notices from Blue Cross,  but his corrected rate of $1,062 was still up 43 percent.  That motivated him to delve into the exchange,  which offers 41 plans for Gaston County residents.  Choosing the right one means not only looking at the premium but at the out-of-pocket costs and the network of doctors and hospitals available under each plan.  He's also trying to figure out whether he qualifies for the federal tax credits.

"I would like more time to evaluate the options," he said.

Anyone who makes a switch,  before or after Dec. 15,  should remember the Kaiser Family Foundation's tips to avoid double-billing:  Cancel your old policy after you've received confirmation of coverage on the new one.  Then keep an eye on your credit card or bank statement to make sure the old payment goes away.

Madison Hardee of Legal Services of Southern Piedmont,  my go-to resource for things related to the exchange,  adds this helpful note:  "When completing the application, the marketplace asks if you will be losing coverage in the next 60 days.  If so,  it asks you to provide the date you will lose coverage.  If you are dropping your current plan and answer this question,  you should indicate the last day you will have coverage,  rather than the first day you will be without coverage.  For example, consumers who are dropping their current plan and enrolling in a new plan for 2015 by the Dec.  15 deadline should enter 12/31/14 as their last day of coverage in order for coverage in their new plan to become effective on Jan. 1. If a consumer enters 1/1/15 as the first day they do not have coverage, instead of 12/31/14, he or she will receive a Feb. 1 effective date for the new marketplace plan."

Obama riffs on Obamacare

If you missed the president's appearance on The Colbert Report earlier this week,  it's worth watching the video.  With so many other people taking shots at Obamacare,  why not give President Obama a crack at it?

The set-up is that Obama is exercising his power to take over Stephen Colbert's  "The Word" segment.  "There are things that people of both parties actually like about Obamacare,"  Obama says,  ostensibly reading Colbert's lines,  as the written commentary adds "Everything but the 'Obama.'  "

As usual,  the side notes make the jokes,  but the president has a pretty good delivery  (I could swear he even nailed some of Colbert's mannerisms and expressions).

Don't delay: Missing this click could cost big bucks

If you've bought subsidized health insurance on the federal exchange, you could be in for a shock in January if you failed to click one button, according to a reminder from Blue Cross and Blue Shield of North Carolina:

"If they haven’t checked the box on giving the site access to their tax information, they could lose their subsidy and end up with a bill for their full premium for Jan. 1. They can fix this in January, but the subsidy won’t be retroactively applied  –  which could cost them hundreds of dollars."

You have five days  --  until the Dec. 15 deadline for making changes effective Jan. 1  --  to make sure you've covered this base.  This applies to people who are continuing 2014 coverage and those who have bought for the first time in 2015  (and of course it applies to people who chose Coventry or UnitedHealthcare plans as well as Blue Cross).

A couple more reminders from Blue Cross for people who got policies in 2014:  If you don't update your information to calculate a 2015 subsidy,  the 2014 information will carry over.  If the 2015 subsidy would be lower,  that means you're paying more than you need to.

And if you do nothing by Dec. 15,  your policy will continue,  but this kind of  "passive renewal"  can lead to delays issuing ID cards and customer materials.

All this is in addition to what journalists and insurance experts have been saying for weeks:  Log on to see if there's a better deal than your current policy  (remember that you need to look at physician networks and out-of-pocket costs as well as premiums).  Switching may seem like a hassle,  but defaulting to last year's choice can be costly.

Carolinas HealthCare adds ACA sign-up center

If you're looking for help buying or renewing health insurance on the federal marketplace,  add Carolinas HealthCare System to the list of options.  There's a new enrollment center at the site of a former ABC store at Morehead Street and Kings Drive.

Dr. Roger Ray, chief physician executive for CHS, said the system is learning along with the patients.  And one of the big lessons from Year 1 of the Affordable Care Act is that not all insurance is good insurance.

Too often,  he and other CHS officials say,  low-income customers who got subsidies on the exchange used them to buy low-cost,  low-benefit bronze plans.  They ended up paying little or nothing in monthly premiums,  but had such high deductibles that they avoided going to the doctor,  or went and incurred bills they couldn't pay.

"We find them newly interested and newly confused,"  Ray says of patients who have little experience with health insurance.  "We need them to have access to the right care.  Ultimately we want them to do well."

CHS chose the site in hopes of attracting walk-ins,  as well as about 1,000 patients who have been encouraged to come for help. And the Carolinas HealthCare Foundation is providing money to supplement government subsidies so that some low-income patients can pay nothing for their premiums. The goal is to get them to choose a better plan,  with government aid covering all or most of their out-of-pocket costs.  To be eligible for that aid,  people have to fall between 100 percent and 250 percent of the federal poverty level  --  $11,760 to $29,175 for one person,  $19,790 to $49,475 for a family of three.

Brokers from Dexter Insurance Associates and Group Benefit Services staff the CHS center to help customers select a plan.

