Here’s a few things you should know:
Higher penalties
Anyone who lacks health coverage — unless they qualify for a hardship exemption — must pay a penalty under the Affordable Care Act. The fee jumps next year to 2 percent of annual household income or $325 per adult and $162.50 per child, whichever amount is higher. Last year, it totaled 1 percent of yearly household income, or $95 per person for the year and $47.50 per child under 18.
Open enrollment
Open enrollment for 2015 coverage starts on Nov. 15 and ends Feb. 15, 2015. With a few exceptions, consumers must enroll or re-enroll during that time, or wait until next year to sign up. If you have a qualifying life-changing event — such as marriage, divorce or the birth of a child — you can sign up even after open enrollment ends. If you want coverage to begin Jan. 1, 2015, you must sign up by Dec. 15.
(Open enrollment for Healthcare.gov is separate from Medicare open enrollment, but the two overlap this year. Medicare’s open enrollment period is Oct. 15 to Dec. 7.)
New plan options
Mainers will have more plans to choose from in 2015. A new insurer, Harvard Pilgrim Health Care, has entered the market, offering four plans through Healthcare.gov. The insurer joins Anthem Blue Cross and Blue Shield and Maine Community Health Options, a nonprofit startup based in Lewiston that sold more than 80 percent of the plans Maine consumers bought for coverage in 2014, the first year of Healthcare.gov.
All three insurers, plus Aetna, also will offer health plans outside the exchange, directly to consumers and through health insurance brokers. Those plans aren’t eligible for federal subsidies.
Subsidies available, for now
The subsidies for Healthcare.gov plans are available to those earning between the poverty level and four times that amount, or between $23,850 to $95,400 per year for a family of four.
The subsidies are most generous for those who earn less money. Eligible consumers can get tax credits to lower their monthly premiums and subsidies to offset their out-of-pocket costs.
Earlier this month, the U.S. Supreme Court made an unusual move that puts the future of the subsidies in doubt. The justices agreed to hear a legal challenge that could potentially deprive millions of Americans, including thousands of Mainers, of the tax credit subsidies. At issue is whether the subsidies should be available in all 50 states, or only in those states that set up their own health insurance marketplaces. Maine was among 27 states that instead relied on Healthcare.gov, the federal government’s marketplace.
The Supreme Court will issue a ruling by the end of June. In the meantime, consumer advocates stress that the court’s decision won’t affect existing subsidies, so enrollees won’t have to repay any money. They’re still urging Mainers to sign up.
Help enrolling
Consumers can shop and enroll on a smartphone, tablet or computer. For assistance, visit Healthcare.gov or call the help center at 800-318-2596. To arrange free in-person help, visit Enroll207.com.
The Maine Bureau of Insurance has posted a rate calculator on its website, where consumers can plug in basic information and view their approximate premium costs (before potential subsidies).
