It’s that time of year again, the time when we need to consider where we are with our health insurance in Texas. We are nearing the end of open enrollment, and to begin your insurance on January 1st, your deadline is December 15th. While you still have until January 15th, it is best to enroll sooner rather than later. You can apply through the Marketplace online, through a certified insurance broker or provider, or via a Marketplace Call Center. If the phone does not suit you, there is also a mail-in option. Through all examples, there is a process to follow. You may wonder why you need to show certain documents to enroll in Obamacare.
What is Obamacare?
Obamacare, or by its official name, the Affordable Care Act, is a method for Americans to obtain health insurance for their families. While many find health insurance in Texas through their employer, some receive coverage through government assistance like Medicaid or, as we spoke of earlier, through an insurance provider. The once mandate no longer exists, except in a handful of states, but Texas is not one of them. You are not penalized for not carrying health insurance in Austin, but it is still wise to purchase a plan to relieve the burden of the costs associated with a doctor visit or health emergency.
Each year during the Open Enrollment Period (OEP), there will be no health penalties, and anyone can sign up. No one is denied coverage. The cost will be determined by your plan selection, family size, age, and part of the state you live in. While health does not play a role in your premium, being a smoker will.
Are There Qualifications for Affordable Care Act Health Insurance in Texas?
Sometimes an applicant will be asked to submit further documentation for their application. There are often deadlines for submitting these documents, and to ignore a request could mean denying an application or if you already have coverage, a suspension of your coverage.
The purpose of the request is twofold:
• To ensure you get the coverage best suited to your need – You never want to leave a benefit on the table. When you submit all your information and it is thoroughly checked, you may be entitled to additional benefits you may not be aware of.
• To avoid a tax penalty at the end of the year. – Then there is the flip side of the coin. When you over-guess or have changes during the year, like someone on your policy becomes ineligible, and you continue to receive benefits, at the end of the year you would need to repay what you were overpaid.
It is always best to be as thorough as possible when you submit your Affordable Care Act application. But occasionally, applications are sent back to the applicant requesting certain documents to complete your enrollment in Obamacare. Among these documents you may be asked to submit would:
• Confirm citizenship: Documents like a driver’s license, U.S. passport, Certificate of Naturalization, Certificate of Citizenship, or tribal documentation. If one does not have one of these, one can submit two of these:
o Birth certificate
o Adoption decree
o Clinic medical record of birth
o U.S. health insurance record of birth
o Census record showing birth date
o Foreign birth record showing birth date
• Verify income: This can be your tax statement (Form 1040), a pay stub, a wage statement such as a W2 or 1099, or a Social Security statement. All forms of income must have your full name, income amount, current pay period, and, if applicable, employer name and income adjustments.
• Confirm Adoption status/Court order: Other documents that can be requested of you will be adoption or foster care papers. Child support or court order documents and legal guardianship paperwork. Medical support orders and the date the support was to begin.
• Prove no coverage elsewhere: Occasionally, you will be requested to submit documentation that you do not qualify for or carry other insurance through programs like Medicaid, CHIP, Tricare, or other sources of insurance like through a spouse’s employer.
Always be prepared the first time you apply. It is better to go in and not need it than not to have the records, be denied, then go and hunt for them and risk missing a deadline and finding yourself without coverage. In today’s day and age, keeping all your financials and personal records filed for quick access is beneficial. This helps you for any situation, Obamacare health insurance or even for tax purposes.
Do I Need to Reapply for Obamacare Health Insurance Every Year?
Every year you hear the media buzzing about Open Enrollment for health insurance in Texas, and that time is running out. The question you may have is when you currently have health insurance through the Affordable Care Act, do you need to reapply and show your documents again to enroll in Obamacare?
There are only a handful of reasons you would need to speak to your insurance representative. For the most part, if you are already enrolled, your ACA health insurance plan will roll over and continue into the following year. You have until December 15 to change plans before you are automatically reenrolled. You can visit the Marketplace website to review your selections and approve or update your information. You will want to make updates if there are any changes in these categories:
• Where you live – If you move. Insurance rates can vary depending on where you live in the state. This can save you money if you move to a lower-rated part of the state. It also costs you money because, at the end of the year, when you file your taxes and report your move, you will be required to pay back the difference from when your change took place. This could prove quite costly.
• Family status – Did someone get married or divorced, or was there a birth in the family? Did someone pass away? Remember above that if these events occur, you must submit documentation. This can affect your Obamacare rates for the following year.
• Job-status – Did you lose your job, take a pay cut, or were promoted or receive a raise? A cut in pay or a job loss does not always mean it makes your insurance unaffordable. Review your policy; it could put you in a position to qualify for Medicaid. You can also be eligible for the Premium Tax Credit, which can help you save money on your insurance premium.
• Home dynamic – Were there any adoptions, or did someone move into your home? This can also qualify you financially for a premium tax credit. On the other side of the coin, did someone move out? Who lives in your home must always be documented when you enroll in Obamacare. This must be included in updates each year. This can go against you if you fail to update your application, especially when claiming a tax credit.
• Health status – Did someone begin to see a doctor more frequently than the previous year? If so, you may want to look at your current plan and if it meets your current needs. Open enrollment is when you can make changes and don’t have to be concerned about medical underwriting.
Every year between November 1st and January 15th is the time to review your health insurance selections for the following year. You’ll want to ensure you are not paying too much for health insurance coverage in Austin, so each year, read over your elections even if nothing has changed. Review the big three, they are the most important: a move, a job change, and a change in the home situation; these will cause a difference in what you will pay for your Obamacare insurance. You may be leaving money on the table by not taking the time to review your policy.
There are changes to health insurance in Texas every year. It is essential to review your current coverage on the Marketplace website before you watch the ball drop on New Year’s Eve. You can find that taking the time may save you money on your policy for 2023. If you have questions, Cover Mile is here for you. We can help you through policy changes and which documents you need to complete your enrollment in Obamacare. Call us today.