It's a New Day in Health Care.

Answers to questions about the Federal Marketplace.

It's a New Day in Health Care.

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Marketplace FAQs

The Health Insurance Marketplace is a convenient way to shop and buy health insurance online. And you probably have many questions about how it will work. Answers to many frequently asked questions are below.

Where can I shop for a health insurance plan and use my tax credit if I am eligible?

Beginning October 1, 2013, you can:

  • Call us, or call a local BlueCross BlueShield of Tennessee agent.
  • Shop online, apply for financial help and buy directly on our website, bcbst.com.
  • Visit one of the enrollment centers which will be located throughout the state of Tennessee.
  • Shop on the Health Insurance Marketplace.

How will the Health Insurance Marketplace work?

The Marketplace is a secure, online shopping portal, developed by the federal government. Starting October 1, 2013, you will be able to use the Marketplace to:

  • apply for health coverage
  • see if you are eligible for tax credits or other financial help to make it more affordable to buy health insurance on your own
  • see if you can get health coverage through a government program
  • shop and compare health plans available where you live
  • buy the health insurance plan that is right for you and your family

How do I apply for government help with health insurance costs?

You will use the Marketplace portal, to apply for government help paying health insurance costs – as well as apply for coverage. When you apply, you will need to provide information about:

  • yourself and your family
  • who you need health coverage for
  • information about your job and income

Have your tax return from last year on hand, so you can provide information on your income. The government will use your income to decide if you are eligible for tax credits to help pay monthly health insurance premiums or additional help with other health care costs.

When will I know if I am eligible for help my paying health insurance costs?

In most cases, if you complete and submit your application for the Marketplace electronically, you will get an answer electronically about whether you are eligible for a tax credit or other financial help.

Who can shop for coverage through the Health Insurance Marketplace?

Anyone who needs health insurance can shop through the Marketplace. If you want to apply for a tax credit or other help from the government to lower your health plan costs, you must apply for and buy your coverage through the Marketplace.

If you already have health insurance coverage through your job, your family or a government program, you don’t need to buy coverage on the Marketplace, but you may want to use the Marketplace to see if you can get the same coverage for less, get better coverage, or get a break on the costs of coverage.

How do I know if I qualify for the tax credit to get help with my health care costs?

The tax credit is designed to help a wide range of Americans afford health insurance. Single people with an annual income up to $45,960* and families of four with an income up to $94,200* (400% of the federal poverty level) may qualify for the tax credit through the Marketplace. The tax credit is a fixed dollar amount each year and remains the same no matter which health insurance plan or company you choose. The federal government will determine if you are eligible and the amount of the tax credit once you submit your application to the Marketplace.

*Figures from Healthcare.gov.

When can I start shopping for coverage?

You can start preparing to shop for health insurance now. You will be able to apply for and buy coverage on the Marketplace starting October 1, 2013 – the first day of Open Enrollment. You will have until March 31, 2014, when Open Enrollment ends, to buy coverage on the Marketplace.

When will health insurance purchased through the Marketplace start?

Coverage you buy on the Marketplace by December 23, 2013, will go into effect on January 1, 2014. If you buy coverage after December 23, 2013, the start date of your coverage will be delayed.

If you buy coverage… Your coverage will start…
Dec. 16, 2013 – Jan. 15, 2014 Feb. 1, 2014
Jan. 16, 2014 – Feb. 15, 2014 March 1, 2014
Feb. 16, 2014 – Mar. 15, 2014 April 1, 2014
March 16-31, 2014 May 1, 2014

What health insurance options will be available?

The Marketplace will give you choices when it comes to health insurance. It will feature a number of plans, with different benefits and premiums, from several companies in your area. All the plans offered on the Marketplace have to meet specific requirements set by the government including:

  • coverage for services and care essential to health
  • standards for provider networks
  • limits for deductibles, copayments and out-of-pocket costs

Do I have to purchase my plan online to use the Marketplace? Can I send in a paper application?

You can send in a paper application, but you should know the process will take several weeks. The advantage to using the Marketplace’s online application process is that you will get an answer electronically if you are eligible for a tax credit or other government help to pay your monthly health insurance premium and other costs.

Do I have to take the tax credit in advance? Can I just pay my full health insurance premium each month myself, and claim the credit on my tax return next year?

If you are eligible for the tax credit, it’s up to you to decide when to take it. You can take it in advance to help pay monthly health insurance premiums or you can claim the full amount on your tax return. There are pros and cons to each choice. A tax professional can help you decide whether you should take the tax credit in advance or not.

Should I take the full amount of the advance tax credit I’m eligible for to help pay my monthly health plan premium?

You should talk with a tax professional about this tax credit. He or she can help you better understand how much in taxes you may need to pay next year based on your income, and if and how much of the health coverage tax credit you should take.

When I purchase a plan, how do I get my insurance card and plan materials?

The health insurance company offering the plan you purchased will send you your card and plan materials. So if you buy one of BlueCross BlueShield of Tennessee’s plans on the Marketplace, you will receive materials and your insurance card from BlueCross.

Who do I call if I have a question about the plan I purchased?

If you have questions or need help with the health insurance plan you bought on the Marketplace, you should call the plan’s carrier. So if you bought a BlueCross BlueShield of Tennessee plan, just call the Member Service number listed in your plan materials.

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