The center is open from 8 a.m.  to 5 p.m.  Mondays,  Wednesdays and Fridays and from 10 a.m.  to 7 p.m.  Tuesdays and Thursdays.  The CHS marketplace hotline,  866-412-0000,  takes calls from 9 a.m.  to 8 p.m.  weekdays.

Novant Health doesn't have an enrollment center or provide financial assistance to supplement the tax credits,  but it is helping patients check their eligibility for ACA coverage.  Click here for more information,  call 704-384-0539 to speak to a Novant counselor or attend an enrollment event in January and February.

If you want coverage that takes effect Jan. 1,  though,  remember that you have to make your selection by Dec. 15 and pay your first premium by Dec. 31.  That applies to first-timers on the exchange as well as people who have a 2014 policy but want to make changes.

PolitiFact on Obamacare, immigrants and death squads

Does the Affordable Care Act give employers a $3,000 incentive to hire illegal immigrants?  The Tampa Bay Times' delved into the claim that's circulating in conservative circles.  The conclusion:  It could,  though the scenario to make that happen is highly unlikely.

Reporter Lauren Carroll details the way the act's employer mandate could penalize large employers that drop employee health insurance.  Because the penalty kicks in if even one employee qualifies for subsidized insurance on the exchange,  and because illegal immigrants aren't eligible for those subsidies,  a business could hypothetically duck that penalty by hiring only illegal immigrants, Carroll reports.

"The claim isn’t so much inaccurate as it is speculative,"  she concludes.

Or as University of Virginia health law professor Margaret Riley puts it,  "It is offered more as another argument against the employer mandate than as something that employers might actually try." 

The ACA has given fact-checkers plenty of fodder for serious analysis,  but PolitiFact's roundup of November's most popular reports includes one that's mostly good for a laugh:  That an 86-year-old woman has been executed on orders from an Obamacare death panel.  As a reasonable person might guess,  that item originated on a satire site and has been circulated by the gullible and the cynical.  If the content isn't enough to spark skepticism,  PolitiFact notes,  the name of the  "victim"  should be:  Dorothy Zborknak was Bea Arthur's character on the sitcom  "The Golden Girls."

"We ruled on this topic five years ago, but we’ll repeat it again:  Death squads are not a part of the Affordable Care Act,  and you can still catch Dorothy on Golden Girls reruns most nights,"  wrote Lauren Burns.  "We rate this claim Pants on Fire!"

Congresswoman's first speech lauds Obamacare

Newly elected Congresswoman Alma Adams,  who took over the 12th district seat vacated by Mel Watt,  made her first speech on the House floor Wednesday and used it to praise the Affordable Care Act.

"Through the Affordable Care Act 208,000 individuals in my congressional district now have access to health insurance,"  Adams said,  referring to a mostly-urban zone that snakes through Charlotte,  Greensboro and Winston-Salem.  "The Affordable Care Act has also had a dramatic effect on unemployment,  creating 9.6 million private sector jobs.  My congressional district’s unemployment rate is 13.9 percent,  so for me this is not only about health,  but jobs and our economy."

Adams,  a Democrat from Greensboro,  was sworn in Nov. 12.  Most who won seats in the Nov. 4 election won't take office until Jan. 3,  but Adams is filling a gap left when Watt resigned early this year to become director of the Federal Housing Finance Agency.

The ACA,  often dubbed Obamacare,  is likely to be a hot topic as the GOP takes a majority of the U.S. Senate,  as well as the House.  Many Republicans,  including Senator-elect Thom Tillis of Mecklenburg County,  made opposition to the act a theme in their campaigns.

Adams got a jump on the debate:  "I urge my colleagues on the other side of the aisle to end talks of repeal and instead work with Democrats to strengthen the law to provide even greater access to health insurance."  She also called on state lawmakers to reconsider their  "purely political decision"  to reject Medicaid expansion.  The Kaiser Family Foundation estimates that 319,000 North Carolina adults who would have been covered by the expansion remain without access to government insurance or subsidies that would help them afford private policies. 

Just moved? You can buy health insurance

Susan Barbee,  who moved to Charlotte from California in February,  called to ask if she has lived here long enough to buy health insurance on the federal marketplace.  She still has her car registered in California,  and wondered if she needed to switch that before she can get insurance here.

There's no waiting period,  and paperwork on a car shouldn't be an issue.  Newcomers can buy insurance in their new market as soon as they move; all that's needed is a permanent home address  (read more here).

In fact,  Barbee didn't need to wait until 2015 open enrollment started last month.  Any time you move into a new market  --  and that can mean simply crossing county lines  --  you're eligible to apply for a subsidy and buy insurance on the Affordable Care Act exchange. Once you've bought insurance,  be sure to go back to and enter your new address if you move;  it may change your options.

Meanwhile,  the clock is ticking for 2015.  Dec. 15 is the deadline to select coverage that takes effect on Jan. 1.  That includes not just first-time buyers but people who want to make changes to their 2014 policies.  I've reported before that it's smart for everyone who already has a policy to check out the new options;  read more about the hazards of health-insurance inertia from the New Yorker's James Surowiecki.
